Outbreak of hepatitis A spread by contaminated drinking glasses in a public house

Ten cases of hepatitis A were associated with a public house whose barman had chronic non-infectious diarrhoea and had served drinks while incubating hepatitis A himself. Eight cases had drunk in the public house in the two weeks before the barman became ill, had no other risk factors for hepatitis A infection, and were regarded as primary cases. Two other cases had visited the pub during the same period, but were classified as secondary cases because they became ill later and were contacts of primary cases. Sexual transmission was excluded. Fomite transmission by contamination of glasses was a more likely route of spread of the infection among the eight primary cases than food or contaminated surfaces in the toilet.