Hepatitis A virus is an important cause of food-borne diseases and has been associated with several European outbreaks linked to berries [1–4]. Here, we describe an ongoing outbreak of hepatitis A virus (HAV) in Sweden and Austria and the confirmation of frozen strawberries imported from Poland as the source of infection. The aims are to highlight the importance of sequencing in outbreak investigations and, due to the long shelf-life of the food vehicle, to increase awareness and warnings towards HAV infections related to frozen strawberries in Europe.
Hepatitis A outbreak linked to imported frozen strawberries by sequencing, Sweden and Austria, June to September 2018
Theresa Enkirch, Ronnie Eriksson, Sofia Persson, Daniela Schmid, Stephan W. Aberle, et al
On 2 May 2018, Denmark reported a cluster of hepatitis A virus (HAV) infections with the subgenotype IA strain DK2018_231, through the European Centre for Disease Prevention and Control (ECDC)’s Epidemic Intelligence Information System (EPIS) for food- and waterborne diseases and zoonoses (FWD).
One of the three confirmed cases had travelled to Morocco. In response, five additional European Union (EU) countries (France, Germany, the Netherlands, Spain and the United Kingdom (UK)) reported cases (n = 20) infected with the same strain between 21 January and 10 April 2018.
Concurrently, Germany reported to EPIS that it observed more cases of hepatitis A with travel history to Morocco than expected, compared with the same period in the previous 5 years. Molecular analysis of the HAV VP1/P2A region revealed an unrelated cluster of the HAV subgenotype IB strain V18–16428. Cases infected with this unrelated strain were also reported from France, the Netherlands, Sweden and UK.
The appearance of clusters with a link to Morocco triggered further epidemiological investigations.
Two concurrent outbreaks of hepatitis A highlight the risk of infection for non-immune travelers to Morocco, January to June 2018
Martyna Gassowski, Kai Michaelis, Mirko Faber, Julie Figoni…
News of the outing emerged earlier this year after Discovery Wildlife Park, located about 70 miles north of Calgary in the town of Innisfail, posted a video on social media showing a captive Kodiak bear sitting in the passenger seat of a truck.
The video later showed the one-year-old bear, known as Berkley, leaning out of the truck’s window, enthusiastically licking an ice cream cone held by the owner of a local Dairy Queen.
Amid widespread criticism, the video – along with a second one showing Berkley licking frosting off an ice cream cake – was taken down.
At the time, the zoo said the drive-thru run had posed no danger to the public, as it had taken place before the Dairy Queen had opened for the day and that the bear had been secured by a chain throughout the entire outing.
Wildlife officials in Alberta said that the zoo and its owners are now facing two charges. “Under the terms and conditions of the zoo’s permit, the charges are directly related to the alleged failure of the park to notify the provincial government prior to the bear leaving the zoo,” Alberta Fish and Wildlife said in a statement.
One count stems from the bear’s jaunt through the drive-thru, while the other dates back to 2017. At the time Berkley had just arrived as an orphan from a facility in the United States and the zoo allegedly failed to inform officials the seven-pound bear was being taken home nightly so that she could be bottle-fed.
The zoo’s owner, Doug Bos, said he planned to plead guilty to the charges, noting that this was the first time in the zoo’s 28-year history that it was facing such charges.
“We made a mistake. I’m embarrassed about it,” he told the Guardian. “Every time we take an animal off the property, we’re supposed to notify Fish and Wildlife, send them an email, and we forgot to do that in both instances.”
He said he had been happy to hear of the charges. “I’m glad that they followed through with it because it shows how strictly regulated the zoo industry is in the province,” he said. “Because there are so many people out there that think it’s not, they think anybody can just do anything they want.”
Bos said that wildlife officials had not necessarily taken issue with the bear’s outing to Dairy Queen but rather the zoo’s failure to request permission beforehand. “That’s all we did wrong,” he added, noting that the bears have been taken off the property many times for a range of reasons.
“We’ve done lots of TV commercials, Super Bowl commercials with bears and food … Some of them the bear was in a grocery store and wandered up and down the aisles.”
He emphasised the difference between bears in the wild and the zoo’s bears, describing those in the facility as hand-raised and well-trained.
At one point the zoo’s bears had even learned to pee in a cup, he said, in order to participate in a Scottish veterinarian’s study aimed at measuring baseline norms for bears. “These bears aren’t just your average bear that we go snag out of the wild and do this.”
In Sept. 2016, at least 89 were sickened in the U.S. with hepatitis A at Tropical Smoothie Cafés in Maryland, North Carolina, Virginia, and West Virginia, linked to consumption of frozen strawberries from Egypt.
Darla Carter of Insider Louisville reports the city is taking aim at the hepatitis A outbreak by offering low-cost vaccination shots to food-service and hospitality industry workers such as restaurant employees.
“It’s a significant discount,” said health department spokesman Dave Langdon, noting that the typical rate is more like $65 to $100 a dose.
Against the Grain, a Louisville brewery and restaurant, is among the businesses that have stepped up to get some workers vaccinated.
“We care for our employees and want them to be well and we care for our customers and want them to be well,” co-owner Adam Watson said. ” … Any place that handles food, it’s probably a wise decision to try and get this done.”
