Chow Line: Stay safe against Ohio hepatitis A outbreak

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I just heard about the health warning advising Ohioans about the ongoing hepatitis A outbreak across the state. What is hepatitis A, and how do I protect myself against it?

Hepatitis A is a highly contagious virus that infects a person’s liver. It can be spread through close contact with a person who has hepatitis A or by eating food prepared by a person with hepatitis A.

In a written statement published last week by the Ohio Department of Health (ODH), the agency warned about the ongoing hepatitis A outbreak impacting Ohio and advised those who believe that they are at high risk for hepatitis A infection to contact their healthcare provider or local health department for information about vaccination.

As of Sept. 23, there have been 3,758 reported cases of hepatitis A statewide, according to ODH, resulting in the hospitalization of 2,343 people and 16 deaths. Most notably, the Ohio counties with the highest number of hepatitis A cases include:

  • Franklin County with 472 cases
  • Butler County with 410 cases
  • Montgomery County with 284 cases
  • Hamilton County with 279 cases

Symptoms of hepatitis A can include abdominal pain, nausea, vomiting, jaundice, fatigue, fever, a loss of appetite, joint pain, dark urine, and gray stool. These symptoms can develop two to six weeks after the infection occurs. During that time, infected people can spread the virus to others without realizing they themselves are ill.

So how can food items become contaminated with hepatitis A?

The virus is found in the stool and blood of people who are infected. It’s spread through person-to-person contact or when someone ingests food or drinks contaminated by the stool of an infected person, according to ODH.

Handwashing is one of the most effective means of preventing the spread of hepatitis A, especially for people who are preparing or serving foods or beverages, said Sanja Ilic, the state food safety specialist for Ohio State University Extension. OSU Extension is the outreach arm of The Ohio State University College of Food, Agricultural, and Environmental Sciences (CFAES).

This is because food and beverages can become contaminated with the hepatitis A virus when microscopic amounts of feces are transferred from an infected person’s hands to the food or beverages.

Additionally, the virus can survive on surfaces for prolonged periods of time and isn’t killed when exposed to freezing temperatures, she said.

“Prevention is the key, considering that contamination of food with the hepatitis A virus can happen at any point: growing, harvesting, processing, handling, and even after cooking,” Ilic said. “There are two options available to the public for hepatitis A vaccine administration, according to the Centers for Disease Control and Prevention.

“Those are the hepatitis A vaccine, and a combination vaccine against both the hepatitis A and hepatitis B viruses called ‘TWINRIX’ for consumers that are at high risk.”

According to ODH, high-risk populations for hepatitis A in this outbreak include:

  • people who use drugs (injection or non-injection)
  • people experiencing unstable housing or homelessness
  • people who are currently or were recently incarcerated
  • men who have sex with men (MSM).
  • people with chronic liver disease, including cirrhosis, hepatitis B, or hepatitis C

People who know that they have been exposed to someone with hepatitis A should contact their healthcare provider or local health department to discuss post-exposure vaccination options, ODH said.

Chow Line is a service of The Ohio State University College of Food, Agricultural, and Environmental Sciences and its outreach and research arms, OSU Extension and the Ohio Agricultural Research and Development Center. Send questions to Chow Line, c/o Tracy Turner, 364 W. Lane Ave., Suite B120, Columbus, OH 43201, or

Editor: This column was reviewed by Sanja Ilic, state food safety specialist for OSU Extension.

Tracy Turner
For more information, contact: 

Sanja Ilic
OSU Extension, Food Safety