2016-01-21
International linkage of two food-borne hepatitis a clusters through traceback of mussels, The Netherlands, 2012
Publication
Publication
Eurosurveillance , Volume 21 - Issue 3
This report describes an outbreak investigation starting with two closely related suspected food-borne clusters of Dutch hepatitis A cases, nine primary cases in total, with an unknown source in the Netherlands. The hepatitis A virus (HAV) genotype IA sequences of both clusters were highly similar (459/460 nt) and were not reported earlier. Food questionnaires and a case–control study revealed an association with consumption of mussels. Analysis of mussel supply chains identified the most likely production area. International enquiries led to identification of a cluster of patients near this production area with identical HAV sequences with onsets predating the first Dutch cluster of cases. The most likely source for this cluster was a case who returned from an endemic area in Central America, and a subsequent household cluster from which treated domestic sewage was discharged into the suspected mussel production area. Notably, mussels from this area were also consumed by a separate case in the United Kingdom sharing an identical strain with the second Dutch cluster. In conclusion, a small number of patients in a non-endemic area led to geographically dispersed hepatitis A outbreaks with food as vehicle. This link would have gone unnoticed without sequence analyses and international collaboration.
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| doi.org/10.2807/1560-7917.ES.2016.21.3.30113, hdl.handle.net/1765/91878 | |
| Eurosurveillance | |
| Organisation | Department of Virology |
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Boxman, I. L., Verhoef, L., Vennema, H., Ngui, S., Friesema, I. H. M., Whiteside, C., … Koopmans, M., D.V.M. (2016). International linkage of two food-borne hepatitis a clusters through traceback of mussels, The Netherlands, 2012. Eurosurveillance, 21(3). doi:10.2807/1560-7917.ES.2016.21.3.30113 |
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