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Source of Hepatitis Outbreak Sought

People who ate at Cafe Pinot between Nov. 25 and Dec. 4 are urged to get medical treatment.

Los Angeles County health officials said Friday that they are investigating a new suspected hepatitis A outbreak at Cafe Pinot, one of downtown Los Angeles' top restaurants.

Four employees of the restaurant at the Central Library have fallen ill in the last few weeks, prompting the county Department of Health Services to urge restaurant patrons who dined there between Nov. 25 and Dec. 4 to contact their doctors for injections of antibodies to prevent infection.

Los Angeles County has seen a spike in hepatitis A cases since August.

Officials have linked some of the cases to contaminated lettuce. Last week, the county urged residents to thoroughly clean even pre-washed lettuce.

However, officials are still trying to determine exactly what caused the outbreak at Cafe Pinot, said Dr. Jonathan Fielding, public health director for Los Angeles County.

"There's nothing at this point that suggests the restaurant is responsible for this," he said. "We don't know if it was produce or hand-washing technique or what. Anything could have caused it."

Fielding, who said he has eaten at Cafe Pinot, said he found no reason to close the restaurant, adding that he would readily eat there again.

"I wouldn't hesitate to eat there," he said. "People have a lot of choices in restaurants, but I would recommend not striking it off any lists. I don't see any reason to avoid it."

The upscale Cafe Pinot is one of several downtown restaurants owned by German-born, French-trained chef Joachim Splichal. His others include Patina and Kendall's Brasserie at the Los Angeles Music Center.

A spokeswoman for Cafe Pinot could not be reached for comment, but Fielding said the restaurant has been cooperative.

Since September, at least 60 people have fallen ill from hepatitis A in Los Angeles County. The outbreak comes after years of declining cases.

Two previous outbreaks occurred in September and October. The first incident took place at an unidentified downtown Los Angeles restaurant and affected 13 people. The latter arose from an event catered by a Hollywood company, at which 19 fell ill. The other cases were scattered.

Officials had observed an increase in hepatitis A in homeless patients in downtown Los Angeles late last summer, but those numbers appear to be dropping. The county's hepatitis A rates had been declining since 1999, when health officials began advising that children be vaccinated against the disease.

Fielding said officials learned of the outbreak Thursday when the restaurant informed them that an employee had contracted the disease.

Further checking revealed that three other employees have symptoms consistent with hepatitis A.

The restaurant is reeducating employees about the disease and the importance of washing their hands.

Friday's announcement caught some who have patronized Cafe Pinot off guard.

When told about the health warning, Imran Hayat immediately pulled out his Blackberry and thumbed a few keys. The 28-year-old real estate litigator breathed a sigh of relief after finding out that he had last eaten there well before the outbreak.

Hepatitis A is caused by a virus and spread by close contact with someone who has it 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.

The Centers for Disease Control and Prevention reported 7,653 acute cases in the United States in 2003, the last year for which figures are available. Most infected people recover with medical treatment, but hepatitis A kills about 100 each year nationally.

Outbreaks are difficult to track because the disease has a two- to eight-week incubation period.

Patrons of Cafe Pinot during the 10 days of the suspected outbreak should, if they have not previously been vaccinated against hepatitis A, get shots of immune globulin from their doctors, health officials said.

The county will also offer immune globulin shots at the Central Health Clinic at 241 N. Figueroa St. from 9 a.m. to 1 p.m. today and Sunday.

Patrons are urged to receive the shot no later than two weeks after possible exposure.

Fielding said it's not a bad idea for all adults to consider getting vaccinated against hepatitis A, which prevents the illness.

"In the past, it hasn't been routine to get immunized. At the national level, it's just becoming routine for infants," he said. "But they should talk to their [medical] providers about getting immunized."

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