Officials link green onions to Chi-Chi's hepatitis outbreak; scallion source still unknown

<br>BEAVER, Pa. (AP) _ Green onions were the likely source of a deadly hepatitis A outbreak at a Mexican restaurant last month, but the origin of the onions and how they were tainted remains unclear, state

Friday, November 21st 2003, 12:00 am

By: News On 6

BEAVER, Pa. (AP) _ Green onions were the likely source of a deadly hepatitis A outbreak at a Mexican restaurant last month, but the origin of the onions and how they were tainted remains unclear, state health officials said Friday.

``All the evidence suggests that people had direct contact with the green onions,'' said Joel Hersh, director of epidemiology for the Pennsylvania Department of Health.

The outbreak, which has killed three people and sickened at least 575, is the nation's largest ever from a single source _ a Chi-Chi's restaurant at the Beaver Valley Mall, about 25 miles northwest of Pittsburgh.

Most of the hepatitis A cases were traced to people who ate mild salsa or one of two particular entrees, which will be identified in an official report expected to be issued later Friday, health officials said.

The restaurant's hot salsa is packaged before it arrives at Chi-Chi's, but the mild salsa is made partly on site, health officials said.

Health officials in Pennsylvania initially suspected that Chi-Chi's employees had failed to wash their hands before handling food or utensils _ the other common way besides raw food that the disease is spread.

But shortly after the outbreak was confirmed Nov. 3, the Food and Drug Administration issued a national advisory that to ensure safety, purchased green onions should be cooked and not eaten raw.

It is not known whether the green onions behind the Pennsylvania outbreak are linked to those already known to have caused smaller outbreaks of hepatitis A in Tennessee and Georgia in September.

The FDA announced Thursday that it has traced green onions in those outbreaks to three Mexican suppliers and is inspecting all green onion shipments from them.

The agency is still trying to trace the source of the onions in the Pennsylvania outbreak and another in North Carolina in September.

Health officials have said the strain of hepatitis found in Pennsylvania is very similar to the one in the Tennessee and Georgia cases.

The number of victims announced Friday by Dr. Calvin Johnson, the state Health Secretary, included 35 additional cases. The numbers of new diagnoses are declining, he said.

People who were sickened said they ate at the restaurant between Sept. 14 and Oct. 18, though investigators were verifying those accounts by checking credit card records.

Each year, 125,000 to 200,000 people contract hepatitis A, an infection that attacks the liver. Symptoms include fever, nausea, diarrhea, jaundice, fatigue, abdominal pain and loss of appetite. Hepatitis A usually clears up in about two months, but the antibody shots greatly reduce the chances of contracting the disease if given within 14 days after exposure.

More than 9,100 people received antibody shots in the Pennsylvania outbreak, health officials said.

Officials still can't explain why the Pennsylvania outbreak was so much broader than previous ones, though it may simply be because the Chi-Chi's served so many meals _ 11,000 in October, state health officials said.

More than 250 people got hepatitis A at more than a dozen Georgia restaurants in September, and 80 were infected at one restaurant near Knoxville, Tenn., about the same time.

At least eight people were sickened after eating green onions at a restaurant in North Carolina in September, according to the Centers for Disease Control and Prevention. The FDA is also still trying to trace the source of those onions, CDC officials said Friday.

Even before the FDA issued its green onion advisory on Nov. 15, the Louisville, Ky.-based chain had pulled green onions from 99 other restaurants in 17 states from Minnesota to the Mid-Atlantic. The Chi-Chi's at Beaver Valley Mall remains closed. Taco Bell has pulled scallions from some 6,000 American outlets, though there have been no reports of hepatitis A at those stores.

Chi-Chi's filed for Chapter 11 bankruptcy protection on Oct. 8 in a move unrelated to the outbreak. The chain on Thursday asked a bankruptcy judge for permission to spend $500,000 on an insurance deductible to free up as much as $51 million in liability insurance. The restaurant hopes to use the money to settle out-of-court claims for medical bills, lost wages and other expenses brought by those sickened in Pennsylvania.

A bankruptcy judge could rule on that request as early as Friday.