PITTSBURGH AREA Epidemic on downswing, officials say

The only ones who caught the virus are people who were at the restaurant.
PITTSBURGH (AP) -- The Pennsylvania Health Department said Wednesday that 530 cases of hepatitis A have been linked to an outbreak from a Chi-Chi's restaurant, 10 more than at last count.
Although the number of new cases continued to climb, it has slowed considerably since last week when dozens of new cases were being reported each day.
Health screenings have shown more than 9,700 people may have been exposed to the virus at the Beaver Valley Mall restaurant since last month.
Nearly 9,000 of those have received antibody shots meant to arrest development of the virus, officials said. The shots must be given within two weeks of exposure to the virus.
Secretary of Health Dr. Calvin Johnson said officials still haven't confirmed that tainted green onions are behind the outbreak, but they were continuing to investigate that possibility.
Although at least one person reported getting the disease after eating at the restaurant as early as Sept. 20, hundreds of the cases have been linked to people who ate there in the first week of October, officials said.
Officials still can't explain why the Pennsylvania outbreak, the largest single-source one in U.S. history, is so much larger than those in Tennessee and Georgia, which have already been linked to scallions.
At least 250 people got hepatitis A at more than a dozen Georgia restaurants in September, and 80 got it from one restaurant near Knoxville, Tenn., about the same time.
The large number of cases may simply stem from the fact that Louisville, Ky.-based Chi-Chi's is a high-volume chain, officials said. The Beaver Valley restaurant served 11,000 meals in October, officials said.
Some good news
All the confirmed cases from the Chi-Chi's are primary cases -- people who contracted the virus from visiting, eating or working at the restaurant.
There have been no reports of secondary cases, in which somebody who didn't go to the restaurant catches the virus from somebody who had, said Joel Hersh, director of epidemiology for the Health Department.
Public relations experts say executives at Chi-Chi's will need to act fast and take responsibility to keep its customer base, despite the deaths of three people who were infected.
"History shows that most companies will bounce back," said Sanjay Dhar, a marketing professor at the University of Chicago's graduate school of business. "But how difficult it is to bounce back is how they controlled the problem when it happened."
"They just have to act very fast. Speed is important. Ownership is important," Dhar said. "They have to say, 'We acknowledge the problem and we're going to take care of it.'"
Since the outbreak, the company has closed the restaurant, announced that it would remove scallions from all 100 of its locations and that it would mandate workers to fill out sick logs.
Dhar said Chi-Chi's will have to spend time and money to correct the problem to keep customers. A task force needs to study what happened and plan actions to take to prevent it, and then relay that information to the public, he said.
"Building confidence back in your customer base is crucial," Dhar said. "They have to get a CEO up there apologizing and saying, 'This is what happened, this is what we're going to do about it and we're going to give you a report card in three months on how we're correcting it.'"
Dhar compared the hepatitis outbreak with the 2000 Ford Motor Co. and Firestone public relations crisis when road crashes were linked to failure of Firestone tires installed on Ford Explorer sport utility vehicles.
Sales dropped for the automotive company but have since bounced back. Dhar says that's because the company reacted quickly by announcing a recall, hiring new top executives and paying out lawsuit settlements to several states.
Response matters
P.S. Raju of the University of Louisville's marketing department cited the rebound of Tylenol and Jack in the Box, who each took hits and then recovered after poisoning and E. coli scares, respectively. How the Chi-Chi's restaurant chain will fare also depends on who is at fault.
"In the Tylenol incident, it was very clear that Tylenol was not responsible; it wasn't anything with their manufacturing facility," Raju said. He noted that the company still "responded to the problem very quickly" after cyanide was found in bottles of the pain reliever.
A 1993 E. coli outbreak that killed three children was linked to hamburgers sold by the Jack in the Box fast-food chain.
Jack in the Box's parent company, Foodmaker, took quick action and took responsibility for the outbreak. The restaurants changed meat suppliers and increased cooking time and temperature for hamburgers. The company pledged to help victims with medical bills and created a program to monitor its meat quality.
Raju stressed that companies recovering from such situations rely heavily on public relations teams and their decisions -- such as closing the affected Chi-Chi's restaurant.
David Watson, a spokesman hired by Chi-Chi's parent company -- Prandium, Inc. of California -- said the company continues to work with investigators in Pennsylvania.