Media reports, press releases and comments from the Rock Island County Health Department, Illinois Department of Health and the McDonald’s in Milan at 400 W. 1st St. on U.S. 67 franchise owner are a bit light, but we know that at least 19 patrons of the restaurant are ill with Hepatitis A – 11 have been hospitalized.

First reports of illnesses were on July 15, 2009 – although oddly, Illinois Department of Health published a press release on the 13th urging families in the State to vaccinate against Hepatitis A. There are rumors that there are at least 2 ill employees.

The restaurant is on U.S. 67, near Highway. 280, and near the Quad-City Airport. You must wonder how many customers may have been exposed to Hepatitis A and where they are now.

From our site

Hepatitis A is a communicable (or contagious) disease that spreads from person to person. It is transmitted by the “fecal – oral route,” generally from person-to-person, or via contaminated food or water.

Food contaminated with the virus is a common vehicle transmitting hepatitis A. The food preparer or cook is the individual most often contaminating the food. He or she is generally not ill: the peak time of infectivity (i.e., when the most virus is present in the stool of an infectious individual) is during the 2 weeks before illness begins.

Symptoms typically begin about 28 days after contracting the hepatitis A virus, but can begin as early as 15 days or as late as 50 days after exposure (Koff, 1998), and include muscle aches, headache, anorexia (loss of appetite), abdominal discomfort, fever, and malaise. After a few days of the aforementioned symptoms, jaundice (also termed “icterus”) sets in.

Hepatitis A is TOTALLY PREVENTABLE. Although outbreaks continue to occur in the United States, outbreaks NEED NOT OCCUR if responsible preventive measures are taken. Responsible restaurant managers will exclude ill food-handlers from work, with pay. Food-handlers must also be taught to always wash their hands with soap and water after using the bathroom, changing a diaper, and certainly before preparing food.

After a known exposure to the hepatitis A virus, administration of a shot of Immune Globulin (IG) should be considered. IG is 80%-90% effective in preventing hepatitis A infection if it is administered within 2 weeks of the exposure.

It appears that the Rock Island Health Department is going to begin IG shots for the public on Monday – seems a bit odd it would not start sooner? Did they have adequate supplies of the IG shots?

Some other questions that need to be answered:

1. When was the first reported case of Hepatitis A linked to this McDonalds reported to the Rock Island Health Department?
2. When did McDonalds have notice if an employee was in fact ill?
3. What are McDonalds hand-washing and glove policies and were they being used?
4. Assuming that the illness originated with an ill employee, how many customers were served during the period of time the employee worked – and where are the customers now?
5. Did the ill employees and customers become so at the same time? If so, this may well point to a food product as the source.

More questions than answers at this point.