Hepatitis A outbreak associated with a revolving sushi bar in Chiba, Japan: Application of molecular epidemiology

Abstract

A revolving sushi bar was associated with a hepatitis A outbreak, and molecular epidemiological investigations proved useful.

Ultra-Deep Sequencing Analysis of the Hepatitis A Virus 5'-Untranslated Region among Cases of the Same Outbreak from a Single Source

“…Although Japan is one of the developed countries in Asia, a universal vaccination program against HAV and HBV has not yet been initiated 17. Although the present study did not include acute liver failure with hepatic encephalopathy such as fulminant hepatitis A, our study is important because UDPS analysis of these HAV strains reconfirmed that a single source might have caused this outbreak as previously reported 16, suggesting that UDPS analysis might be a new analytical tool for the source of hepatitis A outbreaks.…”

“…Then we compared the different HAV IRES sequences derived from a single-source outbreak, based on a single definition of liver failure. In this outbreak, the proportion of acute liver failure was very high (3/29, 10.3%), compared to the previous report 22, although the calculation was performed on the basis of patients admitted into two hospitals 15,16. The reference clonal sequence from patient 12 had only one different nucleotide from the sequence of the severe hepatitis strain HAV PT (A10), which was reported by Fujiwara et al 10, suggesting that our present study might be conducted among specific HAV strains.…”

“…This HAV outbreak in January/February, 2011, was previously reported in detail 15,16. Briefly, this outbreak was based in a revolving sushi bar located in a central area of Chiba, Japan.…”

“…Sixteen patients of this outbreak were included, and one sporadic hepatitis A patient from the same area in June, 2010, was also included in the present study (Table 1). All HAV isolates were classified into HAV IA based on VP1/2A region 15,16. Fourteen of the 16 outbreak patients were admitted to the National Hospital Organization Chiba Medical Center, Chiba, Japan, and the other patients to Chiba University Hospital, Chiba, Japan.…”

Epidemiological and genetic analysis of a 2014 outbreak of hepatitis A in Japan

“…Taken together, these observations indicated that the 2014 hepatitis A outbreak was caused by 2014JapanIA-EPM, that it originated from a single source, and that the one food-or water-borne source may have been distributed nationwide at the same time. The lineage to which 2014JapanIA-EPM belongs is related to the lineage that includes isolates associated with small outbreaks in Shiga and Niigata prefectures in 2006 [19,20] and a large outbreak in Chiba City in 2011 [24]. Isolates that belong to this lineage were collected from at least 2001 to 2011 in Japan [13]; these findings indicated that the isolates classified to this lineage might be local strains endemic to Japan.…”