Hepatitis A outbreak in a refugee shelter in Kiel, northern Germany

Abstract

In the spring of 2023, three Ukrainian war refugees from a municipal community shelter and a volunteer caregiver at an affiliated daycare center in Kiel, Germany, were diagnosed with infectious jaundice attributable to a single hepatitis A virus (HAV) subgenotype IA strain. Similar HAV sequences have been observed in Germany and other European countries for several years. One refugee and the volunteer required hospitalization. Four children were asymptomatically infected but excreted high levels of HAV ribonucleic acid in the stool. The infections were probably acquired in Germany, but a source could not be determined. The outbreak was contained through vaccination, increased hygiene, and education. The existing HAV vaccination recommendation for refugee shelter staff and volunteers should be consistently implemented.

Hepatitis A virus whole genome sequencing strategy using NGS/Illumina technology

“…Together with epidemiological data, it has demonstrated to improve outbreak characterization and response (Lee et al, 2022; Zufan et al, 2024). However, molecular characterization is not always performed, and, when it occurs, it typically involves partial amplification of small genomic fragments of HAV genome, such as a 450 bp genomic fragment corresponding to the VP1/2A region (Bardón De Tena et al, 2023; Freidl et al, 2017; Harries et al, 2014; Krumbholz et al, 2023; Levican et al, 2023; Mariojoules et al, 2019). Whole genome sequencing of HAV has been reported to produce a better phylogenetic signal for outbreak studies, facilitating public health interventions (Lee et al, 2022; Zufan et al, 2024).…”