The success of a worldwide public health manhunt begun Friday -- one spawned by a carrier of the hepatitis A virus at the recent Global Gaming Expo in Las Vegas -- could literally mean the difference between life or death for some of the 26,000 conventiongoers.
If local, state, and health officials can determine before Wednesday who among the 26,000 might have been exposed to the virus by a food handler during the Sept. 13-15 event, those attendees can receive shots of gamma globulin.
The shot can prevent the onset of hepatitis A symptoms that can result in death or dangerous liver transplants.
More than 8,000 Clark County residents attended the gaming conference at the Las Vegas Convention Center, so the Clark County Health District is offering free gamma globulin shots today and Sunday at the Ravenholt Public Health Center at 625 Shadow Lane. The clinic will be open each day from 9 a.m. until 2 p.m.
Those who have had hepatitis A or who have been vaccinated for hepatitis A are immune to the disease and are not at risk.
At a news conference Friday, Dr. Lawrence Sands, director of community health for the Clark County Health District, said the attendees might have been exposed to the virus through an infected individual from Colorado who served ice cream.
The ice cream at the conference wasn't tainted, Sands said. But if the infected man, who didn't know he had the disease, handed a conventioneer an ice cream cone he filled from a machine, and it was eaten, that person is at risk.
More than 70 percent of the attendees are being contacted through e-mail addresses they left at the convention. Others may be contacted by phone or learn about it through media alerts.
The conventiongoers came from about 100 countries.
No matter how they're contacted or in which language, one question will be the same: Were you served ice cream from the Schwan's Food Service Booth?
If they reply affirmatively, they will be notified that a gamma globulin injection is in their best interest.
About 1,000 of the attendees visited the booth, according to Schwan officials, who based their estimate on the amount of ice cream served.
Because public health officials have no way of knowing who those 1000 people are, they are scrambling to contact all 26,000 who attended the conference.
Found in the feces of infected persons, the hepatitis A virus is usually spread via the fecal-oral route. It may be spread by food handled by infected persons who do not wash their hands carefully. It can also be spread by sexual contact or changing the diaper of an infected child.
"It won't be easy to contact 26,000 people," acknowledged Daniel Maxson, an environmental health supervisor for the county health system. "But we usually don't have a window of opportunity like this to try and help people so we have to try. Usually, we find out about a virus when it's too late to do anything about it. But now we've got a chance and we want to get to the word out."
Maxson said Clark County officials didn't learn until late this week from Colorado officials that the Schwan food handler had tested positive for the virus.
Food handlers in Clark County are not required to wear protective gloves, Maxson said.
Although there is no treatment for hepatitis A, gamma globulin -- one of the proteins in the blood that contains antibodies -- offers preventative treatment if taken within two weeks of exposure.
Dr. Anthony Fiore, a medical epidemiologist with the federal Centers for Disease Control and Prevention, said Friday the severity of the disease varies a great deal.
"The large majority of people get somewhat sick and usually recover within a few weeks," he said.
Symptoms include fever, loss of appetite, nausea, vomiting and malaise. Dark-colored urine and jaundice -- yellowing of the skin and whites of the eyes -- also occurs.
Two to three persons out of every 1,000 who contract the disease die from it, Fiore said.
Sometimes, he said, particularly among people with liver ailments and compromised immune systems, liver transplants become necessary.
Fiore also said about 10 to 20 percent of the people who contract the disease require hospitalization for intravenous hydration.
Hepatitis A vaccinations are largely responsible for a drop in active hepatitis from about 25,000 cases a year in the 1980s and 1990s to less than 10,000 a year today, Fiore said.
The first symptoms of the disease often occur at one month after exposure, but can develop between two and six weeks after exposure to the virus.
Medical tests show about 40 percent of Americans living in urban areas have had hepatitis A, but only 5 percent recall being sick.
Although hepatitis A can cause prolonged illness for up to six months, it does not cause chronic liver disease.
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