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He hasn't decided whether he'll file a com- plaint, but said he'll "probably" eat at the Stage again. Zeman declined to be photographed for this story. The good news is that those who fell ill with hepatitis A won't experi- ence it again. Vaccines are available, although they are expensive — about $45 each, minus administrative costs. Some insurance companies, like Health Alliance Plan and SelectCare, cover the cost of the shot if a doctor recommends it. If a company includes the benefit in its scope of employee health coverage, Blue Cross/Blue Shield would pay for the vaccination. Bird noted that counties do not have a federal contract to dispense the vaccine and there are no recom- mendations for widespread vaccina- tions from the Centers for Disease Control. Some travel services and private doctors offer the shots for people traveling abroad. But even if the vaccine would decrease the amount of virus around, Bird pointed out, it is already on the wane. The incidence of the virus has decreased over the years in Oakland County as a result of better hygiene that tends to go hand in hand with higher socioeconomic standards, Bird said. Hepatitis A, predicts Dr. Milton G. Mutchnick, director of gastroen- terology at Detroit Medical Center and professor of medicine at Wayne State University, "is going to disap- pear from this country. "Once you recover from hepatitis A, it's history. The vast majority of the world has had hepatitis A. This is, in some ways, more common than the flu," he said. Mutchnick believes that many people have had hepatitis A and did- n't know it because its symptoms mimic the flu. Only 10 percent of victims turn yellow, and they tend to be over 40. "If we talk about 20 to 25 percent of patients who present with jaun- dice, one could infer that double or triple that number had a subclinical type of hepatitis A that wasn't identi- fied," Mutchnick said. Unlike the other forms of hepati- tis, hepatitis A does not lead to chronic infection. It can only be passed by eating fecal-contaminated food, although oysters, clams and other shellfish that are not cooked properly can carry the virus. In the latest outbreak, the county reported only one or two secondary cases — people who got hepatitis A from an infected family member. Mutchnick worries much less about hepatitis A than hepatitis B and especially C, which he describes as an epidemic "more insidious" than AIDS — 4 million people in the United States suffer from chronic hepatitis C. They account for 22 per- cent of all liver transplant recipients, he said. Hepatitis C is transmitted through the blood, either sexually, through c" transfusions or through the use of contaminated needles. The majority of cases — 85 percent — go chronic, and because most carriers don't expe-0 Hepatitis B and C are much more insidious than AIDS. — Dr. Milton Mutchnick rience symptoms, they don't know they have it until they take a test for antibodies. Half of the victims who develop endstage liver disease from the virus die within five years. Hepatitis B is also blood-borne, and is often transmitted sexually, but its symptoms are like hepatitis A's. It has a 3-8 percent chance of becom- ing chronic, Mutchnick said, and it can be detected through a blood test. However, there is no treatment for hepatitis B. A balanced diet, rest and exercise are advisable. Doctors are using the drug inter- feron to treat hepatitis C, and in Detroit, researchers at Detroit Medical Center are working on new treatments, Mutchnick said. People infected with hepatitis B and C are likelier than others to develop liver cancer or cirrhosis. ❑