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
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Branch A1: Patrons cannot be easily identified within 2 weeks of exposure
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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
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Branch A2: Patrons can be identified within 2 weeks of exposure
- Category A1.2: High risk. Actions include:
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Exclude index case and educate staff and management on hygienic practice
- Offer appropriate PEP and fact sheet to all exposed individuals
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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
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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
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Branch B1: Evidence of infection in other food handlers or patrons
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Category B1.1: Moderate to high risk. Actions include:
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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
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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