HEPATITIS OUTBREAK TIED TO METH ABUSE

Fla. County Disease Rate 6 Times Average

BARTOW, Fla. - For more than six decades, John's Restaurant was a popular
place to eat in the rural town of Bartow, drawing generations of steady
customers with its homestyle food and friendly atmosphere.

Then in February, a 29-year-old woman died of liver failure after eating
chicken wings and cheese fries from John's.

Health officials, already alarmed at a major outbreak of hepatitis A in
Polk County, soon linked the death to an infected cook at John's. Five
other people who were infected were found to have eaten at the restaurant.

The outbreak has been all but fatal for John's, which is situated in
central Florida, about 40 miles east of Tampa, and serves such dishes as
fried chicken, steak, meatloaf and fried fish.

John's shut it doors last month as customers abandoned the restaurant,
which had served 500 to 800 meals a day. Its cooks and waitresses were
shunned when they went to look for other jobs.

The hepatitis A virus is found in the feces of those who have the disease
and is spread by inadequate hand-washing after going to the bathroom.

But Polk County health officials think the disease has its origins in the
county's large numbers of methamphetamine users, who can transmit it among
themselves through sex and the sharing of drug paraphernalia, and then on
to their families and others.

Methamphetamine, dubbed by some in Polk County as the "poor man's crack,"
is a drug whose use has raged among the county's population of migrant
workers, day laborers and others in low-wage jobs, including those in food
service.

Victor Lopez, who bought John's in 1999 from the original owner's family,
hopes to reopen this week after a frantic effort to spruce up the place and
retrain workers in cleanliness.

"It's destroyed my life," said Lopez, who disputes investigators'
conclusion that Paquita Campbell contracted the disease from his cook or
that his business had poor hygiene.

This year, 138 people in Polk County, which has about 500,000 residents,
have been diagnosed with hepatitis A and about a dozen new cases are being
documented each week. At the rate it is going, the county will easily top
its 2000 total of 153 cases of hepatitis A, and that was already 10 times
higher than the year before.

The Centers for Diseases Control and Prevention in Atlanta reports the
national rate for hepatitis A last year was about 4.5 cases per 100,000
residents. That would make Polk's rate more than six times higher.

Tony Fiore, a CDC epidemiologist, said the Polk County outbreak comes at a
time when nationwide rates are at their lowest level in several years. The
disease shot up in the mid-1990s, but then dropped, in part because of
vaccinations and greater awareness of how to prevent it.

The hepatitis A virus attacks the liver, and the symptoms include nausea,
abdominal pain and jaundice. There is no treatment for hepatitis A; doctors
often prescribe bed rest and proper nutrition while the disease runs its
course and the patient recovers. In some cases, people who have been
exposed are offered an immune globulin injection, a blood extract that can
prevent or reduce the symptoms.