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Customers who visited a New Jersey Starbucks between early- to mid-November 2021 are being urged to get a hepatitis A vaccine after an employee at the store tested positive for the highly contagious virus.
Officials from the Camden County Health Department said in a news release that the organization was notified that the worker had hepatitis A and “worked through the infectious period.” The store was closed in response and all employees were vaccinated against the virus.
The employee is not currently working, and health department officials urge anyone who think they may have been exposed—which includes people who visited the Starbucks (at 1490 Blackwood Clementon Road in Gloucester Township) on Nov. 4,5,6, 11, 12, and 13—to get vaccinated against hepatitis A.
If you’ve already been vaccinated against hepatitis A in the past, the health department says that you don’t need to get another dose.
All of this raises a lot of questions about hepatitis A and why, exactly, people should be so concerned about being exposed. Here’s what you need to know.
What is hepatitis A?
Hepatitis A is a short-term liver infection caused by the hepatitis A virus, according to the Centers for Disease Control and Prevention (CDC). People who get hepatitis A—which is highly contagious—may feel sick for few weeks or several months but usually recover without lasting hepatic (aka liver) damage, says Thomas Russo, M.D., professor and chief of infectious disease at the University at Buffalo in New York.
“While most people do get better, there’s a very small subset that may develop more severe hepatic disease and, rarely, hepatic failure,” Dr. Russo says. People can also die of hepatitis A, the CDC says, although this is more common in older people and those with other serious health issues like chronic liver disease.
How common is hepatitis A?
Hepatitis A isn’t overly common in the U.S. but it happens often enough. The CDC says that a total of 12,474 hepatitis A cases were reported in 2018 but, because some people never get diagnosed, the number is likely closer to 24,900. Person-to-person spread of hepatitis A has also been increasing in the U.S., mostly in people who use injection drugs or experience homelessness.
What are the symptoms of hepatitis A?
It’s possible to have hepatitis A and not have any symptoms, the CDC says. But, if you do develop signs of the infection, they’ll usually show up two to seven weeks after you were infected. From there, they usually last two months, but some people can be sick for up to six months, the CDC says.
Those symptoms can include:
Yellow skin or eyes (aka jaundice)
Not wanting to eat
Dark urine or light- colored stools
Some of those symptoms, like a fever, diarrhea, and feeling tired, seem like they could be confused with COVID-19, but infectious disease expert Amesh A. Adalja, M.D., a senior scholar at the Johns Hopkins Center for Health Security, says that it’s more common to get nausea, vomiting, and jaundice with hepatitis A. “It is not a respiratory virus,” he says. So, if you have a cough or other respiratory symptoms, it’s unlikely that you’re dealing with hepatitis A.
How is hepatitis A spread?
Hepatitis A mostly spread through the fecal-oral route, so exposure to an infected person’s bodily fluids can put you at risk, Dr. Adalja says. “It’s kind of yucky,” Dr. Russo says. “Hepatitis A gets shed through feces, and a person can then ingest it.” (A typical way this can happen, he says, is when an infected person doesn’t wash their hands well after using the bathroom and then handles food.)
You're most likely to infect others about two weeks after you develop symptoms, so Dr. Russo recommends doing your best to stay away from others during that time period. “If infected, no food preparation or close contact with those at risk for two weeks,” he says. Hepatitis A can also be spread from close, personal contact with an infected person, including oral-anal sex, caring for someone who is sick, or using drugs with others, the CDC says. It’s important to point out, too, that the hepatitis A virus can live outside the body for months, per the CDC, although heating foods and liquids to temperatures of 185 degrees for at least a minute can kill the virus.
How is hepatitis A treated?
Unfortunately, there is no medication or pill that can treat hepatitis A. “There is no specific treatment other than supportive care, hydration, and monitoring,” Dr. Adalja says. If you have more severe symptoms, though, you may receive supportive care in a hospital.
The recommendation that people who have been exposed get vaccinated against hepatitis A is a little confusing, given that vaccines are supposed to prevent an illness. But Dr. Adalja says that the vaccine can be used as prophylaxis after you’ve been exposed. So can immune globulin, a treatment made from human blood plasma that contains antibodies, which are your body’s natural defense against infection.
“The incubation of the virus is six weeks or so and there is an opportunity to abort the infection if vaccination or immunoglobulin is given soon enough,” Dr. Adalja says. (Worth noting: The hepatitis A vaccine has been a routine part of childhood immunizations since 1996.)
But, again, if you’ve been vaccinated in the past against hepatitis A, you don’t need to get vaccinated again.
Even if you feel relatively OK when you have hepatitis A, Dr. Russo says that it’s still a good idea to connect with your doctor. “They will want to do some baseline labs to see how you’re doing,” he says. And, while most people with hepatitis A get better, Dr. Russo says that you’ll know when your health is improving by keeping tabs on your bathroom habits. “When you have hepatitis A, your urine gets dark and your stools get light,” he says. “As you get better, the color of your urine and stools go back to normal.”
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