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Hepatitis victim received new liver

More than 7,500 people have received injections

Sunday, November 09, 2003

By Anita Srikameswaran, Pittsburgh Post-Gazette

A liver transplant could not save an Aliquippa man who became sick with hepatitis A after eating at a Chi-Chi's restaurant in Beaver County.

Jeffrey Cook

Jeffrey Cook, 38, died Friday at UPMC Presbyterian. An autopsy was performed yesterday and the cause of death appears to be liver failure, said Beaver County Coroner Wayne Tatalovich.

"He had a transplant the day he died," the coroner said. "They tried to do all they could to save him. They just couldn't do it."

Tatalovich couldn't say whether an underlying liver condition or other disease contributed to Cook's death because his office had not received the medical records from UPMC.

"People don't normally die from [hepatitis A]," he said. "This is rare."

Christine Cook, a nurse, told KDKA-TV that her husband and 10-year-old daughter initially became ill with flu-like symptoms. Both had eaten at the Chi-Chi's in the Beaver Valley Mall. A visit to the emergency department at Sewickley Valley Hospital last weekend led to the diagnosis of hepatitis A, and Jeff Cook was transferred to UPMC Presbyterian.

By Tuesday, he was confused, a signal that his liver could be failing.

Christine Cook praised the efforts of UPMC doctors, saying that her husband moved to the top of the transplant list. Although he received a liver from a California donor, the stress of the infection and operation caused his organs to shut down.

"Chi-Chi's should take full responsibility," Christine Cook said.

Her husband was one of three people who were hospitalized in critical condition at Presby. Two other patients remain in fair condition last night, a hospital spokeswoman said.

Children's Hospital yesterday discharged the last of the five patients it has treated.

So far, 185 people from five states have confirmed cases of hepatitis A.

Since the opening Wednesday of a clinic run by the state Department of Health, 7,564 people at risk of infection had received shots of immune globulin. The antibody treatment lessens the chance of acquiring the disease if given within 14 days of exposure.

The clinic, which has been held for four days under the Dome at Beaver County Community College, will also be open from 11 a.m. to 3 p.m. tomorrow.

A majority of people treated at the clinic thus far have been those who ate at the Chi-Chi's in Beaver Valley Mall since Oct. 22.

Health department spokesman Richard McGarvey said 550 of the 569 people screened yesterday got the injections.

"Certainly the numbers have been coming down over the last few days, but that's a fair amount of people," he said. "There was still a line at the door when we opened up, but it was much shorter."

A spokesman for the state Department of Agriculture said Chi-Chi's could reopen tomorrow. From the Health Department's regulatory standpoint, "as long as the workers who are working there are not hepatitis-A positive or active cases, they could open," McGarvey said.

A three-person team from the U.S. Centers for Disease Control and Prevention was expected to assist in the investigation yesterday.

"You try to go back as far as you can to see where the transmission chain started," McGarvey explained. That can help determine when exposure to the virus might have occurred.

But in this unusual situation, where numerous restaurant patrons were diagnosed with the infection before restaurant workers were, it may be impossible to identify the first link in the disease chain, McGarvey said.

"I'm not sure it would be of any help," he said. "Through no fault of their own, they became ill. That's not a crime."

The hepatitis A virus is shed in the stool of infected individuals. Food handlers, in particular, should use special care in washing their hands after going to the bathroom.

The immune globulin clinic isn't just to prevent people who ate at Chi-Chi's between Oct. 22 and last weekend from getting ill. It also is to forestall another round of disease spread.

"At this point, we haven't identified secondary cases," McGarvey said. "We're still in that first wave."

A decision will be made tomorrow whether to continue offering the shots of immune globulin on such a large scale or to downsize the effort.

McGarvey said that if no new cases occur in 50 days, which is the outer limit of the virus' incubation period, health officials could say the danger has passed. The average incubation period, meaning the time between infection and the appearance of symptoms, is 28 to 30 days.

Visitation for Jeff Cook is from 5 to 9 p.m. tomorrow at Darroch Memorial Chapel, 2640 Mill St., Aliquippa. A funeral is planned for 10 a.m. Tuesday at the funeral home.


Anita Srikameswaran can be reached at anitas@post-gazette.com or 412-263-3858.

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