Hepatitis A Lawyer & Attorney : Marler Clark : Hepatitis A Blog

Hepatitis A is a communicable (or contagious) disease that spreads from person to person. (It is not acquired from animals, insects, or other means.) It is transmitted by the "fecal -- oral route." This does not mean, or course, that Hepatitis A transmission requires that fecal material from an infectious individual must come in contact directly with the mouth of a susceptible individual. It is almost always true that the virus infects a susceptible individual when he or she ingests it, but it gets to the mouth by an indirect route.

Food contaminated with the virus is the most common vehicle transmitting Hepatitis A. The food preparer or cook is the individual most often contaminating the food. He or she is generally not ill: the peak time of infectivity (i.e., when the most virus is present in the stool of an infectious individual) is during the 2 weeks before illness begins. Hepatitis A is spread almost exclusively through fecal-oral contact, generally from person-to-person, or via contaminated food or water. Outbreaks associated with food have been increasingly implicated as a significant source of Hepatitis A infection. Such "outbreaks are usually associated with contamination of food during preparation by an HAV-infected food handler."2 Indeed, "[v]iral gastroenteritis was reported as the most common food-borne illness in Minnesota from 1984 to 1991, predominantly associated with poor personal hygiene of infected food handlers."3

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Hepatitis A is one of five human hepatitis viruses that primarily infect the human liver and cause human illness. (There are many other viruses that can inflame the liver which infect us more generally.) The other known human hepatitis viruses are hepatitis B, C, D, and E. Hepatitis A is relatively unusual in nations with developed sanitation systems such as the United States. Nevertheless, it continues to occur here.

Each year, an estimated 100 persons die as a result of acute liver failure in the United States due to Hepatitis A1. Approximately 30 - 50,000 cases occur yearly in the United States and the direct and indirect costs of these cases exceed $300 million1. The unfortunate aspect of these statistics is that with 21st century medicine, Hepatitis A is totally preventable, and isolated cases, and especially outbreaks relegated to food consumption, need not occur.

Viral Hepatitis is a major public health concern in the United States, and a source of significant morbidity and mortality.1 The Hepatitis A virus or "HAV" is heat stable and will survive for up to a month at ambient temperatures in the environment.

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Public health nurse says hepatitis case is nobody's fault

BY ERIN DOWER

MALTA -- During what should be a booming week, business is dwindling at the Ripe Tomato restaurant at Routes 9 and 9P following an announcement last week that an employee was diagnosed with infectious hepatitis.

Joseph Gleason, the owner of the restaurant, said many tables have been empty since state and county health officials announced Thursday that a part-time food service worker had tested positive for hepatitis A, a viral liver infection.

Gleason said he has had to lay off four cooks since last week because business has dropped off so much.

"These are good-standing, family people," Gleason said. "Now they're out of work."

The infected employee was a student who worked three days a week, he said.

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JIM KINNEY , The Saratogian 08/20/2004

MALTA -- A food-service worker at The Ripe Tomato on Route 9 in Malta has tested positive for hepatitis A, Saratoga County Public Health said Thursday.

Nurse Terry Stortz, the prevention team supervisor for Public Health, said the employee didn't work while acutely ill but still could have passed on the virus on uncooked foods including garnishes like lemon slices, chives and scallions.

'We're erring on the side of being safe,' she said. 'There is no ongoing risk of infection,'

She said The Ripe Tomato, a popular restaurant where Route 9 intersects with 9P, is cooperating and has a history of satisfactory sanitary inspections.

Anyone who ate a garnish at The Ripe Tomato between 5:30 and 10 p.m. on Aug. 7, 9 and 10 should come to Saratoga County Public Health at 31 Woodlawn Ave., Saratoga Springs, for a shot of immune globulin.

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Reported by: A.P.
Web produced by: Neil Relyea
8/16/04 4:08:30 PM

Indiana health officials say no new cases of Hepatitis A have been linked to an ill fast-food restaurant worker at Wendy's located in Marion, north of Indianapolis.

