Four cases of hepatitis A were confirmed in a memo released Tuesday by the Alaska Division of Public Health. All four are Homer residents. Three additional cases involving one individual each from Anchor Point, Soldotna and Anchorage also are suspected.
Hepatitis A, a liver disease caused by the hepatitis A virus, is spread by putting something in the mouth that has been contaminated by fecal matter of a person with hepatitis A, according to information from the National Center for Infectious Diseases.
Although there still is no conclusive evidence linking the cases, all individuals, as well as approximately 275 others, had attended a Dec. 2 Icicle Seafoods company-sponsored party held at Land's End Resort.
"This is an annual event we've held for the past 25 years," said Don Giles, Icicle Seafoods Inc. CEO, of the gathering of employees, business associates and fishers.
"It's a lot of people we do business with, so we're certainly concerned and cooperating with whatever the state wants us to do."
Giles said the list of people attending the party has been given to the state.
"They're in the process of contacting them," he said. "That's how they wanted to do it."
The first individual became ill Dec. 27 and was confirmed to have the virus Jan. 8. By Jan. 10, two other cases also were confirmed.
State epidemiologist Louisa Castrodale and other personnel from the Public Health Center and Department of Environmental Conservation traveled to Homer on Thursday to visit the resort, interview resort employees and distribute information on hepatitis A to more than 25 food service establishments in the area.
Fifty-two of the people who attended the Dec. 2 party have been interviewed regarding symptoms they may have experienced. Serum samples were collected from 48 individuals. Samples also were taken from resort employees, none of whom reported having any symptoms while working at the party.
To date, none of 12 blood samples collected on Thursday and Friday have shown abnormal liver functions. Results from the remaining specimens are expected in the near future.
"Preliminary analysis suggests that cold crab legs were associated with (the) illness," Castrodale said. However, she said further analysis is necessary.
"We're trying to get an idea about what is similar about the people who we think have hepatitis A," Castrodale said. "Even though those people ate the crab legs, many other people did, too. We need to decide what made those six people different.
"We did in-depth interviews with both the people that were ill and not ill trying to see what's similar about those people."
On Thursday, the state's Section of Epidemiology contacted the Hepatitis Branch at the U.S. Centers for Disease Control and Prevention in Atlanta, Ga.
"CDC advised that immune globulin should be given to close contacts and close family members of all the cases," Castrodale said. "But there is no specific treatment for hepatitis A. It takes about a week or two to fully recover. They just need to rest."
According to the National Center for Infectious Diseases, 33 percent of Americans have evidence of past hepatitis A infection. Symptoms include: jaundice, fatigue, abdominal pain, loss of appetite, intermittent nausea and diarrhea.
An Infectious Disease Report published by Alaska's Division of Public Health reports nine cases of hepatitis A in Alaska in 2000 and four in 1999.
A public health alert issued Friday gave Kenai Peninsula and regional health care providers details of the investigation and the disease. Health care officials were asked to report suspected or confirmed cases to the state's Section of Epidemiology at (907) 269-8000 during business hours or (800) 478-0084 after hours.
Charlie Franz, CEO of South Peninsula Hospital in Homer, said the state is taking the lead in the investigation.
"Those folks are the experts," Franz said. "This is a public health issue. By state law, they are the people who have the responsibility with it. We work with them to support them, but it's their ballgame."
Reports on the state's investigation can be found on the Web at www.epi.hss.state.ak.us.
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