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1.
Am J Public Health ; 110(S3): S348-S355, 2020 10.
Artículo en Inglés | MEDLINE | ID: mdl-33001731

RESUMEN

Objectives. To examine how and what information is communicated via social media during an infectious disease outbreak.Methods. In the context of the 2016 through 2018 hepatitis A outbreak in San Diego County, California, we used a grounded theory-based thematic analysis that employed qualitative and quantitative approaches to uncover themes in a sample of public tweets (n = 744) from Twitter, a primary platform used by key stakeholders to communicate to the public during the outbreak.Results. Tweets contained both general and hepatitis A-specific information related to the outbreak, restatements of policy and comments critical of government responses to the outbreak, information with the potential to shape risk perceptions, and expressions of concern regarding individuals experiencing homelessness and their role in spreading hepatitis A. We also identified misinformation and common channels of content driving themes that emerged in our sample.Conclusions. Public health professionals may identify real-time public risk perceptions and concerns via social media during an outbreak and target responses that fulfill the informational needs of those who seek direction and reassurance during times of uncertainty.


Asunto(s)
Brotes de Enfermedades , Comunicación en Salud , Hepatitis A , Salud Pública , Medios de Comunicación Sociales , California , Teoría Fundamentada , Hepatitis A/terapia , Hepatitis A/transmisión , Humanos
2.
BMC Infect Dis ; 20(1): 627, 2020 Aug 26.
Artículo en Inglés | MEDLINE | ID: mdl-32842988

RESUMEN

BACKGROUND: The epidemiological pattern of hepatitis A infection has shown dynamic changes in many parts of the world due to improved socio-economic conditions and the accumulation of seronegative subjects, which leads to possible outbreaks and increased morbidity rate. In Tunisia, the epidemiological status of hepatits A virus is currently unknown. However, over the past years higher numbers of symptomatic hepatitis A virus infection in school attendants and several outbreaks were reported to the Ministry of Health, especially from regions with the lowest socio-economic levels in the country. The aim of this study was to investigate the current seroprevalence of hepatitis A virus antibodies in central-west Tunisia and assess the impact of hepatitis A virus vaccination on hepatitis A epidemiology. METHODS: Serum samples from 1379 individuals, aged 5-75 years, were screened for hepatitis A virus antibodies. Adjusted seroprevalence, incidence and force of infection parameters were estimated by a linear age structured SEIR (Susceptible-Exposed-Infectious-Recovered) compartmental model. A vaccine model was then constructed to assess the impact on hepatitis A virus epidemiology of 3 scenarios of vaccination strategies: one dose at 12-months of age, one dose at 6-years and one dose at 12-months and another at 6-years of age during 6 years. RESULTS: A rapid increase in anti-hepatitis A virus seroprevalence was noted during infancy and adolescence: 47% of subjects under 10-years-old are infected; the prevalence increases to 77% at 15-years and reaches 97% in subjects aged 30-years. The force of infection is highest between 10 and 30-years of age and the incidence declines with increasing age. The vaccine model showed that the 3-scenarios lead to a significant reduction of the fraction of susceptibles. The two doses scenario gives the best results. Single-dose vaccination at 6-years of age provides more rapid decrease of disease burden in school-aged children, as compared to single-dose vaccination at 12-months, but keeps with a non-negligible fraction of susceptibles among children < 6-years. CONCLUSIONS: Our study confirms the epidemiological switch from high to intermediate endemicity of hepatitis A virus in Tunisia and provides models that may help undertake best decisions in terms of vaccinations strategies.


Asunto(s)
Virus de la Hepatitis A/inmunología , Hepatitis A/epidemiología , Hepatitis A/transmisión , Modelos Teóricos , Vacunación/métodos , Adolescente , Adulto , Factores de Edad , Anciano , Niño , Preescolar , Femenino , Hepatitis A/sangre , Hepatitis A/prevención & control , Anticuerpos de Hepatitis A/sangre , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Prevalencia , Estudios Seroepidemiológicos , Túnez/epidemiología , Adulto Joven
5.
J Appl Microbiol ; 129(5): 1120-1132, 2020 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-32471014

RESUMEN

Food contaminated by hepatitis A virus (HAV) is responsible of the 2-7% of all HAV outbreaks worldwide. This review provides a description of the HAV characteristics, its infectivity and epidemiological features. In addition, this review compiles existing original papers reporting HAV prevalence, viral titres in foodstuffs and the risk associated with food contamination. The purpose of this revision is to conduct a structured and systematic review of the published molecular procedures for HAV detection in food, including the assessment of its infectivity.


