County health officials report outbreaks of HVA last fall

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From the Los Angeles Times

2 Sources of Hepatitis A Named

County health officials report outbreaks of the virus last fall at an Olvera

Street restaurant and a catering firm favored by film studios.

By Rong-Gong Lin II, Times Staff Writer

February 2, 2006

Los Angeles County public health officials confirmed Wednesday that

hepatitis A outbreaks last fall hit a popular Mexican restaurant in downtown

Los Angeles and a North Hollywood catering company favored by big movie

studios.

At La Golondrina on Olvera Street, 15 patrons fell ill after eating there

Sept. 14 or 15, said Bancroft, a county medical epidemiologist.

On Oct. 3, Silver Grill Catering served what the county suspects was

contaminated baby green lettuce, leaving 19 ill.

Public health officials had for weeks resisted naming the likely sources of

some outbreaks, saying it was not necessary because the window for

prevention was " long over " by the time the county had traced the illnesses

to their point of origin.

However, the agency has been under pressure from some news organizations to

disclose more details about the autumn outbreaks, which collectively

sickened more than 300 people at various locations in Los Angeles County.

" If we have a few cases and we think it's traceable to a restaurant, but

[the infections occurred] six weeks ago and … there's no evidence of

continuing problems, what's the benefit " of identifying the restaurant? said

Dr. Fielding, county public health director. " It may simply be they

got a bad head of lettuce. "

The county said its inspection of La Golondrina showed that no employees

were ill with hepatitis A during the time of infection, and the restaurant's

food preparation practices met federal guidelines. Only patrons in the

two-day period in September were affected, and by the time the county

uncovered the connection in November, it was too late to give anyone a

preventive shot of immune globulin, or antibodies to prevent infection.

By contrast, county officials did identify the restaurant when five workers

at Café Pinot fell ill with hepatitis A in December because the outbreak was

traced in time to give the shots to patrons.

But some patrons of La Golondrina said that they would have preferred to

have been notified of the outbreak.

" I would like to have known, " said J. Partos, a downtown lawyer. " I

wouldn't have eaten there if I knew that they were under a hepatitis

investigation. "

Marie Tervalon, a customer service representative for the MTA, agreed.

" That was wrong, that was really wrong, " she said of the county's resistance

to releasing the information. " I guide people all over the place, and this

is one of the places I recommend. "

Still, the news won't keep Tervalon away. She noted that the restaurant

gives MTA employees a 15% discount.

Tervalon's husband, , saw no problem with the county's approach.

" Why let anyone know now, if they had cleaned up the problem? " he said.

" What do you want them to say? 'We had an outbreak of hepatitis A three

weeks ago, but it's OK now?' "

La Golondrina's manager, Almy Leon, said officials had found no fault in the

way employees handled food. Although no employees were found to have been

ill in September, Leon said, all were recently sent to a clinic to get

tested for hepatitis A as a precaution. None tested positive. The inspectors

checked everything, Leon said, and " we still have a letter A " health rating

from the county. " They didn't find anything wrong with us. Otherwise, we'd

be closed right now. "

Antoine Mascaro, owner of Silver Grill Catering, said he changed produce

suppliers after the county identified contaminated baby green lettuce as the

likely source of infection in his company's case. The company also has begun

washing bagged lettuce that is labeled pre-washed. Public health officials

in December recommended using cool, running water.

Mascaro declined to name the company that had supplied the lettuce.

KTTV-TV Channel 11 first identified the two locations in a report last

month.

Hepatitis A cases began to increase significantly in August 2005. From then

through December, 344 cases of hepatitis A were confirmed, peaking in

November with 113 cases. Before August, the county averaged nine cases a

month.

The numbers have declined in recent weeks. There were 43 cases in December

and nine in January, although those figures are likely to increase as the

county continues to investigate reports of infection.

Fielding said hepatitis A is a particularly difficult disease to monitor,

because unlike other food-borne illnesses, it takes several weeks for

symptoms to appear after exposure.

Contaminated food often is discarded, and people have a hard time

remembering where they ate weeks before.

" In many of the outbreaks of food-borne illnesses, we don't find a

definitive source, " Fielding said.

In a report to the Board of Supervisors, the county said it had traced other

infections during the fall to a downtown communal home that ran a soup

kitchen and a drug treatment center.

Hepatitis A is normally spread from person to person through fecal matter.

Symptoms include fever, chills, muscle aches, fatigue, jaundice, nausea,

vomiting and cramps.

About 7,000 people fall ill with the disease annually in the U.S. While most

recover with medical attention, hepatitis A kills about 100 each year.

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