Cost Comparison Between 2 Responses to Hepatitis A Virus Incidents in Restaurant Food Handlers-New York City, 2015 and 2017.

CONTEXT: While the New York City Department of Health and Mental Hygiene (DOHMH) can use agency-wide emergency activation to respond to a hepatitis A virus-infected food handler, there is a need to identify alternative responses that conserve scarce resources. OBJECTIVE: To compare the costs incurred by DOHMH of responding to a hepatitis A case in restaurant food handlers using an agency-wide emergency activation (2015) versus the cost of collaborating with a private network of urgent care clinics (2017). DESIGN: We partially evaluate the costs incurred by DOHMH of responding to a hepatitis A case in a restaurant food handler using agency-wide emergency activation (2015) with the cost of collaborating with a private network of urgent care clinics (2017) estimated for a scenario in which DOHMH incurred the retail cost of services rendered. RESULTS: Costs incurred by DOHMH for emergency activation were $65 831 ($238 per restaurant employee evaluated) of which DOHMH personnel services accounted for 85% ($55 854). Costs of collaboration would have totaled $50 914 ($253 per restaurant employee evaluated) of which personnel services accounted for 6% ($3146). CONCLUSIONS: Accounting for incident size, collaborating with the clinic network was more expensive than agency-wide emergency activation, though required fewer DOHMH personnel services.

Estimating the burden of foodborne disease, South Korea, 2008-2012.

Estimating the actual occurrence of foodborne illness is challenging because only a small proportion of foodborne illnesses are confirmed and reported. Many studies have attempted to accurately estimate the overall number of cases of foodborne illness, but none have attempted to estimate the burden of foodborne disease in South Korea. This study used data from the Health Insurance Review and Assessment Service (HIRA), a public health surveillance system in South Korea, to calculate the number of cases and hospitalizations due to 18 specific pathogens and unspecified agents commonly transmitted through contaminated food between 2008 and 2012 in South Korea while accounting for uncertainty in the estimate. The estimated annual occurrences of foodborne illness were 336,138 (90% credible interval [CrI]: 258,379-430,740), with inpatient stays (hospitalizations), outpatient visits (foodborne disease infections), and patients' experiences (without visiting physicians) accounting for 2.3% (n=7809 [90% CrI: 7016-8616]), 14.4% (n=48,267 [90% CrI: 45,883-50,695]) and 83.3% (n=280,062 [90% CrI: 201,795-374,091]), respectively. Escherichia coli, including enterohemorrhagic E. coli, caused most illnesses, followed by nontyphoidal Salmonella spp., Staphylococcus aureus, hepatitis A virus, and norovirus. These results will be useful to food safety policymakers for the prevention and control of foodborne pathogens in South Korea.

Shellfish-borne viral outbreaks: a systematic review.

Investigations of disease outbreaks linked to shellfish consumption have been reported in the scientific literature; however, only few countries systematically collate and report such data through a disease surveillance system. We conducted a systematic review to investigate shellfish-borne viral outbreaks and to explore their distribution in different countries, and to determine if different types of shellfish and viruses are implicated. Six databases (Medline, Embase, Scopus, PubMed, Eurosurveillance Journal and Spingerlink electronic Journal) and a global electronic reporting system (ProMED) were searched from 1980 to July 2012. About 359 shellfish-borne viral outbreaks, alongside with nine ProMED reports, involving shellfish consumption, were identified. The majority of the reported outbreaks were located in East Asia, followed by Europe, America, Oceania, Australia and Africa. More than half of the outbreaks (63.6 %) were reported from Japan. The most common viral pathogens involved were norovirus (83.7 %) and hepatitis A virus (12.8 %). The most frequent type of consumed shellfish which was involved in outbreaks was oysters (58.4 %). Outbreaks following shellfish consumption were often attributed to water contamination by sewage and/or undercooking. Differences in reporting of outbreaks were seen between the scientific literature and ProMED. Consumption of contaminated shellfish represents a risk to public health in both developed and developing countries, but impact will be disproportionate and likely to compound existing health disparities.

