Practice ReportHepatitis A Cases Among Food Handlers: A Local Health Department Response—New York City, 2013Ridpath, Alison MD, MPH; Reddy, Vasudha MPH; Layton, Marcelle MD; Misener, Mark MD, MPH; Scaccia, Allison RN; Starr, David MIA; Stavinsky, Faina MS; Varma, Jay K. MD; Waechter, HaeNa MPH; Zucker, Jane R. MD, MSc; Balter, Sharon MD, MFA Author Information Division of Disease Control (Drs Ridpath, Layton, Misener, Varma, Zucker, and Balter and Mss Reddy and Waechter), Office of Emergency Preparedness and Response (Ms Scaccia and Mr Starr), and Division of Environmental Health (Ms Stavinsky), New York City Department of Health and Mental Hygiene, New York, New York; and Epidemic Intelligence Service, Division of Scientific Education and Professional Development (Dr Ridpath), National Center for Emerging and Zoonotic Infectious Diseases (Dr Varma), and National Center for Immunizations and Respiratory Diseases (Dr Zucker), Centers for Disease Control and Prevention, Atlanta, Georgia. Correspondence: Sharon Balter, MD, MFA, Division of Disease Control and Prevention, New York City Department of Health and Mental Hygiene, 42-09 28th St, Box 22A, Long Island City, NY 11101 ([email protected]). This work was supported by Centers for Disease Control and Prevention (CDC) Cooperative Agreement for Public Health Emergency Preparedness (No. 5U90TP000546-02) and CDC Epidemiology and Laboratory Capacity for Infectious Diseases Cooperative Agreement (No. 3U50CI000899-02S4). The authors acknowledge all the New York City Department of Health and Mental Hygiene staff members who assisted in investigation and response efforts; and Drs Stacey A. Bosch and Melissa G. Collier at Centers for Disease Control and Prevention for assistance with manuscript preparation.The findings and conclusions in this report are those of the author(s) and do not necessarily represent the official position of the Centers for Disease Control and Prevention.The authors declare no conflicts of interest. Journal of Public Health Management and Practice: November/December 2017 - Volume 23 - Issue 6 - p 571-576 doi: 10.1097/PHH.0000000000000526 Buy Metrics Abstract During 2013, the New York City Department of Health and Mental Hygiene (DOHMH) received reports of 6 hepatitis A cases among food handlers. We describe our decision-making process for public notification, type of postexposure prophylaxis (PEP) offered, and lessons learned. For 3 cases, public notification was issued and DOHMH offered only hepatitis A vaccine as PEP. Subsequent outbreaks resulted from 1 case for which no public notification was issued or PEP offered, and 1 for which public notification was issued and PEP was offered too late. DOHMH continues to use environmental assessments to guide public notification decisions and offer only hepatitis A vaccine as PEP after public notification but recognizes the need to evaluate each situation individually. The PEP strategy employed by DOHMH should be considered because hepatitis A vaccine is immunogenic in all age groups, can be obtained by local jurisdictions more quickly, and is logistically easier to administer in mass clinics than immunoglobulin. © 2017 Wolters Kluwer Health, Inc. All rights reserved.