HERMANN — In the wake of the response to a recent outbreak of hepatitis A cases in Franklin County, the Gasconade County Health Department Board of Trustees is again considering the adoption of a food ordinance that in part would be aimed at requiring food handlers to be immunized against the disease.

In their monthly session Monday morning, the trustees heard an update on the response to the Franklin County cases, which involved the participation of some of the Gasconade County Health Department nurses in providing immunizations in Franklin County.

Board Chairman Sharen Speckhals said she was surprised that more food and retail operations don’t require their employees to be vaccinated to prevent the spread of hepatitis A, which can seriously affect the liver. According to the Missouri Department of Health and Senior Services (DHHS), there have been 414 hepatitis A cases in 35 of the state’s 114 counties. More than 230 of those resulted in people being treated in hospitals and two of the cases resulted in death.

In the most recent outbreak in Franklin County, several dozen cases were confirmed, leading to a large immunization effort.

The Gasconade County health agency is concerned about the matter because of the proximity of the two counties and the potential movement of food-service workers between establishments in the two counties.

In Franklin County, the County Commission adopted legislation requiring all food-service workers to be immunized against hepatitis A. However, the Gasconade County Commission cannot take similar action; third-class counties such as Gasconade County do not have ordinance-making authority. Franklin County is a first-class class and as such enjoys broader authority.

However, in third-class counties the local health agency board does have the ability to adopt such an ordinance. 

“That needs to be a goal for us, eventually,” said Speckhals. The matter of adopting a food ordinance, primarily sparked by the recent debate in Hermann regarding meals served at bed-and-breakfast and guesthouse operations, was raised within the last year or so; however, such a move was not further developed.

But the hepatitis A outbreak in adjacent Franklin County has rekindled the discussion of such an ordinance covering food handlers in Gasconade County. Health Department Administrator Greg Lara will research ordinances covering food workers in other Missouri counties and provide his findings to the trustees at an upcoming meeting.

One area of concern for local health agency officials is food-service workers are not considered among the high-risk groups that are targeted for immunizations either by the state or the federal health agencies. The U.S. Centers for Disease Control and Prevent (CDC) lists seven groups considered to be at a high-risk of contracting hepatitis A:

• Recreational drug users.

• Those who are homeless.

• Men who have sex with men.

• Those in treatment or counseling for substance abuse.

•People receiving drug substitution treatment and/or those participating in a drug court program.

• Those who work in or have been detained in a jail or detention center.

• Anyone who has close contact with any of the above-listed groups or who have contact with someone with hepatitis A.

Hepatitis A is a viral infection of the liver that can cause loss of appetite, nausea, tiredness, fever, stomach pain, brown-colored urine and light-colored stools. The state health agency says yellowing of the skin or eyes might also occur in people with the disease. The agency noted that a person might not become ill up until seven weeks after being exposed to the virus.

Hepatitis A usually is spread when a person ingests the virus from objects, food or drinks that have been contaminated by small, undetected amounts of feces from an infected person. Health officials say that, in addition to vaccination, careful hand washing with soap and water, including under the fingernails, after using the bathroom, changing diapers and before preparing, serving or eating food is key in stopping the spread of the disease. The board’s next session is set for 9 a..m. Monday, Sept. 30, at the Gasconade County Health Department on Schiller Street in Hermann.

In other matters, the board began the process of adopting a new policy handbook. Part of that process involved the formal selection of officers including Speckhals of Hermann as chairman; Glen Duncan of Owensville as secretary; and Stan Hall of Hermann as treasurer. The other members of the Board of Trustees are Pat Smith of Bay and Mary Leeper of Hermann.