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Hundreds vaccinated in alert on hepatitis A

Hundreds of people who dined at an Elmwood Village restaurant in Buffalo lined up Monday for the hepatitis A vaccine at a makeshift health clinic in the Buffalo Niagara Convention Center after a confirmed case in a food server put the community’s readiness to stem an outbreak to the test.

County health officials said 766 vaccinations were administered Monday.

Between 1,500 and 2,000 people ate at Casa-di-Pizza, 477 Elmwood Ave., from March 9 to March 19 and may be at risk, Erie County Health Department officials said. Takeout and bar customers are not affected, official said.

So far, there is just one known case.

On Tuesday, the clinic will be open from 8 a.m. to 6 p.m. at the convention center, 153 Franklin St.

For those at Monday’s clinic, the line moved slowly as public health officials first made sure that the restaurant’s customers were eligible for the vaccine.

Richard S. Abrahamson, of Buffalo, ate pizza at the restaurant with his four granddaughters. “I don’t have any symptoms. It’s more of a precaution,” said Abrahamson, a retired president of the union representing state corrections officers.

His granddaughters had already been immunized.

Risk of exposure to the disease is considered low, and it generally causes only flulike symptoms. Still, officials did not take any chances with a condition that is contagious and, in a few instances, can cause liver damage.

“The risk is very low, but just because it is very low, we should not ignore it,” said County Executive Mark C. Poloncarz.

Dozens of county and state workers, supported by volunteers, pitched in at the clinic. Clinic hours Monday were noon to 8 p.m.

“It’s all hands on deck,” said Dr. Gale R. Burstein, the county health commissioner.

An employee at Casa-di-Pizza was diagnosed Friday with hepatitis A, which is caused by a virus. In food-related outbreaks, the illness is spread primarily by eating raw produce handled by an infected person who didn’t wash his or her hands adequately after using the bathroom.

Within hours of the diagnosis, county and state officials arranged for 2,000 adult and 500 pediatric doses of vaccine that the state procured from its suppliers or through the federal Centers for Disease Control and Prevention, or CDC, said Michael J. Kubik, assistant director for administration in the Health Department.

There is also a limited supply of a shot known as immune globulin for people with compromised immune systems.

The clinic seemed to be orderly, with health educators talking to the public, nurses providing the shots, and a physician on hand.

“We have been planning since Friday,” Burstein said.

It helped that county employees underwent a drill March 13 during which they responded to a hypothetical bioterrorism attack.

The cost of the injections was unclear Monday, as was which level of government would pay for them – the county, the state or both.

Burstein said the unidentified restaurant employee worked in the dining and banquet rooms as a server and also made salads. The employee did not have any contact with takeout foods.

The health commissioner said the restaurant found out Friday that the employee, who is recovering, was infected. The county immediately sent health inspectors to the restaurant.

Casa-di-Pizza has cooperated with public health officials and demonstrated that its employees are aware of proper hand-washing and food-handling procedures, Burstein said.

Rates of hepatitis A in the United States have declined by 95 percent since the introduction of the vaccine in 1995, according to the CDC. Before the hepatitis A vaccine became available, more than 250,000 people were infected with the disease each year, the agency reported.

There were 1,562 reported cases in 2012, but the CDC says that there were likely about twice that number after adjusting for underreporting and estimates of people who were infected but experienced no symptoms.

Symptoms of hepatitis A may include fever, fatigue, nausea and loss of appetite. A classic sign is jaundice, a yellowing of the skin or eyes.

If symptoms occur, they usually appear from two to six weeks after exposure and generally last less than two months, and almost all people recover without liver damage, according to the CDC.

More information on the county’s response is available at