Pubdate: Tue, 07 May 2002
Source: Chicago Tribune (IL)
Copyright: 2002 Chicago Tribune Company
Contact:  http://www.chicagotribune.com/
Details: http://www.mapinc.org/media/82
Author: Vickie Chachere, Associated Press

FLORIDA HEPATITIS A OUTBREAK LINKED TO 'POOR MAN'S CRACK'

BARTOW, Fla. -- For more than six decades, John's Restaurant was a popular 
place to eat in this rural town, drawing generations of steady customers 
with its home-style food and friendly atmosphere.

Then in February, Paquita Campbell, 29, died of liver failure after eating 
chicken wings and cheese fries from John's Restaurant.

Health officials, already alarmed at a major outbreak of hepatitis A in 
Polk County, soon linked the death to an infected cook at John's. Five 
others who were infected were found to have eaten at the restaurant.

The outbreak has been all but fatal for the central Florida restaurant, 
about 40 miles east of Tampa, which serves up such dishes as fried chicken, 
steak, meatloaf and fried fish.

John's shut its doors last month as customers abandoned the restaurant, 
which had served 500 to 800 meals a day. Its cooks and waitresses are 
shunned when they look for other jobs.

Inadequate hand washing

The hepatitis A virus is found in the feces of those who have the disease. 
It is spread by inadequate hand washing after going to the bathroom.

Polk County health officials, however, think the disease has its origins in 
the county's large numbers of methamphetamine users, who can transmit it 
among themselves through sex and the sharing of drug paraphernalia, and 
then on to their families and others.

Methamphetamine, dubbed by some in Polk County as the "poor man's crack," 
is a drug whose use has raged among the county's population of migrant 
workers, day laborers and others in low-wage jobs, including those in food 
service.

Victor Lopez, who bought John's in 1999 from the family of the original 
owner, hopes to reopen this week after a frantic effort to spruce up the 
place and retrain workers in cleanliness.

"It's destroyed my life," said Lopez, who disputes investigators' 
conclusion that Paquita Campbell contracted the disease from his cook or 
that his business had poor hygiene. "I worked 17 years for this. It was my 
dream. This is how I fed my family, this is how I pay my bills. I've lost 
everything I've worked for."

This year, 138 people in Polk County, which has about 500,000 residents, 
have been diagnosed with hepatitis A. About a dozen new cases are being 
documented each week, compared to a 2000 total of 153 cases of hepatitis A, 
which was 10 times higher than the year before.

The Centers for Diseases Control and Prevention in Atlanta reports the 
national rate for hepatitis A last year was about 4.5 cases per 100,000 
residents. That would make Polk's rate more than six times higher.

Tony Fiore, a CDC epidemiologist, said the Polk County outbreak comes at a 
time when national rates are at their lowest level in several years. The 
disease shot up in the mid-1990s but then dropped, in part because of 
vaccinations and greater awareness of how to prevent it.

The hepatitis A virus attacks the liver, and the symptoms include nausea, 
abdominal pain and jaundice. There is no cure for hepatitis A; doctors 
often prescribe bed rest and proper nutrition while the disease runs its 
course and the patient recovers. In some cases, people who have been 
exposed are offered an immune globulin injection, a blood extract that can 
prevent or reduce the symptoms.

Campbell is the only one believed to have died from the virus. A 
48-year-old man needed a liver transplant after contracting the disease in 
February at a church fish fry, which also infected 15 others.

The county has mounted an ambitious effort to find drug users and get them 
tested and vaccinated.

"People are confiding in us so we can help them," said Daniel Haight, 
director of the Public Health Department. "Sometimes the drug makes you 
paranoid, you don't want to tell who your friends are. But we are getting a 
lot of cooperation."

Workers warned of dangers

Meanwhile, the Florida Restaurant Association has launched a campaign to 
warn workers and owners the dangers of not washing their hands. Employees 
are being told to wash their hands as long as it takes to sing "Happy 
Birthday" twice after they use the toilet.

At John's, employees have worked without pay to paint and remodel the 
restaurant in hopes customers will return.

Restaurant manager James Davis said the cook who is believed to have 
contracted the disease in prison no longer works there, and is saddened by 
his suspected connection to Campbell's death.

"If you know anything about the food business, it's a personal thing," 
Davis said. "It's a reflection of who you are."
- ---
MAP posted-by: Keith Brilhart