Hepatitis A menace still looms months later


Hepatitis A is not yet a bad memory for many of the 660 people infected in the outbreak in Beaver County in November. It's still their daily struggle.

Sapping their strength, draining their energy and, for a few, threatening their lives, the infection and its effects linger.

Frank Rossi Jr., of Hopewell, became the outbreak's fourth fatality when he died of hepatitis A complications Thursday after suffering for more than five months with a host of medical problems. Rossi will be buried today on what would have been his 51st birthday.

The outbreak was caused by contaminated, Mexican-grown green onions served at the Beaver Valley Mall Chi-Chi's Restaurant. The liver disease primarily is spread through oral contact with fecal material.

"There's a lot of people who are still sick," said attorney Andy Weisbecker, of the Seattle law firm Marler Clark, which represents 85 to 100 outbreak victims.

About 15 percent of those infected with hepatitis A will have prolonged or relapsing symptoms for six to nine months, according to the U.S. Centers for Disease Control and Prevention. That means about 100 people infected in the Beaver County outbreak still could be sick or become sick again.

The infection is not chronic, according to the CDC.

"There has never been any documented evidence of any strain -- and that includes this strain -- of hepatitis A being more virulent than another. The outcome of a patient very much depends on the age and underlying health effects," said Jennifer Morcone, CDC spokeswoman.

A Monaca man in his early 40s was released from the hospital two weeks ago after suffering from an infection he caught because of his hepatitis A-weakened immune system, according to Weisbecker, his attorney. A liver transplant was considered, but not done, he said.

The man also had been hospitalized for about two weeks after first falling ill, but recently returned to work in airline maintenance, Weisbecker said.

Another client, Richard Miller, 57, of Beaver County, still is recovering after having a liver transplant in November, Weisbecker said.

Most of Weisbecker's clients have gone back to work and resumed their daily activities, he said, but "about 30 to 40 percent are still not back to normal." They are weak, fatigued and have impaired immune systems, he said.

Hopewell attorney Richard Urick said about 10 of the 101 hepatitis A victims his firm represents still are suffering the lingering effects of the illness as well. None is hospitalized or expected to die, he said.

"Some people had a rebound effect, some people have not been able to shake it, some people developed flu-like symptoms," Urick said.

No one is believed to be hospitalized now as a result of the outbreak, according to the attorneys and officials at eight area hospitals and The Cleveland Clinic.

Hepatitis A makes the liver swell and keeps it from working effectively. Some people never develop symptoms, but can be contagious for about three weeks.

Others become seriously ill for about a month, with aches, nausea, abdominal pain, weakness, loss of appetite and jaundice. The illness has a long incubation period, ranging from 15 to 50 days, with an average of 28 to 30 days before the illness strikes.

"In this particular outbreak -- very large outbreak -- we're still within the case-fatality ratio that we would expect," Morcone said.

Less than 1 percent of people who contract hepatitis A die. While not unheard-of, deaths from hepatitis A are still rare. No one died among the 729 people infected in 23 separate outbreaks of hepatitis A nationwide between 1993 and '97, according to the CDC.