Two concurrent outbreaks of hepatitis A highlight the risk of infection for non-immune travellers to Morocco, January to June 2018

Gassowski, Martyna; Michaelis, Kai; Wenzel, Jürgen J.; Faber, Mirko; Figoni, Julie; Mouna, Lina; Friesema, Ingrid; Vennema, Harry; Avellón, Ana; Varela, Carmen; Sundqvist, Lena; Ederth, Josefine Lundberg; Plunkett, James; Balogun, Koye; Ngui, Siew Lin; Midgley, Sofie; Lassen, Sofie Gillesberg; Müller, Luise

doi:10.2807/1560-7917.es.2018.23.27.1800329

Cited by 17 publications

(22 citation statements)

References 17 publications

(10 reference statements)

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“…In conclusion, HAV remains highly endemic in Rwanda with a possible decrease of exposure, which may in the future lead to clinically overt infections at older patient ages as in Europe (Gassowski et al, 2018). HEV shows a moderate endemicity and a possible zoonotic transmission from pigs.…”

Section: Discussionmentioning

confidence: 91%

Hepatitis A and E virus infections have different epidemiological patterns in Rwanda

Twagirumugabe

Saguti

Habarurema

et al. 2019

International Journal of Infectious Diseases

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To investigate the prevalence of anti-HAV and HEV markers in order to better understand spread of these two viruses among adults in Rwanda. Methods: Samples from 1045 and 1133 blood donors, healthy adults and liver disease patients were analysed for anti-HAV IgG and HEV markers respectively. Results: Anti-HAV was present in 96.9% (1013/1045), with proportions of immune persons increasing with age. HEV infection markers were detected in 11.9% (135/1133) without differences between the three categories. Seven persons had low levels of HEV RNA including four blood donors but none of the HEV strains could be sequenced. The highest prevalence of HEV markers was in farmers and persons from the Southern (17.3%) and Western regions (18.6%), which have the national highest density of pigs. This may indicate that pigs constitute an important source of HEV infection for humans in Rwanda. Conclusion: HAV remains highly endemic in Rwanda, but there may now be a decline of exposure during childhood. HEV is also endemic in Rwanda, but has a moderate spread and may be transmitted by blood transfusion. Based on the geographical and occupational differences in HEV prevalence, a possible zoonotic transmission from pigs should be further explored.

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Section: Discussionmentioning

confidence: 91%

Hepatitis A and E virus infections have different epidemiological patterns in Rwanda

Twagirumugabe

Saguti

Habarurema

et al. 2019

International Journal of Infectious Diseases

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“…Over the last 10 years, several outbreaks have been reported throughout the world Table 2 and Figure 2 [92][93][94][95][96][97][98][99][100][101][102][103][104][105][106][107].…”

Section: Hav Outbreaks Over the Last Decadementioning

confidence: 99%

“…The HAV was genotypically identified as belonging to subgenotype IA DK2018-231 and subgenotype IB V18-16428. Common risk factor among the cases was found to be unvaccinated travel due to lack of awareness [102].…”

Section: Hav Outbreaks Over the Last Decadementioning

confidence: 99%

Epidemiology of Hepatitis A: Past and Current Trends

Chakravarti¹,

Bharara²

2020

Hepatitis a and Other Associated Hepatobiliary Diseases

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Hepatitis A virus is a common infectious etiology of acute hepatitis worldwide. It was not until World War II (1973) when hepatitis A virus was first identified by an American virologist, Stephen Mark Feinstone. The virus is most commonly transmitted through contaminated food, water, or sexual contact (oral-anal sex). The discovery of hepatitis A virus vaccine is considered a milestone in the history of acute viral hepatitis. Hepatitis A occurs worldwide and frequent outbreaks have been reported over the years. Major geographic differences have existed in endemicity of the disease depending primarily upon hygiene and sanitation practices. Some countries have experienced shifting of endemicity due to improvement of environmental hygiene, swelled International travel and national recommendations for hepatitis A vaccination. The age of acquiring hepatitis A virus is also shifting toward adolescents and adults. This has led to a more symptomatic disease, since hepatitis A infection among children is usually asymptomatic; this is known as the paradox of Hepatitis A epidemiology.

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“…Hepatitis A virus (HAV) infections have gained increased awareness in Europe in recent years. This is mainly due to large and prolonged European-wide outbreaks [ 1 - 10 ] and an interrupted trend of decreasing hepatitis A notification rates [ 11 ]. In Sweden, the number of yearly reported hepatitis A cases is low [ 11 ], but outbreaks occur at the local/regional and national levels and Swedish cases are repeatedly identified as part of European outbreaks.…”

Section: Introductionmentioning

confidence: 99%

High impact of molecular surveillance on hepatitis A outbreak case detection in Sweden: a retrospective study, 2009 to 2018

et al. 2021

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Background Swedish hepatitis A surveillance includes sequence-based typing, but its contribution to outbreak detection in relation to epidemiological investigations has not been fully evaluated. Aim To evaluate the role of sequence-based typing in hepatitis A outbreak detection and to describe the hepatitis A epidemiology in Sweden to improve surveillance. Methods We retrospectively investigated hepatitis A virus sequences of 447 cases notified in Sweden 2009–18. We performed a phylogenetic analysis of evolutionary distances to identify cases with similar virus sequences (≥ 459/460 identical nt in the VP1/P2A junction). Unique sequences, dyads and sequence-based clusters (SBCs) were identified. We linked non-sequenced cases by epidemiological information and retrospectively assessed the value of typing for outbreak identification. Results Fifty-five percent (n = 542/990) of the notified hepatitis A cases were referred to the Public Health Agency of Sweden for typing and 447 (45%) were sequenced successfully. Subgenotypes included IA (42.5%, n = 190), IB (42.7%, n = 191) and IIIA (14.8%, n = 66). Phylogenetic analysis identified 154 unique sequences, 33 dyads (66 cases) and 34 SBCs (227 cases). The combination of molecular and epidemiological data revealed 23 potential outbreaks comprising 201 cases. Cases were linked by sequence (59%, n = 118), epidemiological data (11%, n = 23) or both (30%, n = 60). Typing was needed to identify 15 of 23 potential outbreak signals. Conclusion Sequence-based typing contributed substantially to detecting clustering cases and identifying outbreaks in Sweden. The results show routine sequence-based typing detects outbreaks, promotes timely outbreak investigations and facilitates international collaboration.

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Two concurrent outbreaks of hepatitis A highlight the risk of infection for non-immune travellers to Morocco, January to June 2018

Cited by 17 publications

References 17 publications

Hepatitis A and E virus infections have different epidemiological patterns in Rwanda

Hepatitis A and E virus infections have different epidemiological patterns in Rwanda

Epidemiology of Hepatitis A: Past and Current Trends

High impact of molecular surveillance on hepatitis A outbreak case detection in Sweden: a retrospective study, 2009 to 2018

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