Antibody Serum Called Highly Effective

Although as many as 9,000 helpings of frozen fruit potentially contaminated by hepatitis A were eaten in Los Angeles city schools, there is no need to panic about a widespread outbreak, health officials said Tuesday.

That is because the disease is largely preventable if those who ate the fruit get immune system-boosting shots within the next week and follow mom’s advice: “Wash your hands.”

“The general public should not be alarmed,” said Dr. Shirley Fannin, director of disease control programs for the county Department of Health Services. The 18 schools in Los Angeles “only began consuming [the frozen fruit] last week.” Because they discovered the potential infection early, she said, “we consider ourselves . . . able to prevent the disease.”

Hepatitis A, a highly contagious virus that affects the liver, is shed from the intestinal tract of an infected person through feces. The disease is transmitted when these particles come in contact with another person’s mouth, usually through consumption of contaminated food. The disease also can be spread by direct physical contact with an infected person.

For the youngsters and adults who consumed the frozen fruit cups, health officials are urging a one-time injection with immune serum globulin, an antibody serum. These protective shots are almost always effective if they are given within 14 days after infection, Fannin said.

“It would be a rare bird that wouldn’t respond,” Fannin said. Although supplies of immune globulin have been limited in the past, Los Angeles health officials said they anticipated no shortfall in this case. School officials say there is a massive mobilization effort to get enough immune globulin here from other states by Tuesday.

The fruit cups were served between March 25 and March 28. The district is arranging to provide shots at school sites Thursday through Tuesday, at no charge to students and employees.

Although a hepatitis A vaccine was approved for use in 1995 by the federal government, the vaccine is not appropriate in this case because infection may already have occurred.

The best way to prevent the disease in general is to wash one’s hands with soap and water after using restrooms and changing diapers or before preparing food, health officials said.

Hepatitis A is generally not considered as severe as type B, which is spread through the exchange of bodily fluids.

Although there is no specific treatment for type A other than bed rest once the disease develops, it is generally mild in children and often produces no symptoms at all.

When symptoms do appear, they generally come two to six weeks after infection. Parents should watch for loss of appetite, fever, diarrhea and vomiting, as well as joint pain. After a few days, urine may darken in color and a child’s skin and eye color may become yellowish. Most patients begin to recover within three weeks and are fully recovered within six to 12 months.

A person with hepatitis A is infectious before showing symptoms. But the disease is not contagious until the end of the two- to six-week incubation period, Fannin said, so among Los Angeles schoolchildren, it apparently is not being silently spread at this point. A firm diagnosis can be made with a blood test.

Officials recommend that members of the household of anyone who is infected also receive immune serum globulin shots.