Underdiagnosis of Foodborne Hepatitis A, the Netherlands, 2008–20101

Petrignani, Mariska; Verhoef, Linda; Vennema, Harry; Hunen, Rianne van; Baas, Dominique C.; Steenbergen, Jim E. van

doi:10.3201/eid2004.130753

Cited by 34 publications

(29 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…NC_001489) of the VP1/2A junction was chosen for genotyping and phylogenetic analysis. This region of HAV was amplified by a nested RT‐PCR reaction as reported . Sequences were obtained by double strand sequencing of the purified PCR products using the GenomeLab DTCS Quick Start Kit and an automated DNA sequencer (Beckman Coulter, Inc., Fullerton, CA).…”

Section: Methodsmentioning

confidence: 99%

Hepatitis A virus strains circulating during 1997-2015 in Campania, a Southern Italy region with periodic outbreaks

et al. 2017

View full text Add to dashboard Cite

In Italy, the incidence of hepatitis A has progressively declined over the last 30 years, though not homogeneously throughout the country. In Campania, Southern Italy, high annual incidence rates have been reported and several periodic outbreaks have occurred. To investigate the phylogenetic and epidemiologic relationships among HAV strains circulating in Campania over the period 1997-2015, 87 hepatitis A cases were investigated. The most frequent risk factor was the consumption of raw/undercooked shellfish (75/87, 86.2%). During 1997-2002 most viral strains were subtype IA (16/23, 70%); the phylogenetic pattern suggests that the incidence peaks observed in 2000-2001 had likely been caused by multiple strains. During a large 2004 outbreak, almost all viral variants were subtype IB (38/41, 93%); most of them (22/38, 58%) were recognized to be one of two main strains (differing for just a single nucleotide), the remaining sequences were strictly related variants. In 2014/2015, only IA strains were observed; two phylogenetically related but distinct strains were responsible, respectively, for a small cluster in 2014 and an outbreak in 2015. In each outbreak, several strains unrelated to those responsible for most cases were detected in a minority of patients, documenting a background of sporadic cases occurring even in the course of outbreaks; some of them proved to be identical to strains detected 11-14 years previously. Overall, the data suggest that several related and unrelated HAV strains have endemically circulated over the last 15 years in Campania, with some strains gaining epidemic transmission likely because of a local combination of multiple factors, including inadequate waste water purification and dietary habits.

show abstract

Section: Methodsmentioning

confidence: 99%

Hepatitis A virus strains circulating during 1997-2015 in Campania, a Southern Italy region with periodic outbreaks

et al. 2017

View full text Add to dashboard Cite

show abstract

“…Imported food from HAV-endemic countries has been identified as the source for recent increases in cases of HAV disease in European and other developed countries (53)(54)(55)(56). Some investigators suggest that a substantial proportion of cases without recognized exposure are related to contaminated food (55,56). Herd protection provides a barrier against spread of HAV in populations but will not protect susceptible persons when exposed (43,57).…”

Section: Discussionmentioning

confidence: 99%

“…Imports of fresh and frozen fruits and vegetables to the United States from HAV-endemic countries have increased steadily (52). Imported food from HAV-endemic countries has been identified as the source for recent increases in cases of HAV disease in European and other developed countries (53)(54)(55)(56). Some investigators suggest that a substantial proportion of cases without recognized exposure are related to contaminated food (55,56).…”

Section: Discussionmentioning

confidence: 99%

Progress Toward Eliminating Hepatitis A Disease in the United States

et al. 2016

View full text Add to dashboard Cite

Summary Hepatitis A virus (HAV) disease disproportionately affects adolescents and young adults, American Indian/Alaska Native and Hispanic racial/ethnic groups, and disadvantaged populations. During 1996-2006, the Advisory Committee on Immunization Practices (ACIP) made incremental changes in hepatitis A (HepA) vaccination recommendations to increase coverage for children and persons at high risk for HAV infection. This report examines the temporal association of ACIP-recommended HepA vaccination and disparities (on the absolute scale) in cases of HAV disease and on seroprevalence of HAV-related protection (measured as antibody to HAV [anti-HAV]). ACIP-recommended childhood HepA vaccination in the United States has eliminated most absolute disparities in HAV disease by age, race/ethnicity, and geographic area with relatively modest ≥1-dose and ≥2-dose vaccine coverage. However, the increasing proportion of cases of HAV disease among adults with identified and unidentified sources of exposure underscores the importance of considering new

show abstract

“…Several studies described circulation of different HAV genotypes from both autochthonous and travel-related cases [14–21]. Nevertheless, HAV strains from Bulgaria and other European endemic countries have never been described.…”

Section: Introductionmentioning

confidence: 99%

Hepatitis a virus genotypes and strains from an endemic area of Europe, Bulgaria 2012–2014

et al. 2017

View full text Add to dashboard Cite

BackgroundHepatitis A virus (HAV) infection is endemic in Eastern European and Balkan region countries. In 2012, Bulgaria showed the highest rate (67.13 cases per 100,000) in Europe. Nevertheless, HAV genotypes and strains circulating in this country have never been described. The present study reports the molecular characterization of HAV from 105 patients from Bulgaria.MethodsAnti-HAV IgM positive serum samples collected in 2012–2014 from different towns and villages in Bulgaria were analysed by nested RT-PCR, sequencing of the VP1/2A region and phylogenetic analysis; the results were analysed together with patient and geographical data.ResultsPhylogenetic analysis revealed two main sequence groups corresponding to the IA (78/105, 74%) and IB (27/105, 26%) sub-genotypes.In the IA group, a major and a minor cluster were observed (62 and 16 sequences, respectively). Most sequences from the major cluster (44/62, 71%) belonged to either of two strains, termed "strain 1" and "strain 2", differing only for a single specific nucleotide; the remaining sequences (18/62, 29%) showed few (1 to 4) nucleotide variations respect to strain 1 and 2. Strain 2 is identical to the strain previously responsible for an outbreak in the Czech Republic in 2008 and a large multi-country European outbreak caused by contaminated mixed frozen berries in 2013.Most sequences of the IA minor cluster and the IB group were detected in large/medium centers (LMCs). Overall, sequences from the IA major cluster were more frequent in small centers (SCs), but strain 1 and strain 2 showed an opposite relative frequency in SCs and LMCs (strain 1 more frequent in SCs, strain 2 in LMCs).ConclusionsGenotype IA predominated in Bulgaria in 2012–2014 and phylogenetic analysis identified a major cluster of highly related or identical IA sequences, representing 59% of the analysed cases; these isolates were mostly detected in SCs, in which HAV shows higher endemicity than in LMCs. The distribution of viral sequences suggests the existence of some differences between the transmission routes in SCs and LMCs.Molecular characterization of an increased number of isolates from Bulgaria, regularly collected over time, will be useful to explore specific transmission routes and plan appropriate preventing measures.

show abstract

Underdiagnosis of Foodborne Hepatitis A, the Netherlands, 2008–20101

Cited by 34 publications

References 34 publications

Hepatitis A virus strains circulating during 1997-2015 in Campania, a Southern Italy region with periodic outbreaks

Hepatitis A virus strains circulating during 1997-2015 in Campania, a Southern Italy region with periodic outbreaks

Progress Toward Eliminating Hepatitis A Disease in the United States

Hepatitis a virus genotypes and strains from an endemic area of Europe, Bulgaria 2012–2014

Contact Info

Product

Resources

About