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Toll of hepatitis A outbreak climbing

Published November 21, 2003

News-Leader Staff and Wire Services

Springfield, MO

Pittsburgh — When avid University of Pittsburgh football fan John Spratt skipped the Pitt game on Oct. 11, Joseph Spratt knew his younger brother was sick. Neither of them realized how sick.

Barely a month later — on Nov. 14 — John Spratt was dead at age 46 of liver failure, the third and latest fatality in the biggest known outbreak of hepatitis A in U.S. history.

Spratt, a devout Christian family man, spent his last 10 days heavily medicated, never able to say goodbye to his wife, Robin, and daughters, Jacqueline, 17, and Kristen, 12.

"We were told he could hear us, and if you talked to him there'd be a little flutter of the eyebrow or a soft squeeze of the hand, but that's about it," said Joseph Spratt.

More than 540 people have fallen ill over the past few weeks after going to a now-closed Chi-Chi's Mexican restaurant, and investigators say green onions may have been the source of the virus.

Spratt fell ill after having the chicken fajitas with his 17-year-old daughter on Oct. 5 at the restaurant in the Beaver Valley Mall, about 25 miles from Pittsburgh. (His daughter did not get sick, apparently because she did not eat all the condiments that came with the fajitas.)

But on Nov. 3, the day the state Health Department announced the outbreak, Spratt was hospitalized. The next night, he went into liver failure.

The three deaths have shocked western Pennsylvanians, because health authorities have been saying that hepatitis A is usually not fatal and normally runs its course in a few weeks after causing such symptoms as fever, jaundice, nausea and abdominal pain.

Greene County has had two hepatitis A outbreaks in the last decade or so, said Kevin Gipson, assistant director of the Springfield-Greene County Health Department. One occurred in the early 1990s, the second in 1998-99, he said. Both were traced to person-to-person contact and were not food-borne, he said.

"We're always on alert with hepatitis A," he added.

The health department has sent notices to area physicians to be on the lookout for signs of the virus, which can include flulike symptoms, yellowing of the skin and the whites of the eyes and a general malaise. Those who do contract hepatitis A are immune from getting it again, Gipson said.

The health department has also notified grocery wholesalers and all licensed food outlets in Greene County about the outbreak.

"They may have consumers bring them (green onions) back and want their money back," he said. "Some restaurants have stopped using them."

One is Boston Market on South Glenstone Avenue near U.S. 60. Though raw green onions are considered the culprit, the company has pulled any use of the vegetable from six of its dishes, said Phyllis Hammond, senior vice president of communications with the Golden, Colo.-based company.

"We just decided to take a proactive stance rather than take any risk at all with our customers' or employees' health," she said. "We haven't been impacted by this, but we made the call because we would rather be safe than sorry."

Pennsylvania Health Department spokesman Richard McGarvey said there does not appear to be anything surprising statistically about this outbreak. The fatality rate for hepatitis A is one to three deaths per 1,000 cases, though it rises to 18 per 1,000 for those older than age 50 and higher for those with chronic liver problems, McGarvey said.

Dineen Wieczorek, a 51-year-old diabetic, died at a hospital Nov. 12 while awaiting a liver transplant because of damage done by the virus. A customer service representative at an Ikea store, she had eaten at Chi-Chi's on Oct. 6 for her 32nd wedding anniversary.

Jeff Cook, 38, a laid-off auto-body restorer, died Nov. 7 of liver failure shortly after receiving a transplant because of the virus. The coroner is investigating whether acetaminophen Cook took for his symptoms contributed to his death because overuse of the pain reliever can cause liver damage.

Other victims are slowly trying to get over the symptoms.

Jennifer Parison, a 32-year-old homemaker, has been ill since Oct. 30 and blames her hepatitis on the lobster enchilada meal she had at Chi-Chi's weeks earlier. Seven months pregnant, Parison has been told her unborn child is in no danger. But that has not made her life any easier.

"All you want to do is sleep. It's like you're disoriented all the time," Parison said. "And with four kids screaming and a husband working 12- to 14-hour days, it's like it's never going to end."

She said the TV accounts of the outbreak scare her and make her cry.

"You go out to eat, and you think you're safe and you end up sick. This is ridiculous," she said. "I wouldn't wish this on my worst enemy."

Kim and Jim Hite took the virus with them on vacation. They ate taco salads at Chi-Chi's on Oct. 4 and Jim Hite became ill about two weeks later, while the couple were celebrating their 10th wedding anniversary in Florida.

"By the time we left Florida, he was throwing up and had a horrible flight home," said Kim Hite, a 31-year-old kitchen manager at another restaurant. She became ill shortly afterward, as did two others in their dinner group.

"Actually, we thought we had the flu and were treating it like the flu, but once you get into it, it's 10 times more horrible than the flu," she said. "You totally lose your appetite. You actually eat because you have to eat to live. You don't eat because you're hungry."

She said she has lost 25 to 30 pounds and her husband has lost 40 to 50.

For the next week or two, they figure they will pass the time with three or four naps a day, daytime television, puzzles and board games.

"This is not us. We're always on the go," she said. "This really settled us down."

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