Maintaining Public Health Worker Protections: Hepatitis

Key Points:

• In today’s Recommendations for Industry, we discuss continuing your public health worker protections for the control of Hepatitis in the wake of the lingering outbreak. Read More below.
  • COVID-19 infections are on the rise in South Asia. In India, and countries surrounding it (including Afghanistan, Bangladesh, Nepal, Pakistan, and Sri Lanka), COVID-19 cases have risen dramatically in the last week.
  • The CDC has officially declared that the SARS-COV-2 virus “is an airborne threat (NYT)” and highlights that “[the] airborne virus can be inhaled even when one is more than six feet away from an infected individual.” See the official update on the CDC’s site. (It’s in big letters now!)
  • Some COVID-19 patients in India are developing mucormycosis, a fungal disease with 50% mortality rate, affecting immunocompromised individuals. There is thought that this disease is being triggered by the use of steroids and other COVID-19 treatments.
  • On Friday, the CDC updated its testing requirements for international air passengers into the U.S. to allow for (and accept) the use and results of at-home test kits, as long as the test is supervised by a telehealth service associated with the testing kit manufacturers.
  • In the continued discussion on vaccine equity, there are countries whose people want vaccines, but the countries have none to distribute. This continues to highlight the inequities of vaccine distribution.

Maintaining Public Health Worker Protections: Hepatitis

While the world attempts to return to some sort of normalization in 2021, it is important for businesses to learn from and build on the COVID-19 employee protection programs to ensure we are better prepared for the next pandemic – or simply a local or facility-originated infectious disease. TAG is doing exactly that with our new weekly Public Health-focused newsletters. This week we recognize the designation of May as Hepatitis Awareness Month in the US.

Viral hepatitis is an inflammation of the liver commonly caused by a virus, but it may also be linked to certain drugs, toxins, or alcohol. It has five forms – A, B, C, D & E – with varying modes of transmission: Hepatitis A can be transmitted person to person or through food or water contaminated with feces from an infected person; Hepatitis B, C & D are chronic diseases typically linked to contact with infectious bodily fluids (e.g., blood); Hepatitis E is primarily waterborne and not common in the US.

Hepatitis is of such concern in the US that the Department of Health & Human Services has developed The Viral Hepatitis National Strategic Plan: A Roadmap to Elimination for the United States | 2021–2025 with a goal to “eliminate viral hepatitis as a public health threat in the United States.” It was deemed necessary as the nation has an estimated 3.3 million Americans living with chronic viral hepatitis (2016), with:

• unprecedented hepatitis A outbreaks, and cases increased by 850% between 2014 & 2018.
• progress on preventing hepatitis B stalled.
• hepatitis C rates nearly tripled from 2011 to 2018.

The Business Impact. Hepatitis A is of most concern to food businesses because of its spread when someone unknowingly ingests the virus (even microscopic amounts) through close personal contact or through eating contaminated food or drink. Thus an infected person in the workplace can easily and quickly spread the virus to both co-workers and customers. In fact, a widespread person-to-person hepatitis A outbreak which was first identified in 2016 has impacted at least 35 states. As of May 7, 2021, there have been 39,239 cases resulting in 23,883 hospitalizations and 372 deaths even though hepatitis A and hepatitis B are vaccine-preventable diseases, and hepatitis C is curable.

As we have learned from COVID-19 as well as other transmissible viruses (such as norovirus) a key component of reducing the transmission of viruses is eliminating close contact. As relates to Hepatitis A, this would be close contact with other persons as well as direct contact with food/drink. As such, all workers should wash hands before handling any foods, thorough sanitation should be maintained, and infected workers should be excluded from food handling.

For a full list of business recommendations, as well as other information on Hepatitis, download TAG’s Hepatitis Fact Sheet from our Public Health Services webpage. Contact TAG for further assistance with development or assessment of your non-crisis Public Health Program.

• In Friday’s Recommendations for Industry, we discuss new studies on COVID-19 projections for the next few months and how businesses should be preparing. Read more here.
• Both the U.S. and the E.U. have indicated support for waiving COVID vaccine intellectual property rights.
• The Premier of Ontario (Canada) has approached Michigan’s Governor “about the possibility of having essential workers” cross the border from Canada to be vaccinated in Michigan.
• CIDRAP reports that three vaccines (and their boosters) are showing promise against COVID-19 variants.
• The CDC predicts that as we continue vaccinations, it is likely that COVID-19 activity in the U.S. will sharply decline – if most of the country maintains a moderate adherence to non-pharmaceutical interventions (NPIs), including physical distancing. (we also discuss that in Friday’s Recommendations for Industry)!
• A new study from IHME estimates that the global death toll from COVID-19 is probably twice as high as official estimates due to underreporting (of cases and deaths) and insufficient testing. STAT News discusses this further.
• Pfizer/BioNTech announced today that they have submitted an application for full FDA-approval for the COVID-19 vaccine; if this is approved, it will be the first COVID-19 vaccine in the US to receive full FDA approval.
• In Wednesday’s Recommendations for Industry, we discussed this week’s COVID Matrix statistics and what this means to businesses seeking to move forward in putting COVID behind us (as much as feasibly possible). Read more here.
• Every adult in Ontario Canada will be eligible to book a COVID-19 vaccine appointment by May 24.
• A study recently published in Science has found that those previously infected with COVID-19 who later received at least one dose of the Pfizer vaccine were found to have significant neutralizing antibodies effective against both the B117 and B1351 variants.
• In the U.S., President Biden’s new COVID-19 goal is to get 70% of the U.S. population vaccinated by July 4^th. That’ll be done by increasing funds for access to “walk-in appointments”, community vaccination sites, increased vaccine access, and vaccine education in hard-to-reach places including rural health clinics.
• NYT reports that, in the first three months of 2021, Pfizer has generated $3.5B in revenue! They are now hoping to seek clearance for their vaccine to be used in children aged 2 – 11 by September.
• The CDC has updated its advice regarding “People with Certain Medical Conditions” as it pertains to COVID-19. See more information here.
• Children now account for about 22% of new U.S. COVID-19 cases; this is up from 3% of cases last year at this time.
• In the public health realm:
  • The DRC has declared the end to its Ebola outbreak which first began in February 2021!
  • The first genetically modified mosquitoes have been released in the U.S. in Florida. The concept is that these mosquitoes will breed with other mosquitoes that carry severe diseases like (Zika, yellow fever, etc.) and eliminate.

• • In 2020, Ireland has seen an increase in E. coli, Cryptospordium, and Campylobacter cases.
  • There is currently an E. coli outbreak in Washington state that has affected at least 7 children; the source is currently unknown.