Jaundice Not Always A Sign Of Hepatitis A

Not all cases of jaundice are caused by hepatitis. The condition may be the result of hemolytic anemia, cancer of the pancreas, gallstones lodged in the liver duct, or a side effect of certain medications like erthromycin and sulfa drugs, antidepressants and anticancer drugs.

Furthermore, even if you do have hepatitis A, the disease may be so mild that symptoms never appear. Still, the infected person can be a carrier of the disease and bring it elsewhere.

The range of contaminants that cause hepatitis A is unlimited. Most people get the disease by eating in unsanitary places. Food handlers who don't wash their hands properly play a major role in transmitting the disease by touching unwrapped foods that are consumed raw or without further cooking. The US . Centers for Disease Control and Prevention (CDC) said as many as 1,000 infected food handlers are reported every year.

"Food handlers implicated as index cases of infection are often unaware that they are ill. This is probably because they are at the incubation stage of the disease, which is generally asymptomatic but characterized by a high level of viral shedding in feces. The infected food handlers therefore continue to work - and any lapse in standards of personal hygiene can then result in the contamination of food with infected fecal material," researchers said.

"HAV transmission through a single food handler has the potential to infect a large number of people - attack rates as high as 56 infections per 100 consumers have been reported. The risk to other food handlers is estimated to be even higher up to 66 cases per 100 restaurant employees. However, by the time the outbreak has been reported and the source of infection traced, it is usually too late for preventive measures to have any major impact," they added.

Since the virus can resist heat or chemical inactivation, it can be present in salads, sandwiches, cold meats, fruits and fruit juices, and baked goods which are improperly handled.

"Food borne outbreaks observed in the United States are most often due to uncooked food contaminated during preparation by infected food handlers incubating hepatitis A; salads and sandwiches are the most common vehicles. Recently, outbreaks due to raspberries contaminated during picking and to lettuce contaminated prior to wholesale distribution have been reported," according to Stephen C. Hadler of the Center for Infectious Diseases, CDC in Atlanta, Georgia. (Next: Oysters and hepatitis A.)

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