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Lessons from intensified surveillance of viral hepatitis A, Israel, 2017 and 2018.
Gozlan, Yael; Bar-Or, Itay; Volnowitz, Hadar; Asulin, Efrat; Rich, Rivka; Anis, Emilia; Shemer, Yonat; Szwarcwort Cohen, Moran; Dahary, Etti Levy; Schreiber, Licita; Goldiner, Ilana; Rozenberg, Orit; Picard, Orit; Savion, Michal; Fuchs, Inbal; Mendelson, Ella; Mor, Orna.
Afiliação
  • Gozlan Y; Central Virology Laboratory, Ministry Of Health, Sheba Medical Center, Ramat-Gan, Israel.
  • Bar-Or I; Central Virology Laboratory, Ministry Of Health, Sheba Medical Center, Ramat-Gan, Israel.
  • Volnowitz H; Central Virology Laboratory, Ministry Of Health, Sheba Medical Center, Ramat-Gan, Israel.
  • Asulin E; Central Virology Laboratory, Ministry Of Health, Sheba Medical Center, Ramat-Gan, Israel.
  • Rich R; Public Health Services, Ministry Of Health, Jerusalem, Israel.
  • Anis E; Public Health Services, Ministry Of Health, Jerusalem, Israel.
  • Shemer Y; Hebrew University Hadassah Braun School of Public Health and Community Medicine, Jerusalem, Israel.
  • Szwarcwort Cohen M; Virology Laboratory, Soroka University Medical Center, Beer-Sheva, Israel.
  • Dahary EL; Virology Laboratory, Rambam Health Care Campus, Haifa, Israel.
  • Schreiber L; Meuhedet Health Services, Lod, Israel.
  • Goldiner I; Maccabi Health Services, Mega Laboratory, Rehovot, Israel.
  • Rozenberg O; Clinical Biochemistry Laboratory, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel.
  • Picard O; Immunological Laboratory, Emek Medical Center, Afula, Israel.
  • Savion M; Gastroenterology Laboratory, Sheba Medical Center, Ramat Gan, Israel.
  • Fuchs I; Tel-Aviv District Health Office, Ministry Of Health, Tel Aviv, Israel.
  • Mendelson E; Clalit Health Services, Southern district Beer Sheva, Israel.
  • Mor O; Central Virology Laboratory, Ministry Of Health, Sheba Medical Center, Ramat-Gan, Israel.
Euro Surveill ; 26(6)2021 Feb.
Article em En | MEDLINE | ID: mdl-33573709
IntroductionUniversal vaccination of toddlers has led to very low hepatitis A (HAV) endemicity in Israel. However, sporadic outbreaks still occur, necessitating better surveillance.AimTo implement a comprehensive HAV surveillance programme.MethodsIn 2017 and 2018, sera from suspected HAV cases that tested positive for anti-HAV IgM antibodies were transferred to the Central Virology Laboratory (CVL) for molecular confirmation and genotyping. Sewage samples were collected in Israel and Palestine* and were molecularly analysed. All molecular (CVL), epidemiological (District Health Offices and Epidemiological Division) and clinical (treating physicians) data were combined and concordantly assessed.ResultsOverall, 146 cases (78 in 2017 and 68 in 2018, median age 34 years, 102 male) and 240 sewage samples were studied. Most cases (96%) were unvaccinated. In 2017, 89% of cases were male, 45% of whom were men who have sex with men (MSM). In 2018, 49% were male, but only 3% of them were MSM (p < 0.01). In 2017, 82% of cases and 63% of sewage samples were genotype 1A, phylogenetically associated with a global MSM-HAV outbreak. In 2018, 80% of cases and 71% of sewage samples were genotype 1B, related to the endemic strain previously identified in Israel and Palestine*. Environmental analysis revealed clustering of sewage and cases' sequences, and country-wide circulation of HAV.ConclusionsMolecular confirmation of HAV infection in cases and analysis of environmental samples, combined with clinical and epidemiological investigation, may improve HAV surveillance. Sequence-based typing of both clinical and sewage-derived samples could assist in understanding viral circulation.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Vírus da Hepatite A / Minorias Sexuais e de Gênero / Hepatite A Idioma: En Ano de publicação: 2021 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Vírus da Hepatite A / Minorias Sexuais e de Gênero / Hepatite A Idioma: En Ano de publicação: 2021 Tipo de documento: Article