Virus report affects 3,000 Former food handler at Wendy's dTC outlet tests positive for hepatitis A

Free inoculations offered

Health officials ask patrons of Sept. 8-12 to call department

September 23, 1998|By Brenda J. Buote and Mary Gail Hare | Brenda J. Buote and Mary Gail Hare,SUN STAFF Sun staff writer Sheridan Lyons contributed to this article.

As many as 3,000 people may have been exposed to hepatitis A, a contagious virus that attacks the liver, at a busy Wendy's restaurant in Eldersburg this month, the Carroll County Health Department announced yesterday.

Health officials are asking that anyone who ate at the restaurant Sept. 8 to 12 call the department to receive a free shot of immune globulin (IG), which contains antibodies to the virus and can help prevent the disease.

Patrons who ate at the restaurant Sept. 1 to 7 also may have been exposed, but the IG shot would not be effective for them. The antibody can prevent or limit the disease up to two weeks from the time of exposure.

The county ordered $46,000 -- or 3,000 doses -- worth of immune globulin from an out-of-state company yesterday after learning the state had only about 300 doses available. The antibody is expected to arrive today, health officials said.

"We found out on Monday that a food handler had tested positive for the disease," said Larry L. Leitch, health officer for Carroll County. "This is a dangerous, communicable disease. The community needs to be aware so we can interrupt its spread. We want people to take this seriously.

"We estimate the upper range of those exposed is 3,000, but it's anybody's guess how many will show up" to get a shot, he added. "This is such a mobile area."

Hepatitis A is carried in human feces and often is a food-borne disease associated with poor hygiene, said David M. Portesi, a public health expert in the epidemiology and disease-control program of the Maryland Department of Health and Mental Hygiene.

It can be spread by food-service workers who don't wash their hands after a trip to the restroom, by babies and toddlers in day care centers or -- in rare cases -- shellfish.

"She was shedding the virus, and was infectious while she was working," said Debbie Middleton, the nurse who examined the ** Wendy's employee yesterday, a day after the patient was admitted to Carroll County General Hospital in Westminster.

Wendy's officials said last night the employee worked at the restaurant for about two weeks and handled uncooked food, such as lettuce and other salad ingredients. She was fired Sept. 11 for bad work habits, said Dave Norman, general counsel for DAVCO, the local franchisee for Wendy's.

"We're having other employees tested for hepatitis A and they will be getting shots," Norman said. "We've had no indication of other employees having hepatitis A and no complaints from any of our customers. We intend to do everything necessary to protect the safety of our guests."

Hepatitis A is one of 40 diseases that health workers are required to report to state officials.

"The incubation period is 15 to 30 days," said Leitch, who consulted with Portesi before making a public appeal to patrons to receive IG shots. "Many who ate food she may have handled in that time could be contaminated."

The shots are injected into the upper hip with a thin needle and are relatively painless.

"Symptoms mirror a stomach flu," said Dr. Michael Kerr, an emergency room physician at Carroll County General Hospital. "They can range from slight nausea to severe diarrhea, intense cramping and even jaundice," a yellowing of the skin and eyes.

Health workers recommend that anyone experiencing symptoms consult their doctor and get tested for hepatitis A. "About 40 percent of the population will contract hepatitis A sometime in their life, but only about 5 percent will remember it," Kerr said.

The virus has a mortality rate of less than 0.1 percent. "It's most dangerous for the elderly, for feeble seniors," Kerr said.

Supervisors at the Eldersburg Wendy's at Carrolltown Center said the restaurant is aware of the dangers generated by poor hygiene and takes steps to ensure food safety.

"We require employees to wear gloves and follow a strict hand-washing policy," said Dan Basgier, a temporary manager.

The restaurant employs about 30 people, each of whom must view a food-safety video before starting work.

The Eldersburg Wendy's serves about 100 customers each weekday and more than 200 a day on weekends, Basgier said.

County officials said the restaurant -- which has been in business several years -- has never been cited for a health violation. Health officials conduct spot inspections monthly. A full inspection is done twice yearly.

This is the first time Carroll County has experienced the threat of a widespread outbreak of hepatitis A, health officials said.

Nationally, 23,000 to 35,000 people are diagnosed with the infectious liver disease each year, said Dr. Beth P. Bell, an epidemiologist with the hepatitis branch of the Centers for Disease Control and Prevention in Atlanta.

"The majority of hepatitis A in this country is transmitted from person to person in family or extended-family settings," Bell said.

The most recent outbreak in the Baltimore region occurred in January, when 19 cases of hepatitis A were reported. The outbreak was clustered along the York Road corridor from the city line into northern Baltimore County, said state health officials. But the cause, and why it was concentrated there, remains unexplained.

Shots are being offered from 2 p.m. to 8 p.m. tomorrow and Friday at the Medical-Surgical Building at Springfield Hospital Center in Sykesville. Information: 410-876-4900.

Pub Date: 9/23/98

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