BEAVER VALLEY Tylenol probed in hepatitis death

The victim's wife, a nurse, said her husband never had liver problems before.
STAFF/WIRE REPORTS
PITTSBURGH -- A coroner says he will investigate whether over-the-counter medication contributed to the unexpected death of a man who contracted hepatitis A during an outbreak traced to a Mexican restaurant.
Jeff Cook, 38, of Aliquippa, died of liver failure Friday after receiving a transplant the same day. His wife, Christine, said he began taking Tylenol for flulike symptoms after the family dined at the Chi-Chi's restaurant in Beaver Valley Mall in early October.
State health officials are still trying to determine the cause of the hepatitis A outbreak traced to the restaurant, about 45 miles southeast of Youngstown. Officials believe the virus, which has affected at least 185 people and hospitalized up to 10 people in Pennsylvania and Ohio, was spread by an employee who failed to wash his or her hands before touching food.
Beaver County Coroner Wayne Tatalovich said he was waiting for Cook's medical records from a Pittsburgh hospital to help determine whether Tylenol, which contains acetaminophen, a pain reducer that goes directly to the liver, could have exacerbated any liver problem before doctors performed the transplant on the auto technician.
"It could have been a combination of the hepatitis A and Tylenol that caused the liver failure," Tatalovich said Sunday. "But I don't know because I haven't gotten the records. There could have been a pre-existing problem that we're not aware of."
Christine Cook, a nurse, said her husband never exhibited symptoms of liver problems. He didn't drink or smoke, she said.
The coroner said he's hoping to receive records Tuesday. "We're hoping this is an isolated case, because people don't normally die from this," Tatalovich said.
Others admitted
Cook was one of five patients admitted to the University of Pittsburgh Medical Center. One patient was discharged Saturday night, while two remained in critical condition and one in fair condition, according to hospital spokeswoman Susan Manko.
As of Sunday, state health officials had confirmed 185 cases of the infectious liver disease, 158 of them affecting residents of Pennsylvania. There are also more than 20 victims from Ohio, four from West Virginia, one from Florida and one from South Carolina, Health Department spokesman Richard McGarvey said.
Mike Ruta, an Ohio Department of Health epidemiologist, said this morning there are 23 confirmed cases of hepatitis A in Columbiana County and four probable cases. There had been seven people hospitalized, but all have been discharged, he said. Ruta said none of the new cases has been hospitalized. The last county patient hospitalized was Wednesday, he said.
Hepatitis A is spread by the ingestion of something contaminated with the feces of an infected person, according to the Centers for Disease Control and Prevention. Food-borne outbreaks generally involve fresh vegetables or other uncooked foods handled by a contaminated person, but the disease is relatively rare.
Symptoms of hepatitis A include fever, nausea, diarrhea, jaundice, fatigue, abdominal pain and loss of appetite. The disease usually clears up in about two months, but it can cause serious complications for those who already have liver problems or immune deficiencies.
Salsa connection?
Because Jeff Cook and one of his two daughters tested positive for hepatitis A, his wife says she wonders whether the outbreak might be connected to the restaurant's salsa.
"I ate more of the hot than the mild and those two ate the mild," Mrs. Cook said.
Health officials say they have not determined the source of the food contamination because four workers tested positive for hepatitis A, McGarvey said. The restaurant, which voluntarily closed, had a good sanitation record, according to the state Agriculture Department.
Christine Cook says the restaurant and health officials could have acted sooner to limit the outbreak.
The funeral is scheduled for Tuesday for Jeff Cook, who was recently staying at home to take care of his daughters and had a passion for restoring cars.
Clinic set up
In response to the outbreak, the health department set up an inoculation clinic at a community college and has immunized more than 7,000 people who ate at Chi-Chi's between Oct. 22 and Nov. 2 or who had close contact with those infected. The clinic was to open again today.
Because the disease takes about two weeks to incubate, the injections won't help those who may have been infected before Oct. 22.