Hepatitis A Threat Widens Third Food Handler Infected; 20,000 People Possibly Exposed

FRIDAY, JAN. 16, 1998

(From For the Record, January 17, 1998): Day wrong: Friday’s A-1 photograph of people lining up for shots at the Spokane Regional Health District offices was taken Wednesday not Thursday.

(From For the Record, January 21, 1998): Vaccine prices: A vaccination against hepatitis A costs $84 - $42 each for two shots. A story in Friday’s paper indicated otherwise.

(From for the Record, January 26, 1999): Cost incorrect: The cost of hepatitis A vaccinations dropped to $26 for each of two doses during last year’s epidemic. In most cases, the bill was paid by the person receiving the vaccinations. A story incorrectly reported the cost.

Health officials boosted the estimated number of people possibly exposed to hepatitis A to 20,000 as another worker at a Spokane Valley restaurant was diagnosed with the bug on Thursday.

More than 420 people received immune globulin shots Thursday against a possible outbreak of hepatitis A. More than 1,500 people have been inoculated this week since three workers at Players and Spectators contracted the illness.

The new case broadens the time and potential severity of an outbreak. The worker diagnosed Thursday had worked until last Sunday. Health workers previously thought exposure was only between Dec. 21 and Jan. 5.

The type of customer potentially exposed also was expanded Thursday to include anyone who ate food at the sports bar. Previous warnings focused on people who drank iced drinks or munched on garnishes.

No customer from Players and Spectators has been diagnosed with the illness, but at least 31 cases have been identified so far this year.

The outbreak prompted health officials and restaurants to again demand vaccinations of all area food handlers.

His voice quavering, H.T. Higgins, owner of Players and Spectators, told the Spokane County Health Board that he would begin an advertising and public service campaign goading the local restaurant industry into getting the $42 vaccinations for workers.

The campaign, he said, could be the silver lining in the dark cloud that is killing his business.

“If we don’t act now, it’ll disappear in a month and business owners will go back to what they are doing,” said Higgins, who is paying cost of each immune globulin shot.

Immune globulin protects against hepatitis A if given to people within 14 days of exposure.

“The cost is so minuscule compared to the cost to the community, Higgins said.”

Kim Thorburn, health officer for the Spokane Regional Health District, agreed, praising Higgins’ plan.

“I’m presenting this to businesses as an insurance investment,” Thorburn said. “It may not happen to them, but if it does, it’s pretty serious.”

While the numbers of people potentially exposed to hepatitis A continue to swell, available doses of immune globulin shrink.

After raiding health clinics statewide, Thorburn has about 1,300 doses in stock.

She expects the stash to go quickly when news of the wider exposure breaks.

The doses are the last until the middle of next week, when a new shipment may arrive, Thorburn said. No shots will be given Monday, because of the Martin Luther King holiday, she said.

The immune globulin, which costs up to $30 per shot, is manufactured by just two companies nationwide. One of the companies briefly shut down, contributing to a nationwide shortage.

The U.S. military is also hoarding doses, fearful of an outbreak among its forces in the Middle East, Thorburn said.

The virus is spread via an oral-fecal route, often by people with unwashed hands who handle food.

It causes symptoms similar to a nasty flu, such as fatigue, diarrhea, nausea and loss of appetite. Hepatitis A causes about 100 deaths a year nationwide.

One Spokane teenager who recently caught the virus suffered liver damage.

At Thorburn’s request, hospital emergency rooms are vaccinating people with typically bad hygiene, including intravenous drug users or people living in impoverished, unemployed households.

The shots are paid by Medicaid and some private health insurers, such as Group Health.

She also told the health board Thursday she may demand vaccinations for all 1,000 county jail inmates, people who are likely in the same atrisk groups.

The cost would likely be absorbed by the county government and city and state police, she said. The health board did not formally endorse the idea.

Luckily, she said, there is no outbreak among child-care providers, a group vulnerable because of the erratic hygiene of children.

Instead, the focus of the outbreak is on restaurants.

At least 22 restaurants have vaccinated all their servers. They’ll post signs, boasting participation in the “Hepatitis A Prevention Program.”

Janice Pettit, part-owner of Luigi’s, spent about $1,600 vaccinating her 40 workers, and said it’s money well spent.

“That’s a lot less than if you had to close your doors,” Pettit said.

She is encouraging other owners to pony up. She blames the outbreak for a drop in business. “It effects everyone when it effects one,” Pettit said. “People are going to be associating going out to eat with getting sick.”

Higgins said his business is suffering, as are the tips of his employees.

“Frankly, I don’t want to know how down we are.”

, DataTimes ILLUSTRATION: Color photo

Tags: disease

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