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Outbreak of hepatitis A genotype IB in Australia associated with imported frozen pomegranate arils.
Epidemiol Infect. 2019 01; 147:e74.EI

Abstract

Locally acquired hepatitis A infection is re-emerging in Australia owing to person-to-person outbreaks among men who have sex with men and imported frozen produce. This paper describes a multi-state foodborne outbreak in the first half of 2018. Enhanced human epidemiological investigation including a case-control study, as well as microbial surveillance and trace-back investigations concluded that the outbreak was caused by consumption of imported frozen pomegranate arils. A total of 30 cases of hepatitis A infection, genotype IB with identical sequences met the outbreak case definition, including 27 primary cases and three secondary cases. Twenty-five (83%) of the cases were hospitalised for their illness and there was one death. Imported frozen pomegranate arils from Egypt were strongly implicated as the source of infection through case interviews (19 of 26 primary cases) as well as from a case-control study (adjusted odds ratio 43.4, 95% confidence interval 4.2-448.8, P = 0.002). Hepatitis A virus (HAV) was subsequently detected by polymerase chain reaction in two food samples of the frozen pomegranate aril product. This outbreak was detected and responded to promptly owing to routine genetic characterisation of HAVs from all hepatitis A infections in Australia as part of a national hepatitis A enhanced surveillance project. This is now the third outbreak of hepatitis A in Australia from imported frozen fruits. A re-assessment of the risk of these types of imported foods is strongly recommended.

Authors+Show Affiliations

NSW Ministry of Health,Sydney,Australia.National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University,Canberra,Australia.Australian Government Department of Health,Canberra,Australia.Queensland Health,Brisbane,Australia.NSW Ministry of Health,Sydney,Australia.NSW Ministry of Health,Sydney,Australia.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

30869018

Citation

Franklin, N, et al. "Outbreak of Hepatitis a Genotype IB in Australia Associated With Imported Frozen Pomegranate Arils." Epidemiology and Infection, vol. 147, 2019, pp. e74.
Franklin N, Camphor H, Wright R, et al. Outbreak of hepatitis A genotype IB in Australia associated with imported frozen pomegranate arils. Epidemiol Infect. 2019;147:e74.
Franklin, N., Camphor, H., Wright, R., Stafford, R., Glasgow, K., & Sheppeard, V. (2019). Outbreak of hepatitis A genotype IB in Australia associated with imported frozen pomegranate arils. Epidemiology and Infection, 147, e74. https://doi.org/10.1017/S0950268818003515
Franklin N, et al. Outbreak of Hepatitis a Genotype IB in Australia Associated With Imported Frozen Pomegranate Arils. Epidemiol Infect. 2019;147:e74. PubMed PMID: 30869018.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Outbreak of hepatitis A genotype IB in Australia associated with imported frozen pomegranate arils. AU - Franklin,N, AU - Camphor,H, AU - Wright,R, AU - Stafford,R, AU - Glasgow,K, AU - Sheppeard,V, PY - 2019/3/15/entrez PY - 2019/3/15/pubmed PY - 2020/3/28/medline KW - Disease outbreaks KW - foodborne infections KW - hepatitis A SP - e74 EP - e74 JF - Epidemiology and infection JO - Epidemiol. Infect. VL - 147 N2 - Locally acquired hepatitis A infection is re-emerging in Australia owing to person-to-person outbreaks among men who have sex with men and imported frozen produce. This paper describes a multi-state foodborne outbreak in the first half of 2018. Enhanced human epidemiological investigation including a case-control study, as well as microbial surveillance and trace-back investigations concluded that the outbreak was caused by consumption of imported frozen pomegranate arils. A total of 30 cases of hepatitis A infection, genotype IB with identical sequences met the outbreak case definition, including 27 primary cases and three secondary cases. Twenty-five (83%) of the cases were hospitalised for their illness and there was one death. Imported frozen pomegranate arils from Egypt were strongly implicated as the source of infection through case interviews (19 of 26 primary cases) as well as from a case-control study (adjusted odds ratio 43.4, 95% confidence interval 4.2-448.8, P = 0.002). Hepatitis A virus (HAV) was subsequently detected by polymerase chain reaction in two food samples of the frozen pomegranate aril product. This outbreak was detected and responded to promptly owing to routine genetic characterisation of HAVs from all hepatitis A infections in Australia as part of a national hepatitis A enhanced surveillance project. This is now the third outbreak of hepatitis A in Australia from imported frozen fruits. A re-assessment of the risk of these types of imported foods is strongly recommended. SN - 1469-4409 UR - https://www.unboundmedicine.com/medline/citation/30869018/Outbreak_of_hepatitis_A_genotype_IB_in_Australia_associated_with_imported_frozen_pomegranate_arils_ L2 - https://www.cambridge.org/core/product/identifier/S0950268818003515/type/journal_article DB - PRIME DP - Unbound Medicine ER -