As if three deaths and nearly 500 illnesses weren't enough, fears and rumor are adding to the tension surrounding the massive hepatitis A outbreak outside of Pittsburgh.

SYMPTOMS Jaundice Fatigue Abdominal pain Loss of appetite Nausea Diarrhea Fever RESOURCES Overview CDC Info.

People have become so frightened that they're lining up by the thousands for vaccinations and are no longer eating out after what's believed to be the largest such outbreak in the United States.

Health officials are trying to squelch rumors that the virus is spreading out of control to other restaurants. Officials at the mall where it apparently began said sales at the food court are off by as much as 40 percent and overall mall sales are down up to 25 percent.

The outbreak, which is linked to a Chi-Chi's restaurant in a mall in suburban Pittsburgh, has infected at least 490 people from a handful of states. A third hepatitis A patient died early Friday.

The Chi-Chi's restaurant in the mall, to which the outbreak has been linked, has been shut down, and the chain has removed scallions from all its kitchens as a precaution. Health investigators are focusing on whether contaminated produce caused the outbreak.

The Mexican restaurant chain also announced that it's removing green onions from all salsas, garnishes and cooked dishes it offers at its 100 locations nationwide.

Bill Zavertnik, the company's chief operating officer, said contaminated green onions are "the prime suspect" in the outbreak.

Zavertnik said there's no "definitive information" green onions caused the outbreak, but said health officials are focusing on certain foods.

Pennsylvania officials are continuing to interview patients for clues on how the virus spread. They say some of the newer cases may have resulted from people passing the virus to others who hadn't eaten at the restaurant.

Green onions were the culprit in another hepatitis scare last month at a Tennessee restaurant that sickened people in three states.