FLORIDA HEPATITIS A OUTBREAK LINKED TO 'POOR MAN'S CRACK'

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

Then in February, Paquita Campbell, 29, died of liver failure after eating
chicken wings and cheese fries from John's Restaurant.

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
others who were infected were found to have eaten at the restaurant.

The outbreak has been all but fatal for the central Florida restaurant,
about 40 miles east of Tampa, which serves up such dishes as fried chicken,
steak, meatloaf and fried fish.

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

Inadequate hand washing

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

Polk County health officials, however, 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 family of the original
owner, 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. "I worked 17 years for this. It was my
dream. This is how I fed my family, this is how I pay my bills. I've lost
everything I've worked for."

This year, 138 people in Polk County, which has about 500,000 residents,
have been diagnosed with hepatitis A. About a dozen new cases are being
documented each week, compared to a 2000 total of 153 cases of hepatitis A,
which was 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 national 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 cure 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.

Campbell is the only one believed to have died from the virus. A
48-year-old man needed a liver transplant after contracting the disease in
February at a church fish fry, which also infected 15 others.

The county has mounted an ambitious effort to find drug users and get them
tested and vaccinated.

"People are confiding in us so we can help them," said Daniel Haight,
director of the Public Health Department. "Sometimes the drug makes you
paranoid, you don't want to tell who your friends are. But we are getting a
lot of cooperation."

Workers warned of dangers

Meanwhile, the Florida Restaurant Association has launched a campaign to
warn workers and owners the dangers of not washing their hands. Employees
are being told to wash their hands as long as it takes to sing "Happy
Birthday" twice after they use the toilet.

At John's, employees have worked without pay to paint and remodel the
restaurant in hopes customers will return.

Restaurant manager James Davis said the cook who is believed to have
contracted the disease in prison no longer works there, and is saddened by
his suspected connection to Campbell's death.

"If you know anything about the food business, it's a personal thing,"
Davis said. "It's a reflection of who you are."