Most people think of hepatitis A as something you get from traveling abroad or eating bad sushi. But in 2025, the biggest threat isn’t overseas trips-it’s your local deli, food truck, or grocery store salad bar. The virus doesn’t need dirty water or poor sanitation to spread. All it needs is one infected person handling food with unwashed hands. And because symptoms can take weeks to show up, people often keep working, cooking, and serving food while unknowingly spreading the virus.
How Hepatitis A Moves Through Food
The hepatitis A virus (HAV) is tiny, tough, and terrifyingly efficient. You only need 10 to 100 virus particles to get infected. That’s less than a speck of dust. It survives freezing, drying, and even brief boiling. Studies show it can live on stainless steel surfaces for over 30 days and stay infectious in frozen shellfish for years.
Most outbreaks trace back to food handled by someone who’s infected but doesn’t feel sick yet. About 30% to 50% of adults with hepatitis A have no symptoms at all-especially younger people. They go to work, touch raw vegetables, make sandwiches, or scoop ice cream. Then, someone else eats it. In one documented case, a single infected cook at a restaurant led to 500+ people getting sick.
Shellfish are a major risk because they filter water. If they’re harvested from waters polluted with sewage-even slightly-they can concentrate the virus. Produce like berries, herbs, and leafy greens is another big culprit. A 2025 study found that just 10 seconds of casual hand contact with lettuce can transfer nearly 10% of the virus from fingers to food. No cooking, no washing, no warning.
Why Handwashing Alone Isn’t Enough
You’ve heard it a thousand times: wash your hands. And yes, washing with soap and water for 20 seconds cuts transmission risk by 70%. But here’s the problem: most food workers don’t do it right. Or they don’t do it often enough. And even when they do, the virus doesn’t just live on hands-it’s on countertops, cutting boards, door handles, and gloves.
Surveys show only 35% of food workers can name the main symptoms of hepatitis A. Just 28% know that post-exposure treatment must happen within 14 days. In quick-service restaurants, staff turnover hits 150% a year. New hires get a 10-minute safety video, not hands-on training. Language barriers make it worse. In big cities, nearly half of kitchen staff don’t speak English fluently, and safety materials aren’t always translated.
And gloves? They’re not magic. If a worker puts on gloves after touching their face or using the bathroom without washing, the gloves become contaminated. If they change gloves but reuse the same tongs or prep surfaces, the virus just moves around. The CDC says bare-hand contact with ready-to-eat food is one of the top three causes of outbreaks. Yet 78% of food establishments still allow it.
What to Do After You’re Exposed
If you’ve eaten food from a place linked to a hepatitis A case-or you’re a food worker who touched something contaminated-you have 14 days to act. After that, the vaccine won’t help.
There are two options for post-exposure prophylaxis (PEP): the hepatitis A vaccine or immune globulin (IG). The vaccine is preferred for people aged 1 to 40. It’s a single shot that gives you protection for at least 25 years. It costs $50 to $75. IG is a shot of antibodies that gives short-term protection-just 2 to 5 months. It costs $150 to $300 and is used for people over 40, pregnant women, or those with weakened immune systems.
But getting the shot isn’t the end. You still need to avoid spreading it. The CDC says you must wash your hands carefully after every bathroom visit and before handling food for the next six weeks. You can’t go back to work handling food until you’re no longer contagious-which means at least 7 days after jaundice starts, or two weeks after symptoms begin. Some states like California require 14 days from symptom onset. Rules vary, but the risk doesn’t.
Why Vaccination of Food Workers Matters
Only 30% of food service workers in the U.S. are vaccinated against hepatitis A. In fast-food and seasonal jobs, it’s as low as 15%. That’s not just a gap-it’s a public health emergency waiting to happen.
Since 2020, 14 states have passed laws requiring hepatitis A vaccination for food handlers. California’s law, passed in 2022, prevented an estimated 120 infections and saved $1.2 million in outbreak response costs. That’s not just good policy-it’s cost-effective. Experts estimate every dollar spent on vaccinating food workers saves $3.20 in outbreak investigations, lost wages, and medical bills.
Some restaurants are starting to offer incentives. A pilot program in Washington gave workers a $50 bonus for getting vaccinated. Vaccination rates jumped 38 percentage points. Simple. Direct. Effective.
What’s Changing in 2025
Public health is shifting from reaction to prevention. New tools are emerging:
- Wastewater testing: Restaurants in pilot programs are now testing their drains for hepatitis A RNA. If the virus shows up, they can alert staff before anyone gets sick. Sensitivity is at 89%.
- Point-of-care tests: A rapid test for hepatitis A is in Phase 3 trials. It can detect the virus in blood within 15 minutes with 94% accuracy.
- Vaccination on permits: In 22 U.S. jurisdictions, food handler permits now require proof of hepatitis A vaccination. No shot, no license.
- Training that works: Hands-on training with real-life scenarios improves compliance by 65%. Videos don’t cut it anymore.
These aren’t futuristic ideas-they’re being used right now. And they’re working.
What You Can Do
If you’re a customer: Ask your restaurant if their staff are vaccinated. It’s not a weird question anymore-it’s a smart one.
If you’re a food worker: Get vaccinated. Even if your employer doesn’t require it. Your health, your coworkers’ health, and your customers’ health depend on it.
If you think you were exposed: Don’t wait. Go to your clinic or urgent care within 14 days. Bring details about where you ate and when. Time is everything.
Hepatitis A isn’t gone. It’s just quieter. And it’s still hiding in plain sight-in your salad, your sushi roll, your sandwich. The tools to stop it exist. The question is: will we use them before the next outbreak hits?
