No abstract

Export-oriented seafood trade faltered during the early months of the COVID-19 pandemic. In contrast, alternative seafood networks (ASNs) that distribute seafood through local and direct marketing channels were identified as a “bright spot.” In this paper, we draw on multiple lines of quantitative and qualitative evidence to show that ASNs experienced a temporary pandemic “bump” in both the United States and Canada in the wake of supply chain disruptions and government mandated social protections. We use a systemic resilience framework to analyze the factors that enabled ASNs to be resilient during the pandemic as well as challenges. The contrast between ASNs and the broader seafood system during COVID-19 raises important questions about the role that local and regional food systems may play during crises and highlights the need for functional diversity in supply chains.

Hepatitis A illness severity increases with age. One indicator of hepatitis A illness severity is whether persons are hospitalized. We describe changes in primary hepatitis A hospitalization rates in the United States from 2002‐2011, including changes in demographics, secondary discharge diagnoses, and factors affecting hospitalization duration. We describe changes from 2002‐2011 among U.S. residents hospitalized with a principal hepatitis A diagnosis and accompanying secondary diagnoses using ICD‐9 codes from the National Inpatient Survey discharge data. We calculated rates of hospitalizations with hepatitis A as the principal discharge diagnosis and rates of secondary discharge diagnoses. Using multiple regression, we assessed the effect of secondary diagnoses on hospitalization length of stay for five time intervals: 2002‐2003, 2004‐2005, 2006‐2007, 2008‐2009, and 2010‐2011. Rates of hospitalization for hepatitis A as a principal diagnosis decreased from 0.72/100,000 to 0.29/100,000 (P < 0.0001) and mean age of those hospitalized increased from 37.6 years to 45.5 years (P < 0.0001) during 2002‐2011. The percentage of hepatitis A hospitalizations covered by Medicare increased from 12.4% to 22.7% (P < 0.0001). Secondary comorbid discharge diagnoses increased, including liver disease, hypertension, ischemic heart disease, disorders of lipid metabolism, and chronic kidney disease. No changes in length‐of‐stay or in‐hospital deaths from hepatitis A over time were found, but persons with liver disease were hospitalized longer. Conclusion: Hospitalization rates for hepatitis A illness have declined significantly from 2002‐2011, but the characteristics of the hospitalized population also changed. Persons hospitalized for hepatitis A in recent years are older and more likely to have liver diseases and other comorbid medical conditions. Hepatitis A disease and resulting hospitalizations could be prevented through adult vaccination. (Hepatology 2015;61:481‐485)

The incidence of hepatitis A virus (HAV) infection has been low in developed countries for decades; however, many adults in these countries are susceptible to HAV infection. In recent years, the global trade of food products originating from HAV-endemic countries resulted in HAV outbreaks associated with imported foods in developed countries. This article aims to review the characteristics of selected HAV outbreaks associated with imported food in developed countries during 2012-2018, and discusses improvements in global public health capabilities and new tools for effective detection, control, and prevention of HAV outbreaks.