Amarillo Globe News
By GEORGE SCHWARZ
george.schwarz@amarillo.com
HEREFORD – Public health officials here are fighting an outbreak of hepatitis A, and the battle could continue for months.
Officials have warned people who consumed food from the McDonald’s in Hereford after 4 p.m. Sept. 20, 22 or 23 that they may have been exposed to the mild liver disease. And they urge those people and others to consider an immune globulin shot, which prevents the viral disease, according to the Texas Department of State Health Services. The agency reported the health issue late Tuesday.
The number of cases has not been determined, said Dr. Connie Lindley, an epidemiologist with the TDSHS office in Canyon.
In a written statement released Wednesday, Susan Credle, the restaurant’s owner-operator, said she was aware of the investigation.
“Restaurant safety and cleanliness are extremely important to me, as well as my restaurant managers and crew employees,” she wrote. “Although this appears to be an isolated case, we are cooperating fully with the health department in their investigation, and we’re working with them to gather all the facts. We believe our restaurant is absolutely safe.”
The outbreak extends well beyond McDonald’s, Lindley said.
“We’ve had other cases,” she said. “It’s just that this worker happens to have worked at McDonald’s.”

The department’s investigation of hepatitis A began in early September in Deaf Smith County when cases began emerging, Lindley said.
“This is the only food restaurant that’s been investigated so far,” Lindley said. “As we’re investigating, there are more cases turning up.”
The investigation will continue until the outbreak runs its course, at least 50 days from the date of the last case’s exposure, she said.
Lindley said she is concerned that individuals who haven’t eaten at this McDonald’s will think they are not at risk.
“It’s not true, because we’re having problems in Hereford,” she said. “With hepatitis A, we can have youngsters in day care that can have hepatitis A and not even exhibit clinical signs and transmit it.”
An infected child can bring the disease home, and if people don’t wash their hands after changing a diaper, after going to the bathroom or before preparing food, the disease can spread, she said.
“Hepatitis A vaccine is the best protection,” the Centers for Disease Control and Prevention states. “Short-term protection against hepatitis A is available from immune globulin. It can be given before and within 2 weeks after coming in contact with (the virus).”
The TDSHS will hold a free clinic to administer the immune globulin from 1 to 4 p.m. today at the Hereford Independent School District Administration building at 601 N. 25th mile Ave.
Hepatitis A
Hepatitis A is a viral disease of the liver caused by the hepatitis A virus, which is more prevalent in areas of poor hygiene. It is transmitted by the fecal-oral route. The incubation period averages 30 days with a range of 15 to 50 days. Most cases manifest no clinical signs or symptoms, although occasionally fatigue, abdominal pain, vomiting, diarrhea and jaundice are evident. The disease rarely is serious and generally has no long-term effect.
Sources: Dorland’s Illustrated Medical Dictionary, 29th Edition and the Centers for Disease Control and Prevention.