A warning prompted nearly 6,000 people to receive immunization shots more than two weeks ago.

The state Health Department offered the shots after an employee at a Wendy's restaurant tested positive for the liver disease.

Health officials say no other employees or customers who ate at the restaurant have yet to show signs of hepatitis, but because of the incubation period of the disease, some cases may yet appear.

Wendy's officials say customers have been returning to the restaurant.

The ill employee spent only a short time in the hospital and plans to return to work after his recovery period.

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By RACHEL KIPP
rlkipp@marion.gannett.com

Fewer customers have stopped by the Wendy's south restaurant since an employee there was found to have contracted Hepatitis A, but things may be on the upswing.

"As you can imagine business has been impacted," said Gary Boyer, director of operations for the locally-owned fast food restaurant. "But we're seeing friends and associates coming back and it's improving every day."

He said business has decreased at both the store at 1410 S. Western Ave., and at the north location, 1223 Wabash Ave., which has seen customers return more quickly.

Grant County Health Inspector P.J. Culley said she and other health department employees have eaten at the south restaurant in the past few weeks.

"People need to know it's safe to eat there again," she said.

Beginning Jan. 1, the state will require food establishments to have at least one certified food handler overseeing food safety operations. Boyer said employees at his restaurants have been taking the requisite class and receiving the certification for several years.

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The Associated Press

People who ate at a mall restaurant on several dates in late July and early August may have been exposed to hepatitis A, Durham County health officials warned.

A worker at the Big Bowl restaurant at The Streets of Southpoint mall was diagnosed with the mildest form of the viral disease after working part time on July 24, 25, 26 and 30, and Aug. 2 and 8.

The county health department offered free shots to people who ate at the restaurant during the hours the infected worker was on duty in August.

Shots were not offered to customers on the July dates because it's too late to do any good. Immune globulin can prevent hepatitis A only when given within two weeks of exposure, said county health director Brian Letourneau.

Hepatitis A is a sometimes serious and highly infectious liver disease, typically contracted by eating or drinking food or fluids contaminated by traces of fecal material.

An infected person can pass along the disease by failing to wash properly after using the bathroom and then touching another person or handling uncooked food or beverages.

Children who contract hepatitis A often don't show any symptoms. In adults, it can produce tiredness, loss of appetite, fever, abdominal discomfort, nausea, vomiting, diarrhea, jaundice and darkened urine.

"The odds of anybody getting sick from this incident are really pretty small," Letourneau said.

He said any customers who develop symptoms should contact the health department or their doctor.

---

Information from: The Herald-Sun,

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By Whitney Ross
wross@marion.gannett.com

Hepatitis facts

- Free clinic: Because of the risk to the public, a free clinic will be set up within the next few days with immune globulin, an immunization that provides temporary immunity from the disease and may prevent illness in people who have been exposed to it in the last 14 days.

- Incubation period: People with Hepatitis A are most contagious from about one week before symptoms begin until two weeks after. Most start to have symptoms about one month after exposure. Some have no symptoms, but sill spread the virus.

- Symptoms: Tiredness, stomach pain, fever, loss of appetite, yellowing of skin and eyeballs (jaundice) and nausea, dark urine or pale-colored stool

- Who is at risk: People who live with or have sex with an infected person, children and staff of child care centers where a child or employee has Hepatitis A, residents and staff or centers for disabled children when a child or employee has Hepatitis A, travelers to countries where Hepatitis A is common and where there is little clean water or proper sewage disposal.

- Is there a cure? No. There is no medicine for Hepatitis A once you have it. Immune globulin can be taken within two weeks after exposure to prevent or lessen symptoms.

- How it can be prevented: Washing hands after using the bathroom, cleaning the toilet, changing or handling soiled towels or linens, fixing food or eating.

- What to do? If exposed to Hepatitis A, ask a doctor about immune globulin. If traveling to areas where Hepatitis A is common, get immune globulin or vaccination before travel, drink bottled beverages and do not eat uncooked fruits or vegetables, unless you peel them yourself.

