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On the Menu, Dinner and a Shot

Cafe Pinot tells patrons who dined during a 10-day span that they may have been exposed to hepatitis A and urges them to get injections.

More than 450 diners and employees at swanky Cafe Pinot have received shots to combat hepatitis A after workers at the downtown Los Angeles eatery contracted the disease.

A customer and five employees have been diagnosed with hepatitis A, county health officials said Wednesday, as they continued to track a puzzling outbreak of the virus over the last few months.

There have been 214 confirmed cases in Los Angeles County since August, compared with 52 cases between January and July.

The county Department of Health Services on Friday urged patrons of Cafe Pinot who dined there between Nov. 25 and Dec. 4 to contact their doctors for injections of antibodies to prevent infection.

A Pinot spokeswoman said business was down about 30% over the weekend but that it was picking up. The restaurant, located next to the Central Library, had 135 reservations Wednesday night, said Julie Priceman, a spokeswoman for chef Joachim Splichal and his Patina Group, which owns Cafe Pinot and several other well-known downtown restaurants.

Using phone numbers provided for reservations, Pinot officials called 1,000 patrons who might have been infected by the virus. Other patrons — some from as far away as Boston and New York — called a hotline established by the restaurant to answer questions about the outbreak.

Cafe Pinot marks the fourth known outbreak since August. One took place at an unidentified downtown Los Angeles restaurant and affected 13 people. Another occurred after an event catered by a Hollywood company, at which 19 fell ill. The remaining cases were scattered. Officials have linked some of the hepatitis cases to contaminated lettuce and urged residents to thoroughly clean even pre-washed lettuce.

Hepatitis A is caused by a virus and spread by close contact with an infected person or by eating food or drinking liquid contaminated by the virus. Symptoms include fever, chills, aches, fatigue, nausea, vomiting, abdominal cramps, dark urine and jaundice.

Outbreaks are difficult to track because the disease has a two- to eight-week incubation period. Officials aren't sure if the Pinot patron who tested positive for hepatitis A contracted it at that restaurant.

Health officials said they were still trying to determine the source of the outbreaks.

"At this point, if there's a point source that everyone was exposed to at one time, we expect we would see more employees over time and we're continuing to investigate that," said Dr. Jonathan Fielding, Los Angeles County's director of public health. "And we're looking at things like that, produce invoices to see if they are from common suppliers, to see if there are any common suppliers or produce."

The outbreak had a small ripple effect throughout the state's restaurant industry.

Andrew Casana, a spokesman for the California Restaurant Assn., based in Sacramento, said the trade group sent notices to members this week, reiterating the importance of thoroughly washing lettuce and other produce to rid them of germs and chemical contaminants used in the fields.

At Cafe Pinot, officials say they are fully cooperating with the health department and are doing everything they can to reach patrons.

"We're very sure we've reached out to 100% of our patrons, especially those who had reservations," Priceman said, adding that credit card companies refused to provide contact information for those without reservations.

Cafe Pinot officials have agreed to pay for shots administered by private physicians. The bills so far have ranged from $25 co-payments to $380 for a full regimen.

Shots will continue to be free at county health centers through the week, said Maria Iacobo, a spokeswoman for the Department of Health Services. Forty-three people received shots from the county Friday, 307 Saturday and Sunday, 100 on Monday and 103 Tuesday. Fewer than 50 had received them Wednesday.

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