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The diagnosis of another northeast Arkansas food-service worker with hepatitis A prompted the state Department of Health on Tuesday to issue its second alert on the virus in less than a week.

The latest case involves an employee of the Doublebee's gas station at 1003 U.S. 63 in Walnut Ridge and is part of an outbreak that has infected 13 people in the state's northeast, including four other food-service workers.

The Doublebee's employee was diagnosed Saturday, Health Department spokesman Meg Mirivel said.

The previous alert came after the diagnosis of an employee at a Subway and Flash Market gas station in Corning.

Although the department has been warning people who ate at the businesses, health officials haven't identified anyone who has gotten the virus by eating contaminated food at those locations, said Gary Wheeler, the department's medical director.

Instead, he said, those who have been affected are connected by social relationships. Within those groups, the virus is probably being transmitted through contaminated food, but "we just don't know at this point," he said.

He noted that restaurants typically have stringent requirements for hand-washing and other precautions that prevent the spread of foodborne illnesses.

The department inspected each of the five businesses where a worker has been diagnosed with hepatitis and "found no significant breaks in their procedures that would allow an outbreak to occur," he said.

According to the department, the virus is usually spread when a person ingests tiny amounts of fecal matter, such as through contact with contaminated objects or food.

It also can be transmitted by sharing drug needles or having unprotected sex.

People who ate at the Doublebee's station between April 7 and April 18 should seek care immediately if they have never been vaccinated for hepatitis, the department said.

Such care can be provided through vaccination or treatment with immune globulin, both of which can prevent illness after exposure to the virus, the department said.

The department will offer the vaccine from 8 a.m. to 4:30 p.m. today at the Lawrence County health unit at 1050 W. Free St. in Walnut Ridge.

On Saturday, 266 people were vaccinated at a similar clinic at the Clay County health unit in Corning, three days after the diagnosis in that city. An additional 253 people were vaccinated Monday at the health unit.

The other food workers who have been diagnosed also worked at businesses in Clay County, which is northeast of Lawrence County and borders Missouri.

The Health Department has urged all food-service workers in the county to get vaccinated, and immunized almost 100 as of last week. Wheeler said the department has not yet expanded the food-service workers effort to Lawrence County.

"We haven't taken it off the table, but at this point, we're in a pause situation waiting to see if there are further cases," he said.

Jennifer Dillaha, medical director for the Health Department's immunization program, noted that all the Arkansas cases so far have been in adults. While most adults have not been immunized, the vaccine has been required for Arkansas children in day cares, kindergartens and first grade since 2014.

"I think that's making a difference and shows why we've had no [affected] children so far," Dillaha said.

The outbreak, which Mirivel said is the first cluster of related cases in the state in at least a decade, is linked to several others around the country, including one in southeastern Missouri, which had infected almost 100 people as of last week.

Two other Arkansans have been diagnosed with hepatitis A in other parts of the state this year, but their infections were not related to the northeast Arkansas outbreak, she said.

Health care providers reported seven cases in the state last year, 13 in 2016 and 10 in 2015.

The virus affects the liver and can cause illness two to seven weeks after exposure, with most people developing symptoms in three or four weeks. Typical symptoms include fever, fatigue, loss of appetite, nausea, abdominal pain, dark urine, clay-colored bowel movements, joint pain or jaundice.

About 1 in 3 adults who become infected must be hospitalized, according to the Health Department. Although they may feel sick for months, most people infected with hepatitis A will recover completely and will not have any lasting liver damage, the department said.

Metro on 04/25/2018

Print Headline: Hepatitis A case raises fresh alert

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