About 2,000 people flooded the Carroll County Health Department with calls yesterday after learning they might have been exposed to hepatitis A, a virus that attacks the liver, at a busy Wendy's restaurant in Eldersburg.
"The callers are not panicked, but they are asking a lot of questions," said Carroll County Health Officer Larry L. Leitch, who issued a public appeal Tuesday to patrons who ate at the restaurant earlier this month.
Health officials are asking customers to contact the department to receive shots against the virus today and tomorrow. The virus has been traced to a former employee who tested positive for hepatitis A on Monday.
"None of the callers have said that they are sick, nor have we been notified of any hepatitis A cases," Leitch said. "In fact, we've gotten a good share of calls from people who have never eaten at a Wendy's but just want to know more about the disease."
Hepatitis A is one of 40 diseases that health workers are required to report to state officials.
Several regular patrons of the Eldersburg restaurant, on Route 26 in Carrolltown Center, expressed concern yesterday about exposure to the disease. Wendy's supervisors gave the Health Department phone number to customers.
"I'm going to call and see," said John Scelsi, 39, of Randallstown. "I eat here almost every day. I always eat that garden veggie pita."
Health officials estimate that as many as 3,000 people might have been exposed, and they are offering free shots of immune globulin (IG) to anyone who ate at the restaurant between Sept. 8 and 12. The shots will be administered at Springfield Hospital Center in Sykesville.
"We are advising that they get the shot if they ate anything at Wendy's," said Leitch. "It is the conservative way to go."
Immune globulin is a manufactured substance made of pooled antibodies from humans. If taken within two weeks of exposure to hepatitis A, it can prevent or limit the disease.
'Does it hurt?'
Twelve nurses answered phones at the Health Department yesterday, fielding questions about which foods might present a risk and where to get an injection.
"One of the most frequently asked questions was whether the shot hurts," said Leitch, who received an IG injection last summer before traveling to Mexico. "I can say from experience that it is relatively painless."
The department announced late Tuesday that a former Wendy's employee had tested positive for hepatitis A. The woman, who was fired Sept. 11 for poor work habits, had handled lettuce and vegetables, company officials said.
"This problem appears to be isolated to a single case at a single restaurant," said Beth Shumway, a spokeswoman for DavCo, the Crofton company that owns the Eldersburg Wendy's and others in the Baltimore-Washington region.
Said Deborah Middleton, supervisor of Carroll's communicable-disease program, who interviewed the woman at Carroll County General Hospital on Tuesday: "She was responsible for fixing salads and preparing lettuce. She told me when she began to jaundice, and from that I determined she was infectious while working."
Worker didn't wear gloves
Although the restaurant requires food handlers to wear plastic gloves, several sources said the woman did not use them.
"Gloves would have made a difference in how we considered our reaction to this incident," said Charles L. Zeleski, county director of environmental health. "With gloves, transmission of the disease might have been interrupted."
Hepatitis A is carried in human feces and often is a food-borne disease associated with poor hygiene, said David M. Portesi, a public health expert in the epidemiology and disease-control program of the Maryland Department of Health and Mental Hygiene.
Symptoms include diarrhea, nausea, cramping and jaundice, a yellowing of the eyes and skin. The virus can be spread by food handlers who don't wash their hands after a trip to the restroom, by babies and toddlers in day care centers or -- in rare cases -- by shellfish.
Sickness is temporary
Hepatitis A does not cause permanent damage and doesn't recur: Once you've had it, you won't contract it again, health officials said. It is less severe than hepatitis B and C, which are blood-borne illnesses that are spread by dirty needles, sexual contact and transfusions, said Portesi, who took part in the decision to issue a public appeal to patrons to receive IG shots -- a move seldom made by health officials.
"A lot of times we don't notify the public because the case might have been reported a month ago and it wouldn't do any good," Portesi said. "We don't want to panic people."
The public appeal in Carroll was issued as a precaution, health officials stressed.
"It's not an outbreak. At this point, it's only a single case," Portesi said.
Health officials arranged Tuesday to have $46,000 -- or 3,000 doses -- worth of immune globulin shipped from FFF Enterprises, Inc. in Temecula, Calif., the only company in the country that manufactures IG.
It arrived in Westminster yesterday. Additional shipments are on standby, if needed, Leitch said. Unused doses will be returned ++ to the manufacturer.
Shots available in Springfield
The Health Department has organized a temporary clinic in the Medical-Surgical Building on the Springfield campus, where the IG shots will be administered. Signs will be posted throughout the hospital property directing visitors to the clinic.
"We chose Springfield, because we wanted to be in the neighborhood where the exposure occurred," said Leitch. "Rather than ask people to drive a half-hour to Westminster, we ** are taking the IG to them."
Carroll County has never faced an outbreak of hepatitis A, health officials said. Middleton recalled a measles epidemic at Western Maryland College more than a decade ago.
"We knew the population then, the number of students and professors," she said. "For this situation, we don't know how many. We have prepared for the maximum."
Shots are being offered from 2 p.m. to 8 p.m. today and tomorrow at hospital center in Sykesville.
Pub Date: 9/24/98