For a food-service worker diagnosed with hepatitis A, what is the work restriction?

• A. Exclusion from work until liver function tests are normal or seven days after onset of jaundice.
• B. Return to work after 24 hours of liver function improvement.
• C. Work restrictions do not apply to hepatitis A.
• D. Return to work after antibiotic therapy.

Answer: (A)

When a food-service worker has hepatitis A, the priority is preventing spread of the infection through contaminated food. Hepatitis A spreads via the fecal-oral route, and the person is most contagious around the time jaundice begins and for a short period afterward. Because of this, excluding the worker from work until the contagious period has passed protects customers and coworkers.

The best rule is to keep the worker away from work until either liver function tests have returned to normal or seven days have passed after the onset of jaundice. Normalizing liver tests suggests recovery, and seven days after jaundice onset is a practical window during which infectiousness declines significantly, making it safer for the worker to return.

Returning after just 24 hours of improving liver function doesn’t guarantee that the person is no longer contagious, so that option isn’t sufficient. Antibiotics aren’t used to treat hepatitis A (it’s viral, not bacterial), so returning after antibiotic therapy isn’t applicable. And saying no restrictions at all contradicts infection-control practices for viral hepatitis in food handling.