KEY POINTS:
The McDonald's worker who has sparked a hepatitis A scare had no symptoms to warn of the disease when handling customers' food on December 15 and 16.
Health authorities issued an alert on Saturday to warn people who ate food which may have been contaminated by the worker, who prepared salads without wearing gloves.
But they are not blaming the restaurant concerned - which has an A-grade food-hygiene certificate from the Auckland City Council - and emphasise that McDonald's restaurants pose no ongoing risk of hepatitis A. They do not know how the worker caught the illness.
By yesterday, more than 20 people had contacted the Auckland Regional Public Health Service to report having eaten from the McDonald's Greenlane restaurant between 7pm on December 15 and 2am the following morning, the infected worker's shift.
Patrons who ate from the restaurant that night are urged to be extra careful with hand hygiene, so as not to infect others, and to see a doctor if they suffer hepatitis A symptoms.
Medical officer of health Dr Greg Simmons said yesterday none of the customers who had phoned in had symptoms.
Symptoms often appeared within two weeks, but it could take up to 50 days after exposure to the virus to become unwell. Symptoms include mild fever, feeling unwell, tiredness, loss of appetite, yellowing of the skin and eyes, vomiting and, rarely, diarrhoea. There is no specific treatment, although injections of hepatitis A antibodies within two weeks of infection can be effective.
The virus is transmitted through faeces, making hand-washing and drying crucial after using the toilet and before preparing food or drinks.
The part-time McDonald's employee worked a second shift - on December 23 - after catching the disease, but only handled money on that occasion, not food. On that shift, the worker had non-specific symptoms.
"They just weren't well, but nothing they could put a finger on, not unwell enough to go off work," said Dr Simmons. "No vomiting or diarrhoea."
Hepatitis A was hard to deal with because people excreted it for two weeks before developing any symptoms. A policy, like McDonald's, of sending unwell staff home was powerless against the disease. "You've got to rely on routine hand hygiene."
He endorsed use of medical gloves in food preparation but only to avoid specific risks - such as when handling raw meat - and said good hand washing was needed too. If workers used gloves for all food tasks, they would probably end up causing rather than stopping contamination.
"McDonald's, in terms of their food safety procedures, they're one of the safest food chains there is," Dr Simmons said.
McDonald's spokeswoman Joanna Redfern-Hardisty said the sick employee was off work and improving. She did not know how many people ate at the Greenlane restaurant during the December 15-16 night shift.
Unrelated to the disease scare, the company was reviewing its food-handling procedures and this would look at the use of gloves, which it required to be worn in certain areas including when handling raw meat patties.
She said staff must wash their hands when they started work, when they moved between tasks and additionally at regular intervals.
* The public health service asks people who bought food from the restaurant on the night of December 15 to phone (09) 623-4600 for advice.
Outbreaks and scares
* About 50 cases of hepatitis A are reported to health authorities every year, down from 300 in 1996.
* In 1996, a Wellington delicatessen worker infected 36 customers.
* In 2002, 22 cases were linked with eating raw blueberries, some of which came from a Waikato farm where a person had the disease.
* The same year, a waitress at Bluefins restaurant in Auckland was hospitalised with the illness, but no other cases were linked to her.