Unusual cardiac features in cholestatic hepatitis A in an adolescent: improvement with corticosteroid treatment.

Hepatitis A is one of the most frequent infectious liver diseases affecting children worldwide. Extra-hepatic manifestations of acute hepatitis A virus are rare in pediatric age group. We report a case of a 16-year-old, otherwise healthy adolescent who had viral hepatitis A with cardiac manifestations. The patient is the first pediatric case of hepatitis A with a combination of hypotension, persistent bradycardia and progressive cholestasis.

Higiene alimentaria para la prevención de trastornos digestivos infecciosos y por toxinas / Food safety for the prevention of the infecious and toxine of the foodborne diseases

El principal factor que interviene en el origen y prevención de las enfermedades trasmitidas por los alimentos es la higiene alimentaria. Dichas enfermedades son causadas por la ingestión de alimentos o agua contaminados con microorganismos patógenos ocasionando una infección o por la ingestión de alimentos contaminados con toxinas. Los principales agentes involucrados son Escherichia Coli, Campylobacter, Salmonella, Shigella, Listeria Monocytogenes, Norovirus, virus Hepatitis A, Astrovirus, Rotavirus, y Virus Coxsackie. Toxinas producidas por hongos o por microflora marina y los contaminantes orgánicos persistentes pueden también causar serios problemas de salud. La inocuidad alimentaría ha tomado relevancia debido a una mayor exigencia por consumidores cada día más informados y por las demandas del comercio exterior. Medidas que aseguren una adecuada higiene alimentaría nos permitirá prevenir enfermedades, principalmente digestivas, causadas por variados agentes en los alimentos. Esto se logra por la implementación de las medidas propuestas por la Comisión Internacional conocida como Codex Alimentarius

Food Safety is the main factor involved in the origin and prevention of Food-borne diseases. These diseases are caused by either the intake of contaminated foods or water or by the intake of toxin-contaminated foods. Escherichia Coli, Campylobacter, Salmonella, Shigella and Listeria Monocytogenes, Norovirus, Hepatitis A virus, astrovirus, rotavirus, and coxsackie virus are the main causative agents involved in food-borne diseases. Toxins produced by fungi or marine microflora and the presence of persistent organic polluting agents can also cause serious health problems. Food safety has become an important topic due to a more demanding and informed consumer and the foreign food trade. Measures leading to ensure a better food safety will allow us to prevent various foodborne preventive diseases, mostly in the digestive system, caused by different etiological agents. This can be achieved through the implementation of the different measures proposed by the international commission called Codex Alimentarius

Major foodborne illness causing viruses and current status of vaccines against the diseases.

Even though viruses, unlike bacteria, cannot grow in or on foods, foodborne illnesses are associated with viruses due to contamination of the fresh produce or processed food by virus-containing fecal material. The commonly reported major foodborne illnesses are due to Noroviruses, hepatitis A and E viruses, rotaviruses, and astroviruses. Among all illnesses caused by foodborne pathogens, recent estimates of as high as 67% have been attributed to viruses alone, and an upward trend in the of transmission of viruses by food and water has been recently acknowledged. Due to the highly infectious nature of these viruses and their survival under drastic conditions such as high acidic pH and low temperatures, it has long been recognized that immunization against such pathogens is the ideal solution to provide protection against the illness and disease outbreaks associated with these viruses. With an increased recognition of the clinical significance and impact of acute viral illness associated with food and water in humans of all ages, there has been a recent surge in developing prophylactic vaccines against such viruses. So far, except for hepatitis A virus, there are no vaccines available to prevent illness associated with foodborne viruses. Outbreaks of hepatitis A have been significantly reduced due to widespread immunization of some risk groups. It is clear from the literature that novel strategies currently in development may lead to vaccines against noroviruses and rotaviruses in the near future, offering hope that such vaccines will significantly reduce the burden associated with foodborne illnesses associated with these viruses.