July 18, 2009
The Rock Island County Health Department will hold vaccination clinics Monday and Tuesday at Rock Island High School for those people who dined at a Milan, Ill., McDonald's that authorities say is connected to a recent hepatitis A outbreak.
Vaccinations will only be administered to people who ate at the restaurant on specific dates.
After being closed Wednesday for intense cleaning and to meet other Health Department requirements, the McDonald's, located at 400 W. 1st St., also U.S. 67, reopened for business Saturday.
Rock Island County Public Health Administrator Wendy Trute said that when the vaccination clinics are done, she has to investigate why there was a failure in reporting a positive hepatitis A test result of a Milan McDonald's employee in June.
"There was a case diagnosed in early June, a McDonald's employee, that was not reported to us until July 13," Trute said.
"McDonald's was not aware that the employee had it," she said, adding that the failure of reporting was not on the restaurant, but on another entity.
She added that state code says that a food worker has the responsibility to report when they have been tested positive for a contagious disease, "but I doubt that most employees would know that."
Two McDonald's employees ultimately were confirmed to have hepatitis A, Trute said.
Safety nets are supposed to be in place to prevent such a delay in reporting a positive hepatitis result, Trute said, so it was a surprise to learn of the result so late.
"The delay is a problem, and we're investigating why the Health Department was not notified in a timely manner," she said. "But right now we have to focus on preventing further spread."
Trute said she wanted it clearly understood that the McDonald's restaurant had no control over the delay, and that the ball was dropped elsewhere.
By the time it was reported to the Health Department, she said, the administration of a prophylactic, such as a hepatitis A vaccine or immune globulin, to some people was moot because they only work within two weeks of people's last exposure.
According to the Centers for Disease Control and Prevention, hepatitis A is a mild form of the disease that does affect the liver but has no lasting or permanent effects. It can last from a few weeks to several months, but does not lead to chronic infection. It is contracted by the ingestion of fecal matter, even in microscopic amounts, from close person-to-person contact or ingestion of contaminated food or drinks.
The restaurant re-opened at 5 a.m. Saturday.
"They had cooperated fully with us," Trute said. "We followed all the requirements and protocols that we received from the state and passed it along, and they cooperated fully and willingly. They've been really good to work with throughout this whole situation."
The Health Department interviewed all the employees face-to-face in order to identify anyone exhibiting symptoms and administer further testing, she said.
All employees were taught proper hand-washing techniques in one-on-one interviews, and each received either a hepatitis A vaccine or an immune globulin before returning to work.
The building also went through a thorough cleaning that was observed by sanitation experts.
Trute said they were trying to get the vaccination clinic set up earlier but they had to wait for results from two suspected cases that turned out to be negative. Had they been positive, she added, "that could have expanded the eligibility of the dates, and tripled or quadrupled the numbers to be treated."
As it is, the Health Department had to come up with enough vaccine and immune globulin to treat an estimated 5,000-10,000 people who may have dined at the restaurant during specific dates.
Theresa Foes, assistant administrator of the Rock Island County Health Department, said they were able to get enough vaccine and immune globulin by scouring five states and getting help from the Centers for Disease Control and Prevention.
The immune globulin was particularly tough to gather, she said. States generally don't keep that much on hand, and it does have a shelf life.
Foes said the vaccination clinics will be held from 10 a.m. to 6 p.m. Hepatitis A vaccine will be given to people ages 1-40, while immune globulin will be administered to people under 1 year of age or over 40 years of age.
Eligible recipients of the vaccines are those who consumed food or beverages at the Milan McDonald's from July 6-10, and July 13-14.
People who ate at the restaurant on July 11 and 12 were not exposed to the disease.
A person who previously received two doses of hepatitis A vaccine requires no further immunization or immune globulin, she said.
Also, a person who has had hepatitis A in the past has developed immunity and will not become ill from it again.
Foes said that if a person receives the vaccine or immune globulin more than 14 days after they have eaten at the Milan McDonald's, it may not provide protection.