PITTSBURGH Hepatitis A suspected in death of woman

Chi-Chi's is removing green onions from its 100 eateries as a precaution.
PITTSBURGH (AP) -- A diabetic woman died of liver failure -- possibly because of complications from hepatitis A -- apparently becoming the second person to die from an outbreak of the liver disease linked to a western Pennsylvania restaurant, her daughter said.
Dineen Wieczorek, 52, of Hopewell Township, died in a Cleveland hospital Wednesday night, less than a week after she was diagnosed with hepatitis A after eating at a Chi-Chi's restaurant in the Beaver Valley Mall, her daughter, Darleen Trunzo, told The Associated Press.
Also Thursday, Louisville, Ky.-based Chi-Chi's announced it was removing green onions from all meals at its 100 restaurants as a precaution, although state and federal health officials said they have yet to pinpoint the cause of the outbreak, which has affected 410 people.
Pennsylvania Health Department spokesman Richard McGarvey said he couldn't confirm the death Thursday evening. A spokeswoman for the Cleveland Clinic, where family members said Dineen Wieczorek was being treated, also declined to confirm the death.
One meal
Trunzo, 29, of Coraopolis, said her mother and father had eaten at the restaurant for their 32nd wedding anniversary Oct. 6. Dineen Wieczorek went to a hospital Sunday and was diagnosed with hepatitis A; she was transferred Tuesday to the Cleveland hospital for a liver transplant, which she was awaiting when she died, Trunzo said.
"One meal, one meal -- that's all it took. And people eat out every day; I go out to eat every day. And you never think something like this could come of it," Trunzo told Pittsburgh television station WPXI in an interview Thursday night.
Wieczorek is the second person to die since Pennsylvania health officials announced cases of the infectious liver disease apparently linked to the restaurant, about 45 miles southeast of Youngstown. Jeff Cook, 38, of Aliquippa died of liver failure Nov. 7 after receiving a transplant at a Pittsburgh hospital.
Pennsylvania health officials continued to interview each victim for clues about how the virus spread. Pennsylvania Health Department spokesman Jay Pagni told the Pittsburgh Tribune-Review for Friday's editions that some of the newer cases may have resulted from people passing the virus to others who hadn't eaten at the restaurant.
Green onions
Chi-Chi's has agreed to keep the restaurant closed until Jan. 2 -- two months after it voluntarily closed after initial reports of the disease.
Chi-Chi's Chief Operating Officer Bill Zavertnik said in a statement Thursday night that the restaurant chain was pulling green onions from meals because they are "the prime suspect of recent hepatitis A outbreaks in various other states."
Contaminated green onions are suspected of being responsible for recent outbreaks in Georgia, North Carolina and Tennessee.
"We have no definitive information that green onions were involved in this outbreak," Zavertnik said. "But out of an abundance of caution we have decided to remove this ingredient from out menu."
Through Thursday, 31 people infected were known to be from Ohio, eight from West Virginia, one from Florida and one from South Carolina. Although not all 410 had been interviewed, the rest of those who had been were from Pennsylvania -- including 280 from Beaver County, McGarvey said.
"That kind of illustrates the center of where it's all at," McGarvey said. "But there's still no source."
McGarvey said the only real anomaly at this point is one person who reported being infected after eating at the restaurant Sept. 20 -- eight days before any of the other cases.
"That one's kind of hanging out there by itself," he said. "That's certainly something we're interested in, but we don't have an explanation for it right now."
Challenging disease
Infectious disease experts say finding the source of the outbreak can be challenging because hepatitis A has a long incubation period, meaning the virus could be spread to many places before it's detected. Pennsylvania health officials didn't begin warning the public until Nov. 3.
The disease can be spread by an infected person who doesn't wash his hands before handling food, eating utensils or even ice used in drinks. It can also be spread on uncooked foods, like green onions, which are being scrutinized along with other foods as part of the investigation, which involves the U.S. Centers for Disease Control and is being monitored by the Food and Drug Administration.