The outbreak caught the attention of St. Louis city councillors. They came up with a plan to make it mandatory for all food handlers to be vaccinated against hepatitis A. Hastings made an emotional plea for the plan, from hospital in the days after his transplant operation.

The image was enough to persuade lawmakers to adopt the plan. Janet Williams works for the St. Louis County Health Department. "As a public health agency, we’re always looking at a way to prevent illness rather than continue to respond to an outbreak and this was a way for us to be pro-active and not reactive," she said.

Under the program, anyone who handles ready-to-eat food is vaccinated. The shots are paid for by the employer, although often the employee winds up footing the bill.

Once someone's vaccinated, they're issued a card and their name is registered on a central computer. That means there's a record on file if food handlers switch jobs. People who are not vaccinated have 10 days to get it done - or they're fired. The only exceptions:

• Pregnant women
• People with medical issues
• People with religious objections

The St. Louis hepatitis A vaccination program has been in place for two years. Several other American jurisdictions have similar programs. In Canada, the idea is getting the brush-off.

Mandatory vaccinations 'may not be worth the cost'

In Vancouver, Dr. Patricia Daly tracks communicable diseases for the city's health department. She says food handlers are just a small part of Canada's hepatitis A problem - most infections are brought in by travellers who pick it up overseas.

"I think if we look back over the last five or 10 years, the number of people who acquired hep A from a food handler in a restaurant is very small in Canada."

Ten people have developed hepatitis A after recent scares - the most recent confirmed case was the day before this story was broadcast.

But, on top of the inconvenience, vaccinating more than 45,000 people has cost taxpayers more than $1 million. A mandatory program would likely be paid for by employers and employees. Daly suggests the cost may not be warranted.

Vancouver recently set up a voluntary vaccination program. But, of 50,000 restaurant workers, fewer than 600 have signed up. Two restaurants - Carmelo's Ristorante Italiano and Amadeo Bakehouse and Coffees - allowed our cameras to videotape their employees getting the shot.

Proper handwashing is Canada's answer

In Canada people in the food business prefer to stick with Mom's old admonishment: "Wash your hands!"

"Simple old-fashioned practices like thorough hand-washing will certainly minimize the chances of spreading any communicable disease and that’s why they’re emphasized," Joyce Reynolds of the Canadian Restaurant Association told Marketplace.

At Toronto's George Brown College, Lloyd Suydeko dispenses the art of handwashing to food service students.

Before going through the six steps of handwashing, he has his students use crayons - treated with an invisible germ simulator - to trace around their hands.

After thoroughly washing their hands, the students are surprised to discover how much of the germ simulator remained on their hands and clothes.

Later, the students head out to restaurants with an informal survey to find out what food service workers know about hand washing.

Among the students' findings:

• Several restaurants did not display signs informing staff to wash their hands.
• Several restaurant workers were not well acquainted with proper hand washing techniques.
• One worker didn't know what "tepid water" meant.

Chances are slim that what you eat will give you hepatitis A. But unless something changes, you could find yourself in a long line-up, waiting for a hepatitis A shot, wondering if mandatory vaccines are the answer. For now, the fate of your food rests in the hands that handle it.