- Source: Indiana State Department of Health

If you have eaten at the Wendy's Old-Fashioned Hamburgers in South Marion within the past two weeks, you could be at risk for Hepatitis A, the Indiana State Department of Health said Tuesday.

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The Associated Press

PITTSBURGH - Chi-Chi's is suing food wholesalers, including a Campbell County company, in an effort to get them to help pay for scores of hepatitis-A-related lawsuits as it continues to settle its own lawsuits.

The restaurant chain, based in Louisville, has settled 134 of the more than 300 lawsuits filed by people sickened after eating at a Beaver County, Pa., restaurant last fall, said Chi-Chi's lawyer David Ernst. The outbreak, traced to green onions, sickened 660 people and killed four.

Late last month, Chi-Chi's filed suit against three suppliers - Castellini Co. of Wilder; Sysco Corp. of Houston; and one of Sysco's subsidiaries, Sygma Network, Inc. of Lakewood, Colo.

"We have tried for months to get those companies to voluntarily step up to the plate and help the victims. They're refusing to do so and we're continuing to do so ... so we've had to sue them," Ernst said Monday.

Some of victims required liver transplants, although none of the cases Chi-Chi's settled involved deaths or critical injuries.

Chi-Chi's claims in its lawsuit that the green onions were supplied by Castellini, a fruit and vegetable wholesaler, and sold to Chi-Chi's through Sysco or Sygma. Chi-Chi's negotiated onion prices with Castellini, and bought them through the other defendants, the lawsuit says.

Officials at Castellini, a family-owned company with about 2,000 employees and about $500 million in annual sales, didn't return telephone messages left Monday.

Frederic Gordon, a Chi-Chi's lawyer, said Castellini and the others are being sued because Chi-Chi's has written sales agreements with those companies that include product warranties. The wholesalers could, in turn, sue the Mexican growers or others "upstream" in the supply chain, he said.

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By Joe Mandak
The Associated Press

PITTSBURGH - Jerri Reges can tell you what food poisoning feels like.

"This was worse than labor," said Reges, a mother of two.

The 39-year-old woman got severe stomach cramps after eating a hoagie at a convenience store July 5, becoming one of more than 300 people sickened in a recent salmonella outbreak that has hit five states. Roma tomatoes are believed to be the cause.

It's the latest high-profile scare involving fresh produce, which experts say is the new frontier in foodborne disease prevention. In this round, no one has died, in contrast to last year's hepatitis outbreak that killed four people and made hundreds sick. Green onions from Mexico were blamed.

Tainted fresh foods pose more concerns than others because fruits and vegetables are often eaten raw or lightly cooked. That means salmonella, cyclospora, shigella, E. coli and other pathogens often aren't killed before eating, and they generally can't be removed by washing.

The most common of these cause diarrhea and cramps and are not fatal. The germs are often spread from the unwashed hands of food workers.

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By JOE MANDAK
Associated Press Writer
August 2, 2004, 5:24 PM EDT

PITTSBURGH -- Chi-Chi's is suing food wholesalers in an effort to get them to help pay for scores of hepatitis A-related lawsuits as it continues to settle its own lawsuits.

The Mexican restaurant chain has settled 134 of the more than 300 lawsuits filed by people sickened after eating at a Pennsylvania restaurant last fall, said Chi-Chi's attorney David Ernst. The outbreak, traced to green onions, sickened 660 people and killed four.

Late last month, Chi-Chi's, owned by Irvine, Calif. based Prandium Inc., filed suit against three suppliers -- Castellini Co. of Wilder, Ky.; Sysco Corp. of Houston; and one of Sysco's subsidiaries, Sygma Network Inc. of Lakewood, Colo.

"We have tried for months to get those companies to voluntarily step up to the plate and help the victims. They're refusing to do so and we're continuing to do so ... so we've had to sue them," Ernst said Monday.

Some of victims required liver transplants, though none of the cases Chi-Chi's settled involved deaths or critical injuries.

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