Asunto(s)
Microbiología de Alimentos , Enfermedades Transmitidas por los Alimentos/virología , Virus de la Hepatitis A/aislamiento & purificación , Virus de la Hepatitis A/fisiología , Hepatitis A/transmisión , Brotes de Enfermedades/estadística & datos numéricos , Contaminación de Alimentos/análisis , Enfermedades Transmitidas por los Alimentos/epidemiología , Hepatitis A/epidemiología , Hepatitis A/virología , Humanos , Prevalencia , Medición de Riesgo
6.
Pediatr Infect Dis J ; 39(2): 164-169, 2020 02.
Artículo en Inglés | MEDLINE | ID: mdl-31929432

RESUMEN

BACKGROUND: Hepatitis A is endemic in many countries. Swiss guidelines recommend vaccinating patients native from endemic areas. In Geneva's Children's hospital, migrant children are screened and vaccinated if seronegative. Because hepatitis A's prevalence is decreasing worldwide, more children are seronegative at arrival, highlighting the need for immunization in medical centers and refugee camps and questioning the benefits of systematic serology. Other Swiss hospitals vaccinate regardless of serostatus. This study's aim is to assess migrant children's immunity according to origin and age, and the cost-effectiveness of different immunization strategies. METHODS: We retrospectively analyzed 329 children's serostatus (1-16 years of age) between 2012 and 2015, using enzyme-linked fluorescent assay method. Serology and vaccine costs were based on local prices. Groups were compared with χ test and the age-seropositivity relationship was studied with linear regression. RESULTS: The predominant regions were the Eastern Mediterranean and European Regions with mostly negative serologies (71% and 83%) and the African Region with mostly positive serologies (79%). Immunity varied depending on birth country. Regardless of region, seropositivity increased with age (P < 0.001). The most cost-effective vaccination strategy was an individualized approach based on age and origin, reducing costs by 2% compared with serology-guided immunization and by 17% compared with systematic vaccination. CONCLUSIONS: Many migrant children >5 years old are seronegative and at risk of clinical infection. They need to be immunized. New guidelines according to age and origin should be defined to reduce immunization costs. We recommend systematic vaccination for patients <5 years old or native from low endemicity areas (≤25.7% of seropositivity). For the others, we propose serology-based vaccination.


Asunto(s)
Vacunas contra la Hepatitis A/inmunología , Hepatitis A/epidemiología , Hepatitis A/prevención & control , Migrantes , Vacunación , Adolescente , Niño , Preescolar , Análisis Costo-Beneficio , Femenino , Hepatitis A/transmisión , Vacunas contra la Hepatitis A/administración & dosificación , Vacunas contra la Hepatitis A/economía , Humanos , Programas de Inmunización , Lactante , Masculino , Tamizaje Masivo , Vigilancia en Salud Pública , Estudios Retrospectivos , Suiza/epidemiología , Vacunación/economía , Vacunación/métodos
7.
Epidemiol Infect ; 147: e300, 2019 11 12.
Artículo en Inglés | MEDLINE | ID: mdl-31711553

RESUMEN

An outbreak of 18 cases of hepatitis A virus infection across five Canadian provinces was investigated. Case onsets occurred between October 2017 and May 2018. A retrospective matched case-control study was conducted to identify the likely source of the outbreak. Three matched controls were recruited for each case using a previously established control bank, supplemented by landline and cell phone call lists. Univariate and multivariate matched analyses were conducted to identify a potential outbreak source. Seventy-two per cent of controls were recruited through the control bank, and required on average 25.5 calls per recruited control; 20% of controls were recruited through a landline sample and 8% of controls were recruited through a cell phone sample, requiring an average of 847.3 and 331.7 calls per recruited control, respectively. Results of the analysis pointed to shrimp/prawns (odds ratio (OR) 15.75, p = 0.01) and blackberries (OR 7.21, p = 0.02) as foods of interest, however, an outbreak source could not be confirmed. The control bank proved to be a more efficient method for control recruitment than random call lists. Expanding the control bank size and using alternative methods, such as online surveys, may prove beneficial for increasing the timeliness of a case-control study during an outbreak investigation.


Asunto(s)
Brotes de Enfermedades , Hepatitis A/epidemiología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Canadá/epidemiología , Estudios de Casos y Controles , Niño , Preescolar , Femenino , Microbiología de Alimentos , Hepatitis A/transmisión , Humanos , Lactante , Recién Nacido , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Adulto Joven
8.
Enferm. infecc. microbiol. clín. (Ed. impr.) ; 37(9): 569-573, nov. 2019. graf
Artículo en Español | IBECS | ID: ibc-189573

