Last modified: December 22. 2002 12:00AM
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Copyright 2002 The Ledger
Published Sunday, December 22, 2002
eric.pera@theledger.com
LAKELAND -- Three deaths. Hundreds ill. Thousands on edge.
This year's outbreak of hepatitis A was the worst on record for Polk County,
with 257 cases reported.
Stemming the seldom-fatal, yet highly contagious virus required the resources of
dozens of state and federal health officials, physicians and local law
enforcement.
Not to mention the footwork in tracking sources of the contagion and inoculating
carriers and those they may have infected.
No cases have been reported so far this month, a stark contrast to an outbreak
that began in January with 32 cases -- more than seven times the number from the
previous January.
The monthly tally of cases peaked in March at 59, including 13 people infected
after eating coleslaw at a church fish fry in Auburndale.
"I think this is a pretty proud moment for our Health Department," said Polk's
chief health official, Dr. Daniel Haight, who specializes in infectious diseases
and is on staff at the University of South Florida's College of Medicine.
"It could have been a lot worse," Haight said this week.
Some of the more enduring images of the past year: 900 Stambaugh Middle School
students and staff being immunized after a cafeteria worker became infected at
the fish fry; signs posted on restaurant doors to remind workers to wash their
hands; Haight addressing a phalanx of reporters about the outbreak.
For the year, Polk's number of hepatitis A cases was tops in the state. And last
spring, when the outbreak was at its peak, Polk had more cases than any other
county in the country.
That the outbreak was stopped cold reflects on the diligence of Haight and a
team of up to 20 of his staff, who spent hundreds of hours tracking the sources
of confirmed cases and getting them and their contacts to agree to vaccinations.
As of Friday, there were 257 confirmed cases of hepatitis A for the year, a 57
percent increase over 2001's 163 cases.
Polk had only 15 hepatitis A cases in 2000.
The rise is attributed to the growth of methamphetamine use, an illegal drug
that engenders poor hygiene and leads to the spread of the disease, which is
found in feces.
That's why Haight repeatedly stressed the importance of hand washing as a way to
prevent the spread of the disease.
The outbreak began to slow by May, due in large part to the vaccination of
between 3,000 and 4,000 jail inmates.
None of the deaths were related to what health officials say was the primary
cause of the hepatitis A outbreak -- poor hygiene among drug addicts --
particularly methamphetamine users.
By vaccinating inmates -many of whom carry the disease because of drug use --
Haight said his office prevented a major health crisis that may have led to mass
immunization.
"We were all very impressed at how effective this program was," he said. "I
don't think you can hang your hat solely on the vaccination (program). It was
our staff; doctors at hospitals calling us earlier than they ever had with
possible cases."
Since the outbreak, Haight said health officials in Lake County, where there was
a small outbreak, have sought his advice.
He's also been quoted in several national law enforcement publications, which
sought his expertise on linking hepatitis A to methamphetamine.
A BIG CHALLENGE
Haight, 36, said that stemming the outbreak was one of the greatest challenges
of his career, behind an outbreak of typhoid fever at a Haines City apartment
complex in late 1996, just months after he was hired as health director.
With only nine confirmed cases and no deaths, the typhoid incident within a
close-knit Hispanic community did not receive the same media scrutiny as this
year's hepatitis outbreak.
"But it was an intense process here at the Health Department," Haight said, "in
gaining trust of people who were sick and scared, dealing with language
problems, making sure it wasn't spread into the food or water supply."
Hepatitis A is fatal in about 2 percent of cases, but it can make one seriously
ill and cause liver damage.
The disease is mainly spread by poor hygiene and the lack of hand washing after
going to the bathroom. Symptoms include a sudden fever and nausea, dark urine,
yellowing eyes, malaise and fatigue.
This year's outbreak had an impact on the restaurant industry after employees
and customers of several Polk eateries became infected and one customer died.
This led state inspectors to canvas the county's 880 restaurants for safety and
hygiene infractions. Additionally, the Florida Restaurant Association held
seminars to help restaurateurs guard against further outbreaks.
The only restaurant-related death was that of Paquita Campbell, 29, of Bartow, a
single mother of an infant girl who became ill in late February after eating at
John's Restaurant.
The source of the infection was traced to a cook.
Campbell died March 6 at Bartow Memorial Hospital.
Her mother, Dora Campbell of Hamer, S.C., is expected to file a wrongful death
lawsuit early next year, naming John's as defendant, said her attorney, John
Frost of Bartow.
While neither Campbell nor Frost would elaborate, Campbell said she still has
concerns about the safety of restaurants "not only in that county (Polk) but any
county that has workers not tested before they treat food."
Campbell's death dried up business at John's, a Bartow fixture.
The restaurant closed April 18, only to reopen May 8 with assurances by owner
Victor Lopez that all new employees would be vaccinated.
SEEKING THE SOURCE
Health officials never located the source of infection that killed 36-year-old
Michael David Johnson of Auburndale. He died June 7 from hepatitis A complicated
by chronic hepatitis C.
The county's third fatality was Joseph "Mickey" Merritt, 48, of Auburndale, one
of 13 people infected after attending a Canaan Temple Church of God covereddish
supper and fish fry in early February.
Coleslaw caused those infections, Haight said, but it's a mystery how the slaw
became tainted.
Merritt, a former piano player for country musician Ricky Skaggs who worked
full-time as music director of his church, suffered liver failure and was put on
a priority list for a liver transplant at Tampa General Hospital.
He never recovered from the March 23 operation and died July 15 at the hospital,
a month shy of his 30th wedding anniversary.
Merritt's wife, Karen, returned to the Tampa hospital to take Thanksgiving
treats to a staff that came to be like family.
"It was really hard walking in those doors at the intensive care unit, but all
the nurses were wonderful," said Merritt, a secretary at Auburndale Central
Elementary School.
During her husband's fourmonth stay, his precarious health kept him shut
indoors, except for a solitary occasion.
"I got to take him outside one time," Merritt said. "He was an outdoors person;
I knew that would make him feel better."
She said the holidays have been hollow without her husband and his music. "He's
in our every thought."
Eric Pera can be reached at eric.pera@theledger.com or 863802-7528.
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