Monday, March 27, 2006

Blue Plate Special

Would you want to know if patrons of your favorite dining establishment fell ill after eating there?
How about if the number of ill patrons approached several dozen?
Would you be angry if public health officials declined to identify the restaurant, saying it was unnecessary because there was no evidence of "continuing problems"?
That's exactly the scenario that has been unfolding over the last few weeks following an outbreak of hepatitis A last fall that sickened more than 300 people at various locations throughout Los Angeles County.
Under pressure from various news organizations to disclose details about the outbreak, health officials finally came clean, breaking their silence on the matter. They identified La Golondrina in Olvera Street as a locale that experienced an outbreak of hepatitis, sickening 15 patrons.
"If we have a few cases and we think it's traceable to a restaurant but the infections occurred six weeks ago and ...there's no evidence of continuing problems, what's the benefit" of identifying the restaurant, Dr. Johnathan Fielding, county health director, told the Los Angeles Times. "It may simply be they got a bad head of lettuce."
The benefit, Dr. Fielding, is credibility. By dealing honestly with the public you are sworn to protect, you avoid the appearance of having a cozy relationship with the restaurants you inspect. No restaurant owner in his right mind would want the fact that there was evidence of hepatitis at his establishment made public. By keeping that information under wraps, one might reasonably assume that the restaurant's financial well being is a consideration in this policy.
Oddly, the county's Department of Health Services regularly displays restaurant ratings based on its inspections on its web site. And many of the violations listed thereon are often resolved immediately. So what's the difference?
Having said all that, I have to give credit to these same health officials for reacting quickly when workers at Cafe Pinot in downtown Los Angeles fell ill with hepatitis A in December.
The Department of Health Services put out the word that patrons of the restaurant who ate there during a two-week period in November should get a preventive shot of immune globulin.
Those patrons included my wife and I and several friends.
Since the clock was ticking on the incubation period, we immediately contacted our family doctor who told us that his office could not get globulin dosages because most of it was being sent to Iraq.
We were instead directed to a county health clinic in downtown Los Angeles. Since we didn't have time to be picky, we dutifully if reluctantly headed for north Figueroa Street in search of a shot.
Any fears I had of being herded into a room full of consumptive homeless people was qucikly dispelled when I pulled into a parking lot brimming with Lexus, BMW and Mercedes automobiles. After all, Cafe Pinot is a high end restaurant.
The process was slow and we spent the time swapping stories with other patron/patients. The winner was a guy who had taken 16 business associates from around the world to lunch at Pinot and had spent the better part of two days trying to reach them about the problem.
Four hours and a couple of sore rear ends later, we were on our way.
The next day, Cafe Pinot called to explain to us that the infected employee did not work the evening we dined there. Indeed, the Pinot people suggested they were singled out by county health officials because they ran a high-visibility restaurant. The names of similarly affected restaurants, they claimed, were not being disclosed.
This kind of attempted spin and the confusion it causes underscores the need for candid reporting on the part of health officials.
Just how serious can foodborne hepatitis get? In western Pennsylvania in 2003, more than 650 cases including four deaths occured among patrons of one Mexican restaurant in a mall. Officals suspected contaminated green onions.
Federal officials describe the outbreak as the largest in U.S.history, noting that hepatitis A outbreaks contained to a single restaurant typically impact between 25 and 200 people.
The largest hepatitis A outbreak on record occured in 1988 when almost 300,000 people in China ate contaminated clams. In 1997, frozen strawberries caused 262 people in five states to become infected with the virus.

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