The discounted shots are part of an effort to stop an outbreak that has led to nearly 200 cases of acute hepatitis A in the Louisville area, according to the health department. At least one person has died.
Locally, the highly contagious liver infection mainly has stricken the homeless and people who use drugs. It’s usually spread when a person unknowingly ingests the virus from objects, food or drinks contaminated with small amounts of stool from an infected person, according to the U.S. Centers for Disease Control and Prevention.
Also, by taking advantage of the discounted shots, businesses “certainly would be helping to prevent the spread of hepatitis A throughout the community,” Langdon said. “Also, they would be protecting themselves against the potential bad publicity and loss of business that might come with having one of their workers identified with being infected with hepatitis A.”
I’m not a fan of pomegranates, and I’m really not a fan of the way the NSW Food Authority announces recalls.
Here’s what they said.
The NSW Food Authority advises: Entyce Food Ingredients is conducting a precautionary recall of its Creative Gourmet Pomegranate Arils 180g from Coles Supermarkets nationally, due to potential Hepatitis A contamination.
Creative Gourmet Pomegranate Arils 180g, frozen, plastic snap lock bag
All Best Before Dates up to and including 21/03/20
Consumers should not consume this product and should return it to the place of purchase for a full refund.
If you are concerned about your health you should seek medical advice.
What they didn’t mention but ABC did is seven people have been diagnosed with hepatitis A after eating frozen pomegranate purchased at Coles supermarkets, prompting NSW Health to warn anyone who bought the product to throw it out immediately.
Dr Vicky Sheppeard, director of communicable diseases at NSW Health, said it was working with the state’s Food Authority to determine whether the infection could be definitively linked to the Coles frozen pomegranates, despite the fact that each person affected had eaten the product.
I get the difference between NSW Health and the NSW Food Authority. But mention how hard is it to mention there are sick people so consumers can judge how much they should pay attention.
Hundreds of people who dined at one of Melbourne’s best restaurants will be contacted by the health department after a food handler was diagnosed with a highly contagious liver infection.
The Age reports the staff member at Cumulus Inc., in the fine-dining hotspot of Flinders Lane, was recently found to have hepatitis A.
An alert issued by Victoria’s Department of Health on Thursday afternoon said anyone who ate at the restaurant between February 26 and March 19 should visit their GP for a free hepatitis A vaccine, and seek urgent medical attention if they feel unwell.
The department is also contacting anyone who booked at the restaurant during the same time period.
It is not yet clear how the male staff member contracted hepatitis A.
In response to the dozens of cases in recent months, a free vaccine has been offered to Victorian men who have sex with men and people who have injected drugs in the past year.
It follows an unusual increase in hepatitis A cases in Europe and North America that has affected hundreds of people.
The restaurant said that the hygiene systems at Cumulus Inc. were robust and safety of guests paramount.
The sick employee, who was involved in the plating up and preparation of food, is expected to make a full recovery.
Cumulus Inc. is prolific restaurateur Andrew McConnell’s stalwart all-day city restaurant, with wine bar Cumulus Up operating above.
Occupying an old clothing factory in Flinders Lane, the restaurant has consistently maintained a hat in the Good Food Guide since it opened in 2008.
Famous for its slow-cooked lamb shoulder, and still the go-to for boozy business brunches it is a kingpin of the McConnell restaurant empire, which also includes Marion, Cutler and Co. and fellow Flinders Lane occupant Supernormal.
(Many thanks to our correspondent in France for sending this along).
Hepatitis A surveillance has been carried out by mandatory reporting (DO) since November 2005, with the objective of detecting clustered cases in order to quickly take control measures, and estimating reporting incidence rates. The results of the analysis of cases reported during the first ten years of surveillance (2006-2015) are presented.
One case (positive anti-HAV IgM) must be notified to the Regional Health Agency using an OD card. This sheet gathers sociodemographic and clinical information as well as risky exposures (in particular cases in the entourage, stay outside the metropolis, consumption of seafood).
For the period 2006-2015, 11,158 cases of hepatitis A were notified, giving an average incidence rate of 1.7 / 100,000. A downward trend in this rate has been observed since 2010. The average incidence rate of reporting in men was 1.9 / 100,000 and, in women, 1.4 / 100,000, with a downward trend for both sexes. The main exposures at risk were the presence of cases in the entourage (46%) and a stay outside metropolitan France (38%). Thirty-two percent of cases belonged to an identified episode of clustered cases. Each year, the share of grouped cases was relatively stable, ranging between 28 and 37%.
The annual rate of notification incidence has gradually decreased since 2010, reaching in 2015 that of a country of low endemicity for hepatitis A (1.1 / 100,000). The highest incidence of reporting was found in the under-15 age group, which is the most affected by fecal-oral transmission of the virus, favored in families and communities of children. The data collected by the OD and by the investigations of grouped episodes made it possible, in 2009, to develop vaccine recommendations in the family circle of a patient with hepatitis A and in living communities in situation precarious hygiene.
First ten years of surveillance of hepatitis A through mandatory reporting, France, 2006-2015
Elisabeth Couturier 1, Lina Mouna 2 , Marie-José Letort 1 , Dieter Van Cauteren 1 , Anne-Marie Roque-Afonso 2 , Henriette De Valk 1