HEPATITIS; OFFICIALS: NO THREAT IN CAPE COUNTY

Restaurant-goers should quit looking for the "A-plus" stickers on Cape Girardeau County eateries, health department officials say. Hepatitis A isn't here, so the stickers aren't either.

Several restaurants in Scott County, where a hepatitis A outbreak has sickened 43 people in the Sikeston area, have been issued the stickers, which indicate that all of the restaurants' workers have been vaccinated against the disease.

But the outbreak hasn't crossed the county line, so the vaccinations -- and the "A-plus" stickers -- aren't needed here, said Vicky McDowell, communicable disease coordinator for the Cape Girardeau County Health Department.

"People are hearing about the problem down in Scott County with hepatitis A, and they are starting to look for the `A-plus' stickers here," McDowell said.

That's bad news for some restaurant owners.

"We've had a couple of local restaurants call and express concern about people not wanting to eat in their restaurants," she said.

State health officials working to contain the outbreak in the Sikeston area have said hepatitis A, a viral liver infection, has not been found in any restaurant workers in that region.

The Scott County Health Department will be holding a daylong vaccination clinic today at its Sikeston office for people wanting hepatitis A vaccinations.

Several Scott County restaurants have had their workers vaccinated against the disease.

The disease has not been found in restaurant workers in Cape Girardeau County, said Charlotte Craig, director of the Cape Girardeau County Health Department.

One case of hepatitis A has been reported this year in Cape Girardeau County, said McDowell, but it is not related to the Scott County outbreak.

"The public has no more reason now to be concerned about restaurants' employees passing on this disease than they have had in the past," Craig said.

There are other avenues for contracting hepatitis A, say local health officials.

"The public must realize that they have the same potential of passing on this disease also," Craig said. "Family gatherings, potluck suppers, summer picnics, et cetera are all potential vehicles of this disease being spread. The entire world needs to take good sanitation measures with food preparations, like washing hands frequently, paying proper attention to food preparation itself, and so on."

McDowell said the Cape Girardeau County Health Department will meet with local restaurant owners in early January to see how many of them would be interested in getting their workers vaccinated against hepatitis A.

"Letters have already gone out to all food-handling establishments to respond on whether they want to do the hepatitis A vaccination," she said. "When we get their replies in, then we'll have a huge clinic and offer it to those people who are interested in it for their employees."

The vaccination clinics are preventive in nature, Craig said. In Scott County, the clinics are being used to contain the spread of the disease, and in Cape Girardeau County the vaccinations will be offered to keep the disease out.

"We do not have a problem with hepatitis A at this time," McDowell said.

The 43 cases in the Scott County area include one Stoddard County resident and four New Madrid County residents, said Sue Tippen, communicable disease coordinator for the Missouri Department of Health's regional office in Poplar Bluff.

"Those cases are basically direct contacts from our Sikeston cases,' she said.

One case was reported this year in Mississippi County, Tippen said, but it is not related to the Scott County outbreak.

"It's not unusual for counties to have an occasional sporadic outbreak," she said.

No deaths have been attributed to the Scott County outbreak.

Hepatitis A is seldom fatal, but it can cause long-term sickness, said Tippen.

"For an adult, it can mean they can lose about a month's work trying to recover from it," she said.

Hepatitis A Fast Facts

Hepatitis A is the seventh most commonly reported infectious disease in the U.S., says the Centers for Disease Control and Prevention.

Reported number of infections in U.S. in 1995, 31,582

Estimated number of infections in U.S annually, 143,000

Reported cases in Missouri, 1997 to date, 1,018

Distribution of hepatitis A in Missouri, 1997

Central.............61 cases

Eastern.............134 cases

Northeast...........47 cases

Northwest.......... 239 cases

Southeast...........68 cases

Southwest...........469 cases

Risk factors for hepatitis A

-- Household-sexual contact, 24 percent of reported cases

-- Day care-employment attendance, 15 percent of reported cases

-- International travel, 5 percent of reported cases

-- Food-waterborne outbreak, 5 percent of reported cases

-- No identifiable risk factor, 45 percent of reported cases

Annually, hepatitis A causes approximately 100 deaths in the U.S.

Containing contamination:

Hepatitis A is spread through the fecal-oral route. It can be spread through person-to-person contact or through contaminated food or water.

-- Don't drink untreated tap water in drinks or ice cubes, especially if traveling overseas

-- Do not eat unpeeled fruits, salads, uncooked vegetables or raw shellfish, especially when traveling overseas

-- Don't consume food or beverages -- except pre-packaged, commercially prepared items -- from street vendors, especially when traveling overseas

-- Wash your hands with hot, soapy water after eating, using the bathroom, preparing food or contact with very young children or infected or at-risk adults.

Hepatitis A is endemic in Africa, Asia (except Japan), the Mediterranean basin, Eastern Europe, the Middle East, Central and South America and parts of the Caribbean.

Symptoms of hepatitis A include fatigue, nausea, vomiting, fever and chills, jaundice, pain in the liver area, dark urine, light-colored stools and abdominal pain. Symptoms may recur for up to six months.