HEPATITIS A BREAKS OUT IN SIKESTON; FORTY-THREE HAVE BEEN STRICKEN WITH DISEASE

SIKESTON -- On Wednesday morning, Lambert's Cafe got its "A-plus" sticker from the Missouri Department of Health.

More and more of the stickers are appearing on restaurants in the Sikeston area, signifying that all of the food-handlers in the restaurants have been vaccinated against the Hepatitis A outbreak that has sickened 43 people in the area.

Last week a man came into Lambert's, didn't see the sticker, "and he left," said manager Jan Pinnell.

Pinnell said she tried to explain to him that all of Lambert's employees had been vaccinated at the beginning of November, but it didn't matter. "Everybody was looking for restaurants with the stickers," she said.

Sue Tippen, communicable disease coordinator for the Missouri Department of Health's Poplar Bluff office, said shipments of the stickers were delayed because of problems with the manufacturer.

Tippen said "at least 100" restaurant workers in the Sikeston area have been vaccinated against Hepatitis A, a viral liver infection.

Health officials in the region stress that the disease has not been found in any food-handlers. "Hopefully that will not happen," Tippen said.

The disease can be spread through contaminated food and water or direct person-to-person contact. Proper sanitation -- good hand-washing -- and vaccinations can prevent the spread of the disease.

Symptoms include pain over the liver, nausea, fever and diarrhea. It may be confused with flu or other illnesses.

Vaccinations are being offered to all restaurant employees in the Sikeston area through the health departments in Scott and New Madrid counties.

Said Tippen: "One reason is to control the outbreak. The second reason is it can be very devastating to a restaurant if a worker is diagnosed with it. We have to announce, if you've eaten at this restaurant, you need to be vaccinated. It can be financially devastating."

Pinnell said the Lambert's chain -- which includes the restaurant at Sikeston, Ozark, Mo., and Foley, Ala. -- has made it mandatory for all new employees to be vaccinated against Hepatitis A.

The policy will remain in place even after the Sikeston outbreak is cleared up, Pinnell said.

"We've heard of restaurants that have had their businesses shut down because of Hepatitis A," she said. "The vaccination's just going to be routine for anybody getting hired here."

The Scott County Health Department's Friday vaccination clinic schedule for the public is already booked up, said Karen Evans, a registered nurse with the health department.

She estimated 250 people have signed up to receive the vaccinations, and her office keeps getting calls from people concerned about the outbreak.

Evans said 90 percent of the calls received are about Hepatitis A.

The vaccinations are not mandatory, Evans said. "We've had a lot of confusion over that. But it is recommended at this time with the outbreak we've had," she said.

Scott County is offering the vaccination in two doses, which must be taken approximately six months apart. There is a charge.

The first cases of Hepatitis A in the Sikeston area were identified in August, Tippen said, but health officials "have no idea" where the outbreak started.

"Hepatitis A is not a seasonal disease," she said. "It can occur at any time where you have a source. When an outbreak begins, it can last up to three years. What we're hoping is, with offering the immunizations to the restaurant workers and to the public, we can contain this."

Tippen said she can't predict how long the current outbreak will last, but "I don't expect this to let up immediately; I expect it to continue for the next month, at least."

Health officials are trying to prevent the outbreak from spreading to adjoining counties.

"There's always the possibility that it could spread, especially with the holidays and people visiting relatives," Tippen said. "There's always the possibility that somebody becomes infected and goes back to their home county and spreads it."

"We're trying to ward it off," said Vicky McDowell, communicable disease coordinator for the Cape Girardeau County Health Department.

She said her department has had "lots of calls" from people concerned about the outbreak in Sikeston. People have asked about the vaccinations, but no one has requested a vaccination, McDowell said.

Health departments don't keep the vaccine on hand, she said. In the event of an outbreak, health departments have to purchase the vaccine and ask the public to reimburse them for the expense.

People may ask their personal physicians to prescribe the vaccine.