Beware those berries: Three simultaneous, foodborne, multi-country outbreaks of hepatitis A in 2013

I love the berries fresh, so I moved to a sub-tropical climate where we have a steady supply.

I love the berries frozen, because of convenience and continual availability.

Frankenface.berryBut there’s been a lot of outbreaks on berries of late – on the frozen kind. Many of the frozen kind are originating in areas like Egypt and shipped around the world.

Many countries in the European Union advise cooking frozen berries to reduce the risk of Hepatitis A.

Where’s the smoothie fun in that?

According to Gossner and Severi, writing in Eurosurveillance, between March and May 2013, three multi-country outbreaks of hepatitis A virus (HAV) infection were reported through the Epidemic Intelligence Information System for Food- and Water-borne diseases (EPIS-FWD) of the European Centre for Disease Prevention and Control (ECDC).

The aim of this work is to put these outbreaks into a European Union (EU) and European Economic Area (EEA) perspective and highlight opportunities for improving detection and investigation of such outbreaks. Although HAV outbreaks are not unusual in the EU/EEA, having three large food-borne multi-country outbreaks declared within three months is an unexpected event, particularly when at least two of these outbreaks are associated with frozen berries. Factors influencing the occurrence of these events include the increased number of susceptible Europeans, the limited coverage of HAV vaccination, the global trade of potentially contaminated products introduced in the EU/EEA, and the ‘awareness chain effect’ leading to a wave of notifications. Further studies should be conducted to understand the risk posed by frozen berries.

Laboratory capacity and surveillance of viral infections in the EU/EEA, as well as HAV vaccination recommendations to travellers to endemic countries should be strengthened. Finally, timely reporting food-borne events through EPIS-FWD, to ensure timely response.

Eurosurveillance, Volume 19, Issue 43, 30 October 2014

Gossner CM, Severi E.