RESUMEN

INTRODUCCIÓN: La notificación de un caso de hepatitis A en un manipulador de alimentos de una pastelería y de 5 casos en trabajadores de una empresa tras consumir productos de la misma dio lugar a una investigación de brote. MÉTODOS: Se definieron como casos las personas con infección por el virus de la hepatitis A (VHA) confirmada por el laboratorio, con comienzo de síntomas en junio y que, durante el periodo de incubación, trabajaron con el manipulador y/o tuvieron contacto estrecho con él y/o consumieron productos de la pastelería. Se realizó una encuesta epidemiológica y se tomaron muestras de sangre para analizar la presencia de anticuerpos anti-hepatitis A. Se realizó la caracterización molecular por PCR, secuenciación de la región VP1/2A y análisis filogenético con el método de máxima verosimilitud, bootstrap 1000 (software MEGA 7.0). RESULTADOS: Se identificaron 14 casos primarios: 11 relacionados con el consumo de productos de la pastelería, 2 compañeros de trabajo del manipulador y un contacto familiar. Los 12 virus secuenciados eran genotipo IA, coincidiendo con una de las cepas (RIVM-HAV16-090) responsable de los brotes producidos en ese momento en Europa y que afectaban fundamentalmente a hombres que tienen sexo con hombres. CONCLUSIONES: Se debería reforzar la vacunación frente al VHA de grupos de riesgo para prevenir brotes futuros. La implementación del uso del tipado molecular en casos de hepatitis A podría mejorar la investigación de brotes, que se puede esperar que aumenten en el futuro debido al descenso de inmunidad en la población


INTRODUCTION: The reporting of one case of hepatitis A in a food handler at a bakery and five cases in employees of a company after consuming products from the same bakery prompted an outbreak investigation. METHODS: Outbreak cases were defined as individuals with laboratory-confirmed hepatitis A (HAV) infection, with symptoms which started in June and who, during the incubation period, worked with the food handler and/or had close contact with him and/or consumed products from the bakery. Epidemiologic questionnaires were performed and blood samples were obtained to be tested for the presence of anti-hepatitis A antibodies. Molecular characterisation was carried out by PCR, sequencing of the VP1/2A region and phylogenetic analysis with the maximum likelihood estimation method, bootstrap 1000 (MEGA 7.0 software). RESULTS: A total of 14 primary hepatitis A cases were identified: eleven cases related to the consumption of products from the bakery, two cases among co-workers of the food handler, and one case was a household contact. All 12 sequenced viruses were genotype IA, matching one of the strains (RIVM-HAV16-090) responsible for the outbreaks occurring at that time in Europe, mostly affecting men who have sex with men. CONCLUSIONS: HAV vaccination of at-risk groups should be reinforced in order to prevent future outbreaks. Increasing the use of molecular typing in hepatitis A cases could improve the investigation of outbreaks, which can be expected to increase in the future because of decreasing immunity in the population


Asunto(s)
Humanos , Masculino , Femenino , Adolescente , Adulto Joven , Adulto , Persona de Mediana Edad , Hepatitis A/epidemiología , Hepatitis A/etiología , Manipulación de Alimentos , Brotes de Enfermedades , Contaminación de Alimentos/análisis , España/epidemiología , Encuestas Epidemiológicas , Hepatitis A/transmisión , Hepatitis A/sangre , Salud Pública/métodos
9.
Am J Public Health ; 109(S4): S297-S302, 2019 09.
Artículo en Inglés | MEDLINE | ID: mdl-31505154

RESUMEN

Objectives. To identify and analyze common challenges from multiple US communities affected by the hepatitis A epidemic beginning in March 2017, and to identify operational lessons to support preparedness for similar future public health emergencies.Methods. We conducted semistructured interviews with health officials from 9 city or county health departments to collect the firsthand experience of public health responders. We collected data from January to October 2018 via teleconference. Key informants, whom we purposefully sampled, were senior public health officials who were directly involved in outbreak response or in preparing for potential hepatitis A outbreaks in their communities.Results. Several themes emerged during these discussions, including common challenges and solutions pertaining to sanitation and hygiene infrastructure, hepatitis A vaccination, health workforce availability and surge capacity, communication and stigma, and partnerships and coordination with local law enforcement and other stakeholders.Conclusions. By generating key, evidence-based operational lessons, this study can inform response activities in localities currently experiencing outbreaks as well as community preparedness for possible future outbreaks due to the presence of similar at-risk populations.


