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

You are looking at the inside of a typical Chipotle Mexican Grill.   It's a very clean-looking environment.   It's always a function of local management if the interior is really kept clean and the service running smoothly.   To be honest, we don't dine at Chipotles because we don't like standing in lines period, and these places are usually so popular that there lines are long.

Well, if you assume that the Health Department has actually tested all employees (not likely) and that the food (as in many earlier Hepatitis A outbreaks) was not contaminated, then is it possible that customers who were in those lines at the La Mesa, CA Chipotle restaurant came into contact with someone or someones who were carriers of Hepatitis A as the disease has spread to at least 18 other people?  We at Hepatitis Blog have not found such an outbreak in our research.  So, anyone who dined there between March 1 and April 22 are being told by health officials to seek a medical checkup.

Hepatitis A is commonly transmitted when an object contaminated with the stool of someone with hepatitis A comes in contact with another person’s mouth. Exposure also can occur when an individual consumes food or water contaminated with the Hepatitis A virus, according to the health department.  Symptoms of hepatitis A include fever, fatigue, nausea and jaundice.

Chipotle is also dealing with a norovirus outbreak at one of its Ohio restaurants.

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Chipotle Mexican Grill is experiencing its second outbreak of the week, this one at La Mesa, CA involving Hepatitis A.   Fox 6 News reports:

The San Diego Health and Human Services Agency and County Department of Environmental Health are investigating six cases of Hepatitis A linked to a La Mesa Chipotle restaurant.

The county is recommending individuals who dined at the restaurant between March and April 22, 2008, and may see symptoms of Hepatitis A, to see their physicians for screenings.

Hepatitis A is a vaccine-preventable illness, according to health officers, and the public is urged to talk to their physicians about getting vaccinated

The other Chipotle outbreak has made more than 400 people sick in Kent, Ohio.  Go here for more on the Southern California outbreak.

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Hepatitis A is one of five human hepatitis viruses (hepatitis A, B, C, D, and E) that primarily infect the liver and cause illness. An estimated 80,000 cases occur each year in the U.S., although much higher estimates have been proposed based on mathematical modeling of the past incidence of infection. Each year, an estimated 100 persons die as a result of acute liver failure in the U.S. due to hepatitis A, but the rate of infection has dramatically decreased since the hepatitis A vaccine was licensed and became available in the U.S. in 1995.

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Contamination of food by an infected food worker is the most common mode of transmission of hepatitis A in food borne disease outbreaks (Guzewich 1999). A review of food-borne Hepatitis A outbreaks in the United States found that in many cases the infected food handler either did not seek medical care or delayed getting medical care (Fiore 2004).

So says Dr. Rajiv Bhatia, Director, Occupational and Environmental Health of the San Francisco Department of Public Health.  That's just a taste of a long article by Dr. Bhatia on the California Progress Report, in which he makes the case that paid sick days are the key to cutting down on food borne illnesses like hepatitis A.

Two years ago, San Francisco began the first city in America to require all employers to provide for paid sick days.  Now the California Assembly is considering imposing the same requirement statewide.

Dr. Bhatia says paid sick days pay positive dividends in the following areas: Avoiding transmission of infectious disease in communities;  Preventing food borne illness;Reducing expensive hospital care; Providing essential care for family members and dependents;and Addressing health disparities.  He says:

For occupations such as health care workers, child care providers, and food service workers, it is critical to keep sick workers out of the workplace.

See Dr. Bhatia's entire article here.

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We spend a lot of time observing how various state, regional and local health districts handle the challenge of an outbreak, or the potential for one.  

We see the Idaho Central Health District has pretty well put away the threat that one restaurant worker caused at Boise's Red Feather Lounge by working with Hepatitis A.  Here's what that Idaho agency told the public:

It has now been two weeks since the Red Feather Lounge employee with hepatitis A last worked at the establishment. Anyone potentially exposed to the disease between March 5th and 17th will no longer be eligible for a vaccination because it would not be effective. From March 25th through March 31st Central District Health Department (CDHD) provided hepatitis A vaccinations to 283 people. Everyone potentially exposed should continue to wash their hands thoroughly, since receiving hepatitis A vaccine after a potential exposure is not 100% effective prevention. CDHD reminds those that have not been vaccinated or have not been previously infected to watch for signs of hepatitis A infection. CDHD still maintains that the chance of infection is low, but patrons should be aware of the following information.

It goes on to provide excellent write-ups on symptoms, incubation, treatment, and statistics.  Go here for all of that.

As that ends in Idaho,  the Lafayette, Louisiana Parish Schools is confronting the same problem as one of its employees continued working after contracting Hepatitis A.   KLFY-TV 10 is reporting that vaccinations will be available on Wednesday April 9th at these three sites: Acadian Middle, NP Moss at Good Hope Baptist and NP Moss Annex.  The vaccines are free of charge for all students and faculty attending those schools

KLFY-TV 10 reports:

Hepatitis A is serious contagious liver disease. Now hundreds of students in Lafayette are exposed to it.

We will see how Louisiana handles it.  At this point, we haven't seen any involvement by either the state or the Region 4 Health District.   Maybe they just leave it to the Parish Schools.

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