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

It's worth getting vaccinated against hepatitis A even after you've been exposed.

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 exposed co-workers and customers to hepatitis A over 6 days, according to the Camden County Health Department release.

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

County spokesman Dan Keashen told CNN that "the exposure is probably in the thousands." "Starbucks says that that location is busy, as most are. They're saying they have an average of 600 patrons a day and some are return patrons maybe going multiple times a day," Keashen told CNN.

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.

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

First, 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). There are several types of hepatitis—A, B, and C are the most recognized—and each one 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 who's infected. It spreads through oral-fecal transmission, which is when someone ingests the virus without knowing it, whether through close contact with an infected individual or ingesting food or drink that's been 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. (Just to note, 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.")

What Are the Symptoms of Hepatitis A?

The virus usually incubates for up to 28 days before people start to experience symptoms, according to Dr. Malik. 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. According to the World Health Organization, 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 very small 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 2 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 Do People Get Vaccinated Against Hepatitis A?

Vaccination against the virus became routine in 1999, 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 the vaccine if you have certain medical conditions that put you at risk for hepatitis A complications, according to Dr. Malik. For example, if you have chronic liver disease, you've probably been vaccinated.

If you've had hepatitis A in the past, you have antibodies that should protect you for the rest of your life. But because you may not have had symptoms after being exposed to the virus, Dr. Malik said it's best to get vaccinated (especially if you live in an area where there's an outbreak). The good news is, once you're vaccinated, you're protected for life. And the vaccine is so effective that you likely won't 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 ever in a situation where you think you've been exposed to hepatitis A, you can get a vaccine within 2 weeks of exposure to potentially decrease symptoms and reduce transmission of the virus to others. "The vaccine is harmless, and we know it works very well," Dr. Nguyensaid.

In Summary

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 for you to get the shot as a preventative measure and to minimize spreading the virus if you ever get exposed to hepatitis A.

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