Better Health: Smart Health Commentary Better Health (TM): smart health commentary

Article Comments (1)

Hepatitis A Spread by a Bartender in New York City?

Some Hollywood celebrities are up in arms after having been notified of their exposure to hepatitis A through an infected bartender at a trendy New York City club. Those who come in contact with a known virus carrier may prevent infection if they’re vaccinated early. Hepatitis A causes less severe liver disease than its blood-bourne cousin, hepatitis C, but it’s still a formidable foe. (For more information about hepatitis A and its symptoms, check out this article.)

I interviewed Revolution Health consultant and world-renowned liver expert, Dr. Emmet Keeffe, about this outbreak:

Dr. Val: What is the likelihood that people could catch hepatitis A from an infected bartender?

Dr. Keeffe: The hepatitis A virus is transmitted between persons by the fecal-oral route (think unwashed hands after a bathroom break, or drinking water that has come in contact with human sewage). Also this particular virus is very hardy and can live on counter tops and surfaces outside the body for longer than many viruses. Because hepatitis A is found in very high concentrations in an infected persons’ stool, a tiny bit of stool on the hands actually contains large amounts of the virus and can therefore be quite infectious. Although previous outbreaks have primarily been associated with food handlers, there is no reason why a bartender might not also spread hepatitis A virus.

Dr. Val: Yuck. Would a vaccine be effective in preventing hepatitis A after someone’s already been exposed? How quickly after exposure should one get the vaccine?

Dr. Keeffe: The standard recommendation for individuals potentially exposed to hepatitis A is passive immunization using immune globulin administered within 2 weeks of exposure, which is 85% effective in protecting against illness. This is the recommendation for household or sexual exposure, but not generally recommended for “common source outbreaks” (like exposure to food handlers or bartenders), which are usually recognized only after they are well into their course. However, with early recognition, such as the NY case, immune globulin may make good sense. After hepatitis A vaccination, protective levels of antibodies to hepatitis A virus do not appear until 2-4 weeks after vaccination. Thus, active immunization with hepatitis A is used for preexposure prophyaxis, such as in international travelers to areas where hepatitis A is common, but not for postexposure prophylaxis.

Dr. Val: What is the hepatitis A vaccine exactly?

Dr. Keeffe: Hepatitis A vaccine is an injection, which is administered at baseline followed by a booster in 6 to 18 months. Two relatively similar and effective vaccines are licensed in the United States: Havrix and Vaqta.

Dr. Val: What should the bartender do if he has hepatitis A? Can he still work? When can he come back to work?

Dr. Keeffe: To protect the public, the bartender should not work until he has fully recovered. He is most infectious during the late incubation and early illness stage, when excretion of hepatitis A virus in feces is the highest.This post originally appeared on Dr. Val’s blog at

You may also like these posts

    None Found

Read comments »

One Response to “Hepatitis A Spread by a Bartender in New York City?”

  1. RH Host Melissa says:

    I read this article as well.  Thanks for shedding some light on it for us Dr. Val 🙂

Return to article »

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

Read more »

How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

Read more »

See all interviews »

Latest Cartoon

See all cartoons »

Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

Read more »

The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

Read more »

Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

Read more »

See all book reviews »