Hepatitis Outbreaks Underscore Risks of Raw Food

Auburn, November 18, 2003 --- Health-conscious Americans by the tens of millions are eating 
more fruits and vegetables. 

That’s good, say health experts.  But if a recent wave of hepatitis A outbreaks has taught one 
lesson, it is that raw food, no matter how healthy, carries its share of risks.  It is a lesson that 
applies as much to fresh fruits and vegetables as it does to raw oysters and sushi, said one 
expert.

Green onions are the suspected cause of hundreds of recent hepatitis A outbreaks in three states 
--- Georgia, Kentucky and Tennessee.  More recently, a chain of Mexican restaurants removed 
green onions from its menus as a precautionary measure after a similar hepatitis outbreak 
occurred in one of its restaurants in western Pennsylvania.

At Auburn University, Dr. Jean Weese, an Alabama Cooperative Extension System food scientist 
and associate professor of food science, stressed that any raw food is susceptible to 
contamination at any number of points from the farm to the consumer’s plate.  

One of the most common sources of contamination is on the farm.  

“Green onions are a root vegetables after all, and if the ground in which they’re grown is 
contaminated with feces, whether from animals or humans, there’s a good chance pathogens will 
be transferred to the produce.”

Found in the stool, hepatitis A is usually transmitted through oral ingestion and commonly stems 
from poor sanitation or hygiene. 

It’s not certain whether this outbreak was caused by animal or human contamination.  A similar 
outbreak associated with strawberries several years ago was traced to a field where the culprit 
was humans.  In this case, farm workers were relieving themselves in the same location where 
harvesting occurred.

“It’s a problem, a very serious problem,” Weese said, “but one that is not widely known about 
among the consumer public.

“Many consumers can’t understand why workers would relieve themselves in the very fields in 
which they harvest produce.”  

The problem, Weese said, often stems from the way in which workers are paid.  Because they 
are typically paid according the amount of produce they harvest rather than by the hour, there is 
very little incentive to stop long enough to walk the distance to a restroom, she said.

Other sources of fecal contamination include bird and animal droppings and irrigation water 
pumped out of contaminated streams or surface water.

Even if these problems were eliminated, there is still the potential for contamination further along 
the food chain, Weese said.

“Granted, you do have more control during food processing because workers are paid by the hour 
and they are under stringent requirements to wash their hands after bathroom visits.  But you still 
have people who don’t follow the rules, so there always are going to be risks,” she said.

Likewise, restaurants are subject to stringent rules, especially regarding the handling of raw 
foods, such as fresh produce.  But they, too, are guilty of occasional lapses.

“Food workers are under strict guidelines, for example, to wash their hands after bathroom use 
and to wear gloves when handling uncooked food,” Weese said.  “But you go almost anywhere, 
and you’re going to see some food preparers not wearing gloves.”

That, she said, is why consumers ultimately must take responsibility for their own safety.

The best defense against hepatitis and other food borne illnesses is washing, lots of washing, 
Weese said. 

“Every time you wash produce, you’re removing potentially harmful pathogens,” she said.  “You 
may not remove it entirely, but the more you remove, the fewer bacteria you ultimately ingest and, 
consequently, the less severe your illness will be.”

As an added precaution, Weese advises washing produce not once but twice --- “washing it, 
letting the water drain and washing it again.”

When dining out, she advises ordering salads and other raw produce items off the menu rather 
than visiting the salad bar.  Many restaurants, in fact, have eliminated salad bars and now 
prepare their salads entirely with packaged items that have been thoroughly cleaned and sealed 
at processing plants. 

“All the food handlers have to do is open these packages and let the contents fall into a bowl,” 
Weese said. 

(Source: Dr. Jean Weese, Alabama Cooperative Extension System food scientist, 334-844-
3269.)