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A week after her husband died of hepatitis A he contracted at a restaurant, Christine Cook knew she had to make a return to normal life.
She had to take her two young daughters out to eat again. But she couldn't bear going near the Chi-Chi's at a mall five minutes from her home in Beaver County, northwest of Pittsburgh. It was at Chi-Chi's that her husband caught hepatitis, from a dinner of chicken and steak fajitas.
So she drove Cassandra, 10, and Courtney, 8, past the county line to a place near Pittsburgh with Italian fare. Cook ordered chicken fettucini, and the girls had spaghetti. Nothing remotely Mexican. Nothing with green onions.
The family had eaten out hundreds of times before without thinking about whether the food was safe. Now it seemed risky - and courageous.
`I just told myself,I don't want them to have that fear,''' said Cook, 35, an emergency room nurse.
Fear, and attempts to confront it and recover from it, pervade Beaver County, where the nation's largest hepatitis A outbreak has sickened 605 people and killed three, including 38-year-old Jeff Cook. All the cases have been tied to Chi-Chi's.
Health officials confirmed Friday that the culprit was green onions - in items such as mild salsa and chili con queso - possibly contaminated at a farm in Mexico. Imported green onions also have been blamed for recent hepatitis A outbreaks that struck about 250 people in the Atlanta and Macon areas, about 80 in Knoxville, Tenn., and more than a dozen in Asheville, N.C.
For the 180,000 people of Beaver County, clustered in industrial hamlets surrounded by rocky bluffs along a bend in the Ohio River, the outbreak is the latest misfortune to become the talk of the town.
This is former steel country, where many of the mills were shut down in the early 1980s, noted the Rev. Richard Liptak. He is senior pastor at Wildwood Chapel in Aliquippa, where another of the outbreak's victims, 46-year-old John Spratt, was a deacon.
This is also where U.S. Air Flight 427 crashed nine years ago during its descent into Pittsburgh International Airport, killing 132 people. The image of the fiery Boeing 737 is still burned into many people's minds, Liptak said.
The county's economy remains depressed, with many people unable to earn the comfortable union salaries their parents did. Locals say there aren't many places to eat, so establishments such as Chi-Chi's, where entrees run $7 to $10, are a treat.
This whole county is sort of stuck in a rut,'' said Liptak, 47, who grew up in Aliquippa.They're still talking about the mills. They have a hard time getting over things and moving on.
``They're going to be talking about this hepatitis outbreak for a long, long time.''
Richard Lees, a 51-year-old disabled Vietnam veteran, ate at Chi-Chi's with his wife, Georgia, on Oct. 24, nine days before the outbreak became public, causing the restaurant to close. They were among more than 9,000 restaurant patrons and relatives of people with hepatitis who rushed to receive shots of immune globulin, which greatly reduces the risk of getting the disease.
But the shots don't eliminate the risk, and they're effective only if given within two weeks of exposure to the virus. The Leeses got the shots 12 days after their meal at Chi-Chi's. The symptoms of hepatitis A can take up to 50 days to appear.
Now uncertainty is weighing them down. Every hint of a headache, every twinge of nausea, makes them wonder.
``We are two very paranoid people right now,'' Lees said from the dining room of his Cape Cod-style house in Beaver Falls, with Ducks Unlimited prints on the walls.
They wash their hands compulsively. They no longer share glasses of Diet Coke. They're not going to join their adult children for Thanksgiving, for fear of making their grandchildren ill.
Dec. 12 will mark 50 days since eating at the restaurant.
Our window is still open,'' Lees said.It's put a lot of panic in me.''
Others say they can't let the outbreak get them down.
Joseph Spratt, the brother of John, the Wildwood Chapel deacon who died, said he hasn't let the loss alter his way of life. He still eats out and feels badly for local restaurant owners suffering from a lack of customers.
``You have to trust that this was a freak incident,'' said Spratt, 52, a lawyer whose stocky build, bushy moustache and slicked-back hair give him a striking resemblance to former NFL player and coach Mike Ditka, who is also from the area.
Spratt and the rest of his family are struggling with the pain of his brother's death. He suspected something was terribly wrong when his brother, an avid University of Pittsburgh football fan, canceled their plans to attend the Oct. 11 game against Notre Dame. He said he wasn't feeling well.
Two weeks later, when Pitt played Syracuse, John Spratt felt good enough to go. Just a few days after that, however, he developed flulike symptoms again, and then jaundice, testing positive for hepatitis A. He died Nov. 14.
``One day we're tailgating at the football game, and the next we're laying him in the funeral home,'' his brother said.
A virus, hepatitis A attacks the liver and can cause fever, nausea, diarrhea, jaundice, fatigue, abdominal pain and swelling and loss of appetite. Symptoms can last for weeks or months. Most patients recover fully, but this outbreak claimed Spratt and two others: Cook on Nov. 7 and Dineen Wieczorek, 51, on Nov. 12.
Hepatitis anxiety lingers at Bill's Produce in Pittsburgh's Strip District of old warehouses. Owner Bill Komora sold six cases of green onions last week, down from the usual 20 to 25 cases.
He reduced the price by nearly half - to four bunches for $1 - but most of his green onions remain on the shelf.
We're selling them for almost nothing just to move them,'' Komora said.People are still scared.''
At Beaver Valley Mall, where the darkened Chi-Chi's sits at the end of a food court, the atmosphere at dinnertime Friday was subdued. Most of the tables in the area were empty.
``It's normally a lot fuller than this,'' said Glenda Beringer.
Beringer was enjoying pizza from Anthony's Pizzeria with her daughter and two granddaughters. A lifelong resident of the area, she frequently eats at the mall. She said that's not going to change.
I think it's probably cleaner and safer now than it was before,'' Beringer said.You just can't live your life in fear.''
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c.2003 Cox News Service