A few nights ago on Christmas Eve, my wife and I stopped into a donut shop for a quick cup of coffee after an afternoon of last minute shopping. We both needed to use the restrooms, but found there was a lack of hand towels to dry you hands after washing. Seeing this, my first thought was that this was a perfect excuse NOT to wash your hands. We both did indeed wash our hands, but dried them the old fashion way...shaking them dry.
Currently bathrooms in restaurants require employees to wash their hands after using the toilet, and it is only common sense and good hygiene for everyone else to do the same. It is the restaurants responsibility to maintain a clean working toilet, supplied with soap and towels. Guidelines have been established and one of the main goals to avoid the transmission of Hepatitis A. This form of hepatitis A is spread through "fecal-oral" transmission. In other words, the infected person with hepatitis A, who is shedding the virus in their stool (i.e.fecal), transmits this infected stool to another person by having them ingest their infected stool through their mouth or mucus membrane (i.e.oral). Hence, fecal-oral transmission. It sounds very gross to admit that you are ingesting someone else's fecal material, but this is how it all works.
The Center's for Disease Control have an excellent fact sheet on HepatitisA that can be downloded here, outlining all of the key concepts. There are two key items to remember and learn. First, there is a very effective vaccination available. Who should receive this vaccination varies who you talk with. My own personal bias is that everyone needs to be vaccinated. The CDC leans this way as well. Their recommendations include:
In practice, this is not being done. The reasons for this are unclear, but physician and healthcare provided lack of understanding of hepatitis A is one of the reasons.
The second important point is that strict handwashing is important. Most individuals with hepatitis A are shedding the virus through their stool, and are unaware they have active hepatitis A. Symptoms of fatigue and jaundice may develop days or weeks later. By this time, countless people, especially in the setting of food handlers, could have been contaminated.
Hepatitis A is a distinct virus from hepatitis B and hepatitis C. Many ask if hepatitis A turns into hepatitis B or C? The answer is no. Similarly, patients believe that hepatitis A is less of a health concern compared to hepatitis B or C (following the mentality the A is better than B or C in the natural progression). This too is false. Acute hepatitis A can be fatal, especially if you have other underlying medical conditions such as chronic liver diasease, diabetes, heart disease, or suppression of the immune system.
The CDC's frequently asked question site is a good reference for lingering questions.
