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JEFFERSON CITY — Franklin County health officials are planning mass hepatitis A vaccinations as the county grapples with an ongoing outbreak of the highly contagious liver infection.

The Missouri Department of Health and Senior Services said Tuesday an employee at the Bob Evans restaurant in Washington, 3151 Phoenix Center Drive, was infected while working shifts from Aug. 3 through Aug. 10.

The DHSS said it was "uncommon" for restaurant patrons to catch hepatitis A from a sick food handler, but said anyone who dined at Bob Evans between Aug. 3 and 12 should get vaccinated as a precaution.

The county health department is administering a mass vaccination from 9 a.m. to 4 p.m. on Friday at 414 East Main Street, Union; and from 8 a.m. to 12 p.m. on Saturday at the same location.

According to the DHSS website, the state has since September 2017 seen an increase in hepatitis A cases, and has linked 400 cases "to an ongoing outbreak in Missouri."

Franklin County has seen 63 cases, or nearly 16% of all cases. The only other county reporting more cases is Butler, in southeast Missouri, with 109 cases. 

An estimated 103,000 people live in Franklin County, southwest of St. Louis County in the region's exurbs.

"Bob Evans Restaurants, LLC, is working with Franklin County Health Department to prevent any new illnesses from arising in the community because of this case," the state said in a news release.

The Franklin County Commission on July 30 issued an order requiring all restaurant workers to get vaccinated within 90 days of the order. The employees need another dose six months later, according to the order.

The health department advised Bob Evans patrons to monitor their health for 50 days after exposure, wash hands frequently and thoroughly, and to stay home if symptoms of hepatitis A develop.

The disease is spread when someone unknowingly consumes the virus from "objects, food, or drinks contaminated by small, undetected amounts of stool from an infected person," according to the state. Symptoms may include the yellowing of the skin or whites of the eyes, abdominal pain, nausea or diarrhea.

"Transmission appears to be through direct person-to-person spread," the state said. "Based on current information, persons who use injection and non-injection illicit drugs are at increased risk for hepatitis A during this outbreak."

The Bob Evans employee was the third Franklin County diagnosis since June to draw a public warning from the the DHSS.

On July 10, the state announced an employee who handled food at the Roadhouse 100, at 2763 MO-100, in Gray Summit, had been diagnosed with hepatitis A. The employee worked while infectious from June 23 through July 5.

On June 20, the department said an employee at the Jack in the Box in Union, 101 Bourbeuse River Access, had been diagnosed and worked while infected from the end of May until June 10.

Jack Suntrup covers state government and politics for the Post-Dispatch.