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There are several types of hepatitis and each has different modes of transmission, symptoms, and treatment. The most prevalent types are hepatitis A, B, & C:
- Hepatitis A is the most common type of Hepatitis. It is a liver disease that occurs when infected by the Hepatitis A Virus (HAV). HAV is transmitted through a fecal-oral route either by person-to-person transmission between household contacts or sex partners or by ingesting contaminated food or water. Bloodbourne transmission is rare. Hepatitis A is highly contagious if you are in close personal contact with an infected individual. The CDC Department of Health and Human Services publishes a list of infectious and communicable diseases transmitted through handling the food supply. Pathogens that can cause disease after an infected person handles food include the hepatitis A virus. No other type of hepatitis can be transmitted through the food supply. Symptoms include fatigue, nausea, jaundice, fever, and abdominal pain.
- Hepatitis B is a serious disease caused by a virus that attacks the liver. The virus, which is called hepatitis B virus (HBV), can cause lifelong infection, cirrhosis (scarring) of the liver, liver cancer, liver failure, and death. HBV is transmitted by contact with the blood or body fluids of an infected person. It is NOT spread through food, water, or by causal contact. Symptoms include jaundice, fatigue, abdominal pain, loss of appetite, nausea, and vomiting.
- Hepatitis C is a liver disease caused by the hepatitis C virus (HCV). HCV is transmitted by direct contact with infected blood. Symptoms include jaundice, fatigue, nausea, loss of appetite, abdominal pain, and vomiting.
Hepatitis and the Americans with Disabilities Act
The ADA does not contain a list of medical conditions that constitute disabilities. Instead, the ADA has a general definition of disability that each person must meet. A person has a disability if he/she has a physical or mental impairment that substantially limits one or more major life activities, a record of such an impairment, or is regarded as having an impairment. For more information about how to determine whether a person has a disability under the ADA, see How to Determine Whether a Person Has a Disability under the Americans with Disabilities Act Amendments Act (ADAAA).
Accommodating Employees with Hepatitis
People with hepatitis may develop some of the limitations discussed below, but seldom develop all of them. Also, the degree of limitation will vary among individuals. Be aware that not all people with hepatitis will need accommodations to perform their jobs and many others may only need a few accommodations. The following is only a sample of the possibilities available. Numerous other accommodation solutions may exist.
Questions to Consider:
- What limitations is the employee experiencing?
- How do these limitations affect the employee and the employee’s job performance?
- What specific job tasks are problematic as a result of these limitations?
- What accommodations are available to reduce or eliminate these problems? Are all possible resources being used to determine possible accommodations?
- Has the employee been consulted regarding possible accommodations?
- Once accommodations are in place, would it be useful to meet with the employee to evaluate the effectiveness of the accommodations and to determine whether additional accommodations are needed?
- Do supervisory personnel and employees need training?
Fatigue/Weakness: Individuals with Hepatitis may experience decreased stamina or fatigue, making it challenging to perform physically demanding tasks or tolerate extended work hours.
- Flexible leave
- Modified schedule
- Consider access to the facility (ramps, parking, etc.)
- Frequent rest breaks
- Reduce or eliminate strenuous activity
- Flexibility to sit or stand (adjustable workstation)
- Provide a rest area with cot
- Job sharing
Cognitive Complications: Impaired cognitive function may result in memory loss, difficulty managing time, organizational limitations, and executive dysfunction.
- Provide written job instructions and prioritize assignments
- Increase job structure
- Use of day planner or electronic organizer
- Minimize distractions
Psychological Implications: Adjusting to having a disability, as well as the impact on one’s life may result in decreased tolerance for stressors in the workplace.
- Identify stressors and reduce stress
- Educate coworkers, but keep person and his/her condition confidential
- Allow telephone calls to emotional supports
- Open-door policy to supervisor
- Time off for counseling or therapy
- Provide praise and positive reinforcement
- Work from home options
- Reassignment. Reassignment is typically considered if the employee can no longer perform the essential functions of their job (either with or without accommodations).
Situations and Solutions:
A computer programmer with Hepatitis B was experiencing fatigue and nausea, which resulted in problems commuting.
The employer provided a modified schedule and gave the employee an option to work from home.
A factory worker with Hepatitis C, receiving treatment for six months, was experiencing flu like symptoms with extreme fatigue.
The employer provided a modified schedule so that the employee could attend doctor's visits and also leave when symptoms were exacerbated.
A food service worker disclosed Hepatitis C to her employer. The employer was concerned that the employee would risk transmission through the food supply.
The employee provided a note from her doctor, indicating that Hepatitis C was "NOT transmitted through the food supply," and that the individual was "safe to perform the essential job functions." Note: Hepatitis A is a food borne illness, but Hepatitis C is not.
An account representative was out of leave due to treatment for Hepatitis C.
The employee wanted to return to work, but due to side effects of treatment, could not maintain the stamina needed to visit clients. The employer reassigned the employee to another account representative position that did not require travel.