Pa. reporting system speeds fight against hepatitis A

Pa. reporting system speeds fight against hepatitis A

A public health reporting system is turning out to be good medicine for Pennsylvania health officials battling an outbreak of hepatitis A that has killed three people and sickened hundreds more.

On Friday, Oct. 31, an emergency room doctor in Pittsburgh called the state's Health Department. 'He had seen several people with the same symptoms,' said Michelle S. Davis, deputy secretary for health planning and assessment. Department officials checked Pennsylvania's National Electronic Disease Surveillance System (PA-NEDSS) for similar cases (see GCN story).

Sure enough, the Web-based public health reporting system indicated a few other cases in the area. Health officials soon found the common thread among everyone with the illness: They had all eaten at a Chi-Chi's restaurant in Monaca, Pa., about 20 miles northwest of Pittsburgh. By Nov. 2, officials at Chi-Chi's Inc. of Louisville, Ky., announced that the Monaca restaurant would stay closed for at least 60 days.

PA-NEDSS helped mobilize the state's health workers to begin inoculating citizens with hepatitis A vaccine. The vaccine must be given within two weeks after exposure for maximum protection. Within a few weeks, the department had inoculated more than 10,000 people against the virus.

'PA-NEDSS helped us perform the epidemiological investigation,' Davis said. 'We needed to interview everyone who got sick and people who were possibly exposed to the virus.'

The reporting system consolidated all the information'names, symptoms, contact information'in one secure site. 'PA-NEDSS really helped us manage all this,' she said.

The system is also helping the department determine the exact source of the virus.

'We're having to go through the entire Chi-Chi's menu and do a statistical analysis of every item,' Davis said.

Although raw scallions were the culprit in a similar outbreak in Tennessee in September, Pennsylvania officials have not yet pinpointed the exact cause, she said.

Hepatitis A symptoms include fever, fatigue, loss of appetite, nausea, abdominal pain and jaundice, a yellow discoloration of the skin and eyes. The incubation period ranges from 15 days to 50 days. As a result, cases of secondary exposure could appear in people who were infected by someone who had the virus and didn't know it, Davis said.

About the Author

Trudy Walsh is a senior writer for GCN.

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