Hepatitis A Outbreak Involving Bread

An outbreak of hepatitis A involved more than 50 residents of a group of villages in the late spring and summer of 1989. The only food that was common to all the laboratory-confirmed cases was bread, purchased either unwrapped or as rolls, sandwiches or filled rolls, and supplied either directly from one shop or indirectly through its subsidiary outlets. It was concluded that this bread was the most likely vehicle of transmission of the hepatitis A virus and that the bread was contaminated by soiled hands which were inadequately washed because of painful skin lesions. Comprehensive control measures were successful in limiting further spread of the infection. This outbreak highlights the transmissibility of hepatitis A virus on food. The use of disposable gloves when handling food which is to be consumed without further cooking would prevent transmission of this or other infectious agents by this route.