Major Outbreak of Hepatitis A Associated with Orange Juice among Tourists, Egypt, 2004

Frank, Christina; Walter, Jan; Muehlen, Marion; Jansen, Andreas; Treeck, Ulrich van; Hauri, Anja M.; Zoellner, Iris; Rakha, Medhat A.; Hoehne, Marina; Hamouda, Osamah; Schreier, E.; Stark, Klaus

doi:10.3201/eid1301.060487

Cited by 103 publications

(45 citation statements)

References 13 publications

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“…Travellers to endemic areas are typical risk groups in countries with high susceptibility. Onward transmission after recent travel to an endemic area is occasionally seen in countries with low endemicity [29][30][31][32]. Community-wide outbreaks, often related to poor hygienic conditions have been reported, e.g.…”

Section: Discussionmentioning

confidence: 99%

Comparative hepatitis A seroepidemiology in 10 European countries

Kurkela

Pebody²,

Kafatos³

et al. 2012

Epidemiol. Infect.

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SUMMARYThe WHO recommends hepatitis A virus (HAV) immunization according to level of transmission and disease burden. We aimed to identify susceptible age groups by standardized serosurveys to inform HAV vaccination policy in participating countries : Belgium, Czech Republic, England, Finland, Germany, Italy, Lithuania, Malta, Romania, and Slovakia. Each country tested national serum banks (n=1854-6748), collected during 1996-2004, for anti-HAV antibodies. Local laboratory results were standardized to common units. Forty-one per cent of those aged <30 years and 6% of those aged o30 years were susceptible to HAV in Romania ; compared to 70-94 % and 26-71 %, respectively, elsewhere. Romania reported high HAV incidence in children and young adults. Other countries reported HAV disease primarily in older risk groups. The results suggest low level of HAV transmission in most of Europe. Romania, however, appeared as an area with intermediate transmission. Vaccination of risk groups in countries with high susceptibility of young and middle-aged adults needs to be continued.

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Section: Discussionmentioning

confidence: 99%

Comparative hepatitis A seroepidemiology in 10 European countries

Kurkela

Pebody²,

Kafatos³

et al. 2012

Epidemiol. Infect.

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“…In Egypt outbreaks of hepatitis were appeared among European travelers who visited the country between November 2012 and April 2013 and 89 probable cases have been reported as well as other outbreaks that were reported earlier (Frank et al, 2007 andSane et al, 2015). The outbreak in Czech Republic was associated with frozen products made of imported strawberries watered with sewage (Votava et al, 2003).…”

Section: Discussionmentioning

confidence: 99%

Monitoring of Foodborne Hepatitis A virus Outbreaks in the Fresh Foods

et al. 2017

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HEPATITIS A virus (HAV) is one of the most widespread foodborne pathogens and the cause of viral hepatitis. Fresh foods can be considered as a vector of transmission for HAV when contaminated by spoiled irrigation water or when prepared by infected food handlers. To improve microbiological detection and to increase insights into the contribution of fruit and vegetables to foodborne viral transmission, sensitive and standardized methods are needed. Two outlet drainage water samples from El-Mariotia and El-Gable Elasfar canals (Nile River) were collected in each month starting from March 2015 over a period of 12 months. As well as vegetables and fruit samples (lettuce, green onion and strawberry) were irrigated and washed with drainage water were also collected. Samples were extracted and concentrated for viral analysis. Strawberry and lettuce foods collected from El-Mariotia and lettuce from El-Gable Elasfar gave positive serological results by enzyme-linked immunosorbent assay (ELISA) test. Reverse transcription polymerase chain reaction (RT-PCR) was successfully used to detect the virus in strawberry and lettuce samples using HAV-specific primers, designed to amplify a 500 bp fragment covering VP1/2A gene in HAV. The VP1/2A gene was sequenced and the nucleotide sequence similarity was in the range of 95-99.1% between HAV-Eg isolate and 30 HAV sequences retrieved from GenBank. Phylogenetic analysis revealed that HAV-Eg isolate was grouped into a clade comprising Egyptian HAV isolates sub-genotype IB. Phylogenetic tree of nucleotides sequence showed that HAV sub-genotype IB is the circulating strain.

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“…It was shown that viruses of this subtype have a high reproductive activity [14] and can be effectively distributed in every way as typical for infections with the fecal-oral transmission. It is important to emphasize that all the major food outbreaks of HA have recently been associated with this subtype IA [15,16]. Long-term monitoring of circulating genetic variants of the virus HA in St. Petersburg revealed the introduction of new, previously not encountered types of pathogen [12], which gives reason to believe that covert circulation of the pathogen takes place among low-manifestation of the epidemic process.…”

Section: Methodsmentioning

confidence: 99%