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Hepatitis A and B in Canada

  • Published: 2009-09-16 (Revised/Updated 2010-01-17) : Author: Canadian Liver Foundation
  • Synopsis: It is a common misconception among the public that hepatitis A and B are just travelers diseases.

Main Document

Hepatitis A and B are global liver diseases, and know no borders. While many may consider hepatitis A and B to be travel diseases, it is important to recognize that it can affect you right here at home, says Dr. Morris Sherman, Chairman of the Canadian Liver Foundation.

Canadians Hungry For Healthy Food, But What Are They Biting Into- New Canadian Liver Foundation poll finds Canadians concerned about food-related illnesses, yet majority are not taking proper steps to avoid them

Whether it's through fresh foods, a food handler at a grocery store, or even a local restaurant, you can unknowingly pick up unwanted viruses right here in Canada. A new survey from the Canadian Liver Foundation (CLF) reveals more than half of Canadians over the age of 25 (57 per cent) are concerned about contracting food-related illnesses like hepatitis A, but many are unaware that their everyday food preparation and consumption habits may put them at risk for this liver disease.

It is a common misconception among the public that hepatitis A and B are just travelers' diseases. Canadians are nearly twice as likely to recognize they could be exposed to hepatitis A when eating on holiday (65 per cent), versus only 35 per cent who recognize this same risk here in Canada. As we head into the winter months, locally grown food is less available and we rely even more on fresh foods imported from around the world. In the winter months Canadian imports of fresh produce nearly double,(i) and some foods may hail from areas where hepatitis A is endemic or where sanitation practices may not be up to Canadian standards. In fact, 84 per cent of hepatitis A cases in Canada are not directly linked to travel.(ii)

"Hepatitis A and B are global liver diseases, and know no borders. While many may consider hepatitis A and B to be travel diseases, it is important to recognize that it can affect you right here at home," says Dr. Morris Sherman, Chairman of the Canadian Liver Foundation. "While the risks may be lower in Canada versus other parts of the world, there are still risks, and it is key to know what they are and how to help protect yourself."

Canadians mistakenly believe common myths about the risks for contracting food-related illnesses and may have a false sense of security about their foods' safety. Almost two-thirds of Canadians (63 per cent) incorrectly believe going to a "reputable" restaurant means they are safe from food-related illnesses. A further 58 per cent think that visiting a "reputable" grocery store would be enough to help them avoid a food-related illness.

Knowing the risks

There are several ways in which food can become contaminated.

From a food service worker: Hepatitis A virus can be passed along by infected food service workers in a restaurant or grocery store, or by those who handle produce along the supply chain.(iii) You may be at risk when a food service worker with hepatitis A fails to wash his or her hands properly after going to the bathroom and then touches the food you eat.

From the food itself: Contamination can occur during irrigation, harvesting, sorting, shipping, or processing.(iv) Food can be grown in or washed with contaminated water from areas with poor sanitation standards. For example, green onions, lettuce or strawberries have been the source of hepatitis A outbreaks in the past.(v,vi,vii)

"Whether you're getting your food from a big grocery chain, a local market or a five star restaurant, you have no idea how the food was grown, where it was processed or even how many people touched it along the way," says Dr. Sherman. "If an infected worker is not doing a good job of washing his or her hands before touching your food, or the food was grown in contaminated soil, you could be at risk of contracting hepatitis A."

Here are some general food safety tips on how to properly wash fresh fruits and vegetables:

Always wash your hands before preparing food and after going to the washroom
- Soak all fruits and vegetables for one to two minutes in clean, fresh water
- Clean your counter-top, cutting boards and utensils with hot, soapy water after each use
- Don't forget that pre-packaged or frozen fruits and vegetables should also be well washed

Getting Protected

More than half of Canadians (51 per cent) believe they are safe from food-related illnesses as long as they wash their food before eating it. While proper hygiene and food handling can help protect against one of the risk factors for contracting hepatitis A, getting vaccinated is the best way to help protect yourself against both the known, and more importantly, the unknown and uncontrollable risks for exposure to this form of viral hepatitis. Only one in three Canadians (35 per cent) believe they are vaccinated for hepatitis A.

Hepatitis A, however, is not the only vaccine-preventable form of viral hepatitis Canadians can contract at home. Hepatitis B is spread through direct contact with blood or bodily fluids. Risk factors include: having unprotected sex, getting a tattoo or piercing, and getting a pedicure, dental or medical procedure where inadequately sterilized instruments are used. Just over a third of Canadians (37 per cent) believe they are vaccinated against hepatitis B.

"Canadians should consider getting vaccinated against both hepatitis A and B to reduce the risk of contracting these liver diseases here at home," says Dr. Sherman. "Children in Canada are now vaccinated for hepatitis B in grade school, so it just makes sense for adults to consider vaccination as an effective way to help protect themselves as well."

About Hepatitis A and B in Canada

Hepatitis A and B are serious liver diseases with potentially serious consequences.

Hepatitis A can last a few weeks to several months and typical symptoms include loss of appetite, nausea, fatigue, fever, and jaundice. The disease can be quite debilitating, causing missed days or weeks of work in healthy adults. Severe cases of hepatitis A may require hospitalization and serious complications can include death in the elderly or those whose immune system is compromised.

In Canada, between 1990 and 2004 the number of reported hepatitis A cases varied from over 3,500 to less than 400. Due to asymptomatic infection, under-diagnosis and underreporting, the actual number of hepatitis A cases in Canada is estimated to be 10 times higher than the reported cases.(viii)

Hepatitis B is significantly more infectious than HIV(ix) and hepatitis B-associated liver disease kills more than one million people worldwide each year.(X) There are two forms of hepatitis B: acute and chronic.

Chronic hepatitis B infections can lead to cirrhosis (scarring) of the liver, liver cancer,(xi) or liver failure, all of which can lead to death. Many people who become infected don't experience symptoms right away, so they may unknowingly pass the virus on to others like friends and family. Common symptoms include fatigue, nausea, loss of appetite and jaundice. There are approximately 250,000 Canadians with chronic hepatitis B, and approximately 1,100 new hepatitis B cases were reported in 2007(xii). Hepatitis B is the world's leading cause of primary liver cancer,(xiii) causing up to 80 per cent of liver cancer worldwide.(xiv)

Canadians don't realize it, but we make decisions every day that can have positive or negative effects on our liver. Getting educated about liver disease is a good first step to being liver healthy. For more information, visit the Canadian Liver Foundation at, or talk to your healthcare provider to find out about vaccination options and other preventative measures.

About The Canadian Liver Foundation

The CLF is a national charity committed to promoting liver health and reducing the incidence and impact of all forms of liver disease by supporting education and research into causes, diagnoses, prevention and treatment. Through its LIVERight campaign, the CLF wants to make liver health a priority for each and every Canadian - including individuals, health care professionals, government and industry. The CLF has contributed over $10 million dollars to liver research and education in Canada.

Survey Methodology

Leger Marketing surveyed 1,521 adult Canadians aged 18 and older about contracting Hepatitis A and B in Canada. The online survey was conducted from August 17 - 20, 2009, with a confidence level of +/- 2.5 %, 19 times out of 20. The survey was supported through an educational grant from GlaxoSmithKline.


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