With health officials in Franklin County fighting an outbreak of hepatitis A, Warren County Health Department Administrator Ruth Walters said no cases have thus far been detected on this side of the river.Hepatitis A is a virus that affects the liver and can be spread through contaminated food or water, as well as contact with fecal matter or body fluid from an infected person. More than 60 cases have been detected in Franklin County since the beginning of the outbreak early this year.Several of those diagnosed have been food service workers at local restaurants, prompting the Franklin County Commission to mandate vaccinations for all food handlers. Customers at the affected restaurants are also being advised to vaccinate, most recently those who have visited the Bob Evans in Washington.Walters said if a case of hepatitis A is eventually detected in Warren County, health department staff are trained to respond to an outbreak through Missouri State Department of Health and Senior Services (DHSS) guidelines. She said the department regularly conducts exercises to practice disease outbreak response.According to DHSS, the most direct means of preventing the spread of hepatitis is to always wash your hands before eating or preparing food, and after using the bathroom or changing diapers. Primary symptoms include yellowing of eyes and skin, fever and nausea, although the virus can be transmitted before symptoms emerge.DHSS also recommends those at high risk of getting hepatis A seek vaccinations. That includes people who recently ate at restaurants where the virus has been detected, as well as people in close contact with diagnosed patients.Walters said Warren County does not currently have any requirement for food handlers to receive hepatitis A vaccinations. She explained that such a requirement would have to be considered and adopted by the Warren County Commission.Warren County Administration Building