The Spokane Regional Health District, dealing with its largest hepatitis A outbreak in almost 10 years, is out of the medication that prevents the onset of the virus.
And the Panhandle Health District in North Idaho is holding tight to its dwindling supply.
Immune globulin protects against hepatitis A if given to people within 14 days of exposure, but a national shortage of the medicine means supplies are running out in the region.
Vaccinations against hepatitis A still are available, but the vaccine doesn’t help people who already have been exposed.
An infected food worker at Players and Spectators restaurant on East Sprague helped push the Spokane health district to its limit.
People who ate or drank at the restaurant between Dec. 29 and Jan. 5 were advised over the weekend to get shots of immune globulin.
Lines of people wanting a shot stretched out the doors of the health district Monday. The district was drained of its last 480 shots of immune globulin in hours.
“It’s an item in scarce supply,” said Dr. Paul Stepak, epidemiologist at the district.
The district managed to find another 570 doses from Thurston County, which probably will be available on Wednesday, said Dr. Kim Thorburn, district health officer.
About 330 more doses should be available by the end of the week, she said.
But anyone exposed at Players Dec. 29 or 30 is probably out of luck - the 14 days of incubation will have elapsed.
“If they were truly exposed, the likelihood is they will get it,” Thorburn said.
Spokane County is still in the middle of a hepatitis A epidemic.
Last year, 183 people came down with the virus, the highest level since 1988. A public health emergency was almost declared.
The health district is still counting this year’s cases. So far, 22 have been confirmed.
Not one of the cases has been directly linked to a food handler. Most of the time, hepatitis A is transmitted in a household.
The Panhandle Health District, which covers North Idaho, has handled about 40 hepatitis A cases in the past six months.
Idaho has issued a state directive telling its health districts to give immune globulin only to people exposed in households or day-care centers - not in restaurants.
“We’re not trying to be mean,” said Marie Rau, public health nursing supervisor for the Panhandle Health District. “We really don’t have it. We really can’t give it for food-establishment exposures at this time.”
Health-care workers urged people to watch for symptoms of hepatitis A, including yellowing of the skin or eyes, fatigue, diarrhea, nausea and loss of appetite.
The disease is rarely fatal. It’s spread by oral-fecal contact, often because of poor hygiene.
The virus is infectious from about two weeks before symptoms begin until about two weeks after.
Vaccinations against hepatitis A are available at the Spokane Regional Health District and at the Panhandle Health District.
“People can be proactive,” Rau said. “I’ve gotten a hepatitis A vaccine myself, because I eat out, and I’m not always in control of what happens to food before it goes into my mouth. Everybody can do that.
“Everybody can wash their hands with soap and water after they go to the bathroom and before they prepare food and before they eat. We are not always victims.”
, DataTimes ILLUSTRATION: Graphic: Hepatitis A cases