A report from the Illinois Department of Public Health on last summer’s outbreak of Hepatitis A at the Milan, IL McDonald’s is silent about what management of the fast food franchise knew and when they knew it.

The report, on the 34 confirmed Hepatitis A cases stemming from the outbreak that began last June mostly confirms what was already known.

The “index case” was a food handler at McDonald’s, who exposed prior to June 11th other restaurant workers and customers to the Hepatitis A.

There was a big gap between the story the food handler told the media and the one provided by Kevin Murphy, owner of the Milan McDonald’s franchise.  The food handler insisted that on June 25th she told a McDonald’s manager she had been diagnosed with Hepatitis A.  Murphy says the fast food joint did not get the news until July 13th, when it was informed by the Rock Island County Health Department.

The report does cite June 25th as the date hepatitis A prophylaxis would have to be given to co-workers of the index case for the treatment to work in preventing infection.

After the report came out, McDonald’s released another statement to local media saying the franchise learned of its employee with Hepatitis A on July 13th and then “did everything to meet and exceed the Rock Island County Health Department’s requirements.”

The county health department closed the Milan McDonald’s down from July15-18 until it complied with requirements for re-opening.

The report says the food handler who was the index case for the outbreak worked five days while infectious.  “This employee reported washing hands before starting work shifts but reported not using gloves while working,” the report said. “The employee prepared foods such as bread for sandwiches that would not later be cooked.”

Food handlers are not required to wear gloves under Illinois law.

A second food handler at McDonald’s tested positive for Hepatitis A on July 15th.  She worked while infectious July 6 to 10 and July 13 and 14.  She set up for morning shift, handled bread for sandwiches, and did not use gloves.

When the county health department inspected the Milan McDonald’s, the sanitarian found employees using barehanded contact with food and had concerns about hand-washing practices.

The IDPH blames poor hand washing and the slow public health reactions for the numbers involved in the outbreak.  Instead of phone or fax notice of the positive Hepatitis A test as required by Illinois law, the lab put the result in the mail. 

Adding to the problem, the Rock Island Health Department did not open the mail for two weeks, blaming the fact that someone was on vacation.  It meantime a June 17th test result, which was not mailed until June 26, did not get opened and read until July 14th.

A positive test result requires immediate action if someone is employed as a food handler.