Algorithm for case and contact management of food handlers with acute hepatitis A and prepared ready to eat foods.

Food handler with acute Hepatitis A and was working during the infectious period and had contact with high risk ready-to-eat food

• Branch A: Food handler did not have good hygiene practices or had diarrhoea while infectious and working, or facility manager did not receive food service safety training nor uses a hazard control system
• Branch A1: Patrons cannot be easily identified within 2 weeks of exposure
• Category A1.1: High risk. Actions include:
• Exclude index case and educate staff and management on hygienic practice
• Notify patrons through news media if on-site transmission has occurred or premises inspection confirms poor hygiene practices
• Offer appropriate PEP and fact sheet to all exposed contacts
• Advise contacts to minimise at-risk duties or behaviour
• Maintain strict hygiene practices
• Branch A2: Patrons can be identified within 2 weeks of exposure
• Category A1.2: High risk. Actions include:
• Exclude index case and educate staff and management on hygienic practice
• Offer appropriate PEP and fact sheet to all exposed individuals
• Advise all contacts to minimise at-risk duties or behaviour
• Public announcement to prevent a further generation of cases as required
• Maintain strict hygiene practices
• Branch B: Food handler had good hygiene practices and no diarrhoea while infectious and working, and facility manager received food service safety training and uses a hazard control system
• Branch B1: Evidence of infection in other food handlers or patrons
• Category B1.1: Moderate to high risk. Actions include:
• Risk to patrons should be re-evaluated
• Search for common source and send specimens for serology and genotyping
• Investigate illness register and premises for hygiene breaches
• Exclude from work all cases who are food handlers or who provide personal care
• Offer appropriate PEP to identifiable at-risk patrons, staff and their close contacts
• Maintain strict hygiene
• Branch B2: No evidence of infection in other food handlers or patrons
• Category B2.1: Probable low risk. Actions include:
• Transfer case to less risky role or exclude until end of infectious period
• Offer appropriate PEP to other food handlers (if they ate ready to eat food handled by the case or shared toilets or washing facilities) and to contacts with repeated exposure
• PHU and food service managers should monitor at risk food handlers for 1 incubation period (50 days) after last exposure
• Maintain strict hygiene practices

Return to NSW Control Guidelines for Hepatitis A