An Outbreak of Acute Hepatitis Caused by Genotype IB Hepatitis A Viruses Contaminating the Water Supply in Thailand

Ruchusatsawat, Kriangsak; Wongpiyabovorn, Jongkonnee; Kawidam, Chonthicha; Thiemsing, Laddawan; Sangkitporn, Somchai; Yoshizaki, Sayaka; Tatsumi, Masashi; Takeda, Naokazu; Ishii, Koji

doi:10.1159/000455856

Cited by 10 publications

(5 citation statements)

References 21 publications

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“…It is resistant to salt and low pH (Hollinger and Emerson, 2007) and can persist in the environment, particularly in the water. Occasional waterborne outbreaks are described, like recently in Korea (Shin et al, 2017), and contamination of water is proven especially in situations of low sanitation level (Ruchusatsawat et al, 2016). Thus, it is not surprising that untreated water was associated in this meta-analysis with sporadic HAV infection.…”

Section: Fig 2 Forest Plot Of the Association Of Hepatitis A Infection With Low/untreated Water Consumption For Mixed Populationsupporting

confidence: 50%

Risk factors for sporadic hepatitis A infection: A systematic review and meta-analysis

Thébault

Roque–Afonso

Kooh

et al. 2021

Microbial Risk Analysis

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Hepatitis A virus (HAV) is responsible for common acute viral hepatitis worldwide. Improvement in sanitation and use of efficient vaccines have reduced HAV incidence in developed countries. However, naive adult population are most susceptible to severe outcomes, and high endemic areas persist in developing regions. The transmission of HAV through the fecal-oral route is established. However, considering evolving consumption habits and global market exchange of food, investigations on risk factors associated with HAV infection are needed. Thus, a systematic review and a meta-analysis of case-control, cohort and transversal studies was performed to determine the main risk factors associated with sporadic HAV infection. Relevant scientific articles were identified through systematic literature search and subjected to a methodological quality assessment. Mixed-effects meta-analyses models were adjusted by population type to appropriate data partitions. HAV infections are defined by serological testing. The quality assessment stage selected 78 studies investigating risk factors for sporadic infections with hepatitis A conducted between 1985 and 2013. This meta-analysis confirmed that HAV infections are mostly related to inter-human transmissions, either due to contact with an ill person, through oral-anal sex practice, or lack of personal hygiene. Travel to endemic countries, occupational exposure such as working in child daycare, and exposure to wastewater were associated with HAV infection. As HAV can persist in the environment, it was not surprising that consumption of untreated drinking water, shellfish consumed raw, and crop products were risk factors. Food contamination could be due to the use of contaminated water (fruits, vegetables) or originate from infected food handlers at every point of the food chain (from picking to serving). Eating or drinking outside were associated with HAV infection. A lack of recent case-control studies was identified, with only three studies eligible between 2011 and 2017. Case-control studies required a more precise definition of risk factors such as type of crop product, and storing/preparation information (e.g. washed, frozen). The frequency of consumption or duration of environmental exposure could also better inform relationship between exposure and risk of infection. In a context of epidemiological change of HAV, international travel and trade of foods, future case-control studies are needed and should focus on populations at risk of severe infections and acute cases.

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Section: Fig 2 Forest Plot Of the Association Of Hepatitis A Infection With Low/untreated Water Consumption For Mixed Populationsupporting

confidence: 50%

Risk factors for sporadic hepatitis A infection: A systematic review and meta-analysis

Thébault

Roque–Afonso

Kooh

et al. 2021

Microbial Risk Analysis

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“…However, despite these disinfection steps, outbreaks occur − and some authors reported the detection of virus particles in drinking water, demonstrating that viruses can sometimes go through the disinfection processes. , This could result from inadequate treatment (technical failure, high viral concentration, or viral resistance) and suggests that virus inactivation might be overestimated in laboratory conditions. An explanation could be that the efficiency of treatments is usually evaluated using purified viruses, cell culture-adapted strains, and sometimes virus surrogates such as bacteriophages.…”

Section: Introductionmentioning

confidence: 99%

Interaction of Human Enteric Viruses with Microbial Compounds: Implication for Virus Persistence and Disinfection Treatments

Waldman

Meseguer

Lucas

et al. 2017

Environ. Sci. Technol.

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Although the interaction between phages and bacteria has already been well described, it only recently emerged that human viruses also interact with bacteria in the mammalian gut. We studied whether this interaction could occur in tap water and thus confer enteric viruses protection against temperature and the classical disinfection treatments used in drinking water production. We demonstrated that the addition of lipopolysaccharide or peptidoglycan of bacterial origin to enterovirus provides thermal protection through stabilization of the viral capsid. This interaction plays a role when viruses are exposed to disinfection that targets the capsid, but less so when the virus genome is directly targeted. The interaction seems to be serotype-specific, suggesting that the capsid protein sequence could be important. The protection is linked to a direct association between viral particles and bacterial compounds as observed by microscopy. These results show that bacterial compounds present in the environment can affect virus inactivation.

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“…This deployable system has offered the application of real-time metagenomic sequencing in POC testing for virus outbreaks, including chikungunya, Ebola, and hepatitis C viruses in human blood samples [22]. Whole-genome sequencing of zoonotic pathogens in real time has contributed to the identification and characterization of an emerging virus outbreak using epidemiology with genotypic diversity, geographical origin, and infectious source [23][24][25][26][27]. Herein, multiplex PCR-based nanopore sequencing facilitated the nearly complete genome sequencing of HAV directly from human samples containing low copy numbers of viral RNA within 8 h using the singleplex assay.…”

Section: Discussionmentioning

confidence: 99%

Molecular diagnosis of patients with hepatitis A virus infection using amplicon-based nanopore sequencing

et al. 2023

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High-throughput sequencing is a robust tool used for identifying and tracking pathogen outbreaks. Whole-genome sequencing of hepatitis A virus (HAV) remains poor due to ultra-low viral loads, limitations of next-generation sequencing technology, and its high costs in clinical applications. This study evaluated multiplex polymerase chain reaction (PCR)-based nanopore sequencing to obtain whole-genome sequences of HAV. The HAV genomes were obtained directly from patient specimens for a rapid molecular diagnosis of viral genotypes. Serum and stool samples were collected from six patients with hepatitis A infection. Amplicon-based nanopore sequencing was performed from the clinical specimens to identify HAV genotypes by acquiring nearly complete-genome sequences. TaqMan-based quantitative PCR (qPCR) was conducted to detect and quantify multiple HAV genes. Singleplex-based nanopore sequencing demonstrated high genome coverage rates (90.4–99.5%) of HAV within 8 h, at viral RNA loads of 10 to 105 copies/μL. TaqMan qPCR showed multiplex quantification of HAV genes namely, VP0, VP3, and 3C. This study provides useful insights into rapid molecular diagnosis during hepatitis A outbreaks and may ultimately augment public health disease surveillance in the hospital and epidemiology field.

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An Outbreak of Acute Hepatitis Caused by Genotype IB Hepatitis A Viruses Contaminating the Water Supply in Thailand

Cited by 10 publications

References 21 publications

Risk factors for sporadic hepatitis A infection: A systematic review and meta-analysis

Risk factors for sporadic hepatitis A infection: A systematic review and meta-analysis

Interaction of Human Enteric Viruses with Microbial Compounds: Implication for Virus Persistence and Disinfection Treatments

Molecular diagnosis of patients with hepatitis A virus infection using amplicon-based nanopore sequencing

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