A Starbucks Employee Had Hepatitis A—Here's What Experts Say

In November 2021, local health officials urged Starbucks customers in Gloucester Township, New Jersey, to get vaccinated against hepatitis A after a café employee tested positive for the infection. The employee may have exposed co-workers and customers to hepatitis A over six days, according to the Camden County Health Department release.

Until all employees were vaccinated against hepatitis A, the Starbucks location closed. The health department also recommended vaccination for customers who hadn't already been vaccinated against the virus but were at the store on any of the same days as the infected employee.

As of November 21, 2022, the county had administered 800 hepatitis A vaccines at the pop-up clinics it had created, Keashen told CNN, with 17 Starbucks employees also getting the shot. So far, no one from this exposure has tested positive for hepatitis A.

It's also important to note that an inspection found "no evidence of food safety violations," according to the Camden County Health Department. The push for vaccinations among those who might have been exposed was out of an "abundance of caution."

Hepatitis is highly transmissible, but it's possible to prevent sickness and transmission even after exposure. Here's everything you need to know about hepatitis A—including how to protect yourself.

What Is Hepatitis A?

Hepatitis means "inflammation of the liver." Hepatitis A is a liver infection that's caused by the hepatitis A virus (HAV), according to the Centers for Disease Control and Prevention (CDC). Several types of hepatitis exist—A, B, and C are the most recognized. Each is different.

The primary differences are how they spread and how long the conditions last. "Hepatitis B and C are generally transmitted by bodily fluid, and these two conditions can result in chronic disease, including cancer," Mindie H. Nguyen, MD, a hepatologist at Stanford Health Care and professor of gastroenterology and hepatology at Stanford School of Medicine, told Health. Hepatitis A, on the other hand, is an acute infection that's not likely to cause chronic health issues. It also spreads differently than the other forms of hepatitis.

The hepatitis A virus is present in the blood and stool of someone infected. It spreads through oral-fecal transmission, when someone ingests the virus without knowing it, whether through close contact with an infected individual or ingesting food or drink contaminated with the virus. Even microscopic amounts of stool or blood could result in an infection, and it can remain viable outside the body for months, according to the CDC. Once a person has the virus, it's highly transmissible.

Usually, transmission is related to poor hygiene and unsanitary conditions, Shahid M. Malik, MD, clinical assistant professor of medicine in the division of Gastroenterology and Transplant Hepatology at the University of Pittsburgh Medical Center, told Health. "That's why hepatitis A is a much bigger issue elsewhere in the world than in the United States," Dr. Malik said.

Hepatitis A Symptoms

The virus usually incubates for about 28 days (but ranges from 15 to 50 days) before people start to experience symptoms. But not everyone experiences hepatitis A the same way. Some people have mild cases with fewer, less severe symptoms; others develop more symptoms and get sicker.

Some of the most common symptoms of hepatitis A include:

• Fever
• Abdominal discomfort
• General malaise
• Loss of appetite
• Nausea
• Diarrhea
• Dark-colored urine
• Jaundice (yellowing eyes and skin)

The majority of otherwise healthy individuals who develop these symptoms get better without needing any specific medications, according to Dr. Nguyen. Plus, there's no specific treatment for hepatitis A, so Dr. Nguyen said doctors usually focus on helping people manage their symptoms.

However, some people get more severe infections. According to Dr. Nguyen, a tiny fraction of people experience prolonged jaundice or itching related to hepatitis A. "But the risk of acute liver failure where someone would need to be hospitalized is exceedingly low in otherwise healthy people," Dr. Nguyen explained. "In people with compromised immune systems or underlying chronic liver disease, such as hepatitis B or C, the risk of mortality is significantly higher."

What To Do if You've Been Exposed?

If you think you've been exposed to the hepatitis A virus, the CDC recommends that you talk to your healthcare provider or call your state health department as soon as you can—ideally, within two weeks of when you think you were exposed. A healthcare provider will decide the next steps based on your age, overall health, and whether you've been previously vaccinated.

When Should You Get Vaccinated Against Hepatitis A?

Vaccination against the virus became routine in all 50 states in 2006, which Dr. Malik cited as another reason infections are considered rare in the US. The CDC recommends a hepatitis A vaccine as part of a routine vaccination schedule; usually, the two-dose series is given to babies starting at 12 months. And even if they didn't get it as babies, it's recommended that children up to 18 years of age still receive their two doses.

But depending on your age, it's possible the vaccine wasn't part of your routine vaccine schedule. Even if the vaccine wasn't part of your routine vaccination, it's still possible you got it if you have certain medical conditions that put you at risk for hepatitis A complications, according to Dr. Malik.

Some of the situations when the CDC recommends adults get vaccinated include:

• Chronic liver disease
• Human immunodeficiency virus (HIV) infection
• Men who have sex with men
• Travel in countries with high or intermediate endemic hepatitis A
  
• Close personal contact with an international adoptee in the first 60 days
  
• Use of street drugs
• Persons experiencing homelessness
• Pregnancy (if at risk of exposure to hepatitis A)
• Work settings providing services to drug users or group homes or nonresidential day care facilities for developmentally disabled persons
• Work with hepatitis A in a research laboratory

If you've had hepatitis A in the past, you have antibodies that should protect you for the rest of your life. And if you've been vaccinated, you're also protected because the vaccine is so effective that you're not likely to get a breakthrough case. "If you're a healthy person, you're almost 100% protected," Dr. Malik said.

At the moment, you probably don't need to worry about a hepatitis A outbreak. Instead, focus on preventing the disease the best you can. That means practicing good hygiene, Dr. Malik said, especially washing your hands thoroughly and frequently.

If you're an adult and didn't get the vaccine as a child, the CDC doesn't recommend getting vaccinated, unless you've been exposed to hepatitis A or you decide you want to be vaccinated.

So if you're ever in a situation where you think you've been exposed to hepatitis A, getting vaccinated within two weeks of exposure will potentially decrease symptoms and reduce transmission of the virus to others.

A Quick Review

Hepatitis A virus is one of several types of hepatitis that doesn't usually have long-term health effects. If you haven't been vaccinated, talk with your healthcare provider about whether it would be beneficial to get the shot as a preventative measure and to minimize the spread of the virus if you ever get exposed to hepatitis A.