Florida Hepatitis A Outbreak Linked to Drug Use

For more than six decades, John's Restaurant was a popular place to eat in a rural town outside Tampa. Then in February, a 29-year-old woman died of liver failure after eating chicken wings and cheese fries from John's. Health officials, already alarmed at a major outbreak of hepatitis A in Polk County, soon linked the death to an infected cook at John's. Five other people who were infected were found to have eaten at the restaurant.

Polk County health officials think the disease has its origins in the county's large number of methamphetamine users, who can transmit it among themselves through sex and the sharing of drug paraphernalia, and then on to their families and others. Methamphetamine, dubbed by some in Polk County as the "poor man's crack," is a drug whose use has raged among the county's population of migrant workers, day laborers and others in low-wage jobs, including those in the food service industry.

This year, 138 people in Polk County, which has about 500,000 residents, have been diagnosed with hepatitis A, and about a dozen new cases are being documented each week. At the rate it is going, the county will easily top its 2000 total of 153 cases of hepatitis A -- and that was already 10 times higher than the year before. The CDC reports the national rate for hepatitis A last year was about 4.5 cases per 100,000 residents. That would make Polk's rate more than six times higher.

The hepatitis A virus is found in the feces of those who have the disease and is spread by inadequate hand washing after going to the bathroom. The hepatitis A virus attacks the liver, and the symptoms include nausea, abdominal pain and jaundice. There is no treatment for hepatitis A; doctors often prescribe bed rest and proper nutrition while the disease runs its course and the patient recovers.

The county has mounted an ambitious effort to find drug users and get them tested and vaccinated. "People are confiding in us so we can help them," said Daniel Haight, director of the Public Health Department. "Sometimes the drug makes you paranoid, you don't want to tell who your friends are. But we are getting a lot of cooperation."

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