Asunto(s)
Brotes de Enfermedades/prevención & control , Hepatitis A/prevención & control , Administración en Salud Pública/métodos , Fuerza Laboral en Salud , Hepatitis A/epidemiología , Hepatitis A/transmisión , Vacunas contra la Hepatitis A/administración & dosificación , Virus de la Hepatitis A Humana , Humanos , Salud Pública/métodos , Saneamiento , Estigma Social , Estados Unidos , Vacunación
10.
Rev Med Virol ; 29(6): e2078, 2019 11.
Artículo en Inglés | MEDLINE | ID: mdl-31456241

RESUMEN

Hepatitis A (HAV) and E (HEV) viruses are able to cause liver disease in humans. Among the five classical hepatotropic viruses, they are mainly transmitted via the fecal-oral route. Historically, many similarities have thus been described between them according to their incidence and their pathogenicity, especially in countries with poor sanitary conditions. However, recent advances have provided new insights, and the gap is widening between them. Indeed, while HAV infection incidence tends to decrease in developed countries along with public health improvement, HEV is currently considered as an underdiagnosed emerging pathogen. HEV autochthonous infections are increasingly observed and are mainly associated with zoonotic transmissions. Extra hepatic signs resulting in neurological or renal impairments have also been reported for HEV, as well as a chronic carrier state in immunocompromised patients, arguing in favor of differential pathogenesis between those two viruses. Recent molecular tools have allowed studies of viral genome variability and investigation of links between viral plasticity and clinical evolution. The identification of key functional mutations in viral genomes may improve the knowledge of their clinical impact and is analyzed in depth in the present review.


Asunto(s)
Enfermedades Transmisibles Emergentes/epidemiología , Enfermedades Transmisibles Emergentes/virología , Virus de la Hepatitis A , Hepatitis A/epidemiología , Hepatitis A/virología , Virus de la Hepatitis E , Hepatitis E/epidemiología , Hepatitis E/virología , Enfermedades Transmisibles Emergentes/diagnóstico , Enfermedades Transmisibles Emergentes/transmisión , Variación Genética , Genotipo , Geografía Médica , Salud Global , Hepatitis A/diagnóstico , Hepatitis A/transmisión , Virus de la Hepatitis A/fisiología , Virus de la Hepatitis A/ultraestructura , Hepatitis E/diagnóstico , Hepatitis E/transmisión , Virus de la Hepatitis E/fisiología , Virus de la Hepatitis E/ultraestructura , Humanos , Fenotipo , Filogeografía
11.
Epidemiol Infect ; 147: e210, 2019 01.
Artículo en Inglés | MEDLINE | ID: mdl-31364560

RESUMEN

India is experiencing a substantial decrease in early childhood exposure to hepatitis A virus (HAV). Kerala has experienced several hepatitis A outbreaks in young adults/adults in the recent past. The current hepatitis outbreak occurred in Nellikuzhi, Kerala state, India in December 2016. Investigation was carried by preparing a line list of suspected hepatitis cases. The blood and stool samples collected from patients were tested for anti-HAV/anti-Hepatitis E virus (HEV) immunoglobulin (IgM) antibodies and RNA respectively. A total of 562 suspected hepatitis cases were reported during the outbreak. Along with the first case (35 years, male), 86.1% (484/562) of the cases gave history of consuming food/water/cold drinks from one restaurant. Anti-HAV IgM positivity was 74.5% (73/98) in tested samples and amongst the positives, 81% were adults/young adults and adolescents. None of the samples tested positive for anti-HEV IgM. There were three HAV associated deaths without any co-morbidity. Sequence analysis of HAV RNA positive stool samples showed the presence of genotype IIIA HAV. The suspected source of the infection was a private well situated in the premise of a restaurant. Considering increasing HAV naive population in Kerala, there is a need to introduce hepatitis A vaccine in high-risk age groups.


Asunto(s)
Transmisión de Enfermedad Infecciosa , Enfermedades Transmitidas por los Alimentos/epidemiología , Virus de la Hepatitis A/aislamiento & purificación , Hepatitis A/epidemiología , Hepatitis A/transmisión , Restaurantes , Población Rural , Adolescente , Adulto , Anciano , Niño , Preescolar , Heces/virología , Femenino , Genotipo , Anticuerpos de Hepatitis A/sangre , Virus de la Hepatitis A/clasificación , Virus de la Hepatitis A/genética , Virus de la Hepatitis A/inmunología , Humanos , Inmunoglobulina M/sangre , India/epidemiología , Masculino , Persona de Mediana Edad , ARN Viral/análisis , ARN Viral/genética , Análisis de Supervivencia , Adulto Joven
12.
Epidemics ; 29: 100351, 2019 12.
Artículo en Inglés | MEDLINE | ID: mdl-31326355

RESUMEN

A major outbreak of Hepatitis A Virus (HAV) has swept through Europe between mid-2016 and 2017, mainly within the community of men who have sex with men (MSM). Over the same period, about 1000 outbreak-related cases of acute Hepatitis A (AHA) were recorded in Lazio region, Italy. We calibrated a Bayesian model to reconstruct likely transmission events within all 44 households where multiple infections were recorded, representing a total of 103 cases from the HAV outbreak in Lazio. Based on information on the observed times of symptom onset, we estimated the probability distribution function of the HAV generation time and used it to compute the effective and instantaneous reproduction numbers for the considered outbreak from the overall epidemic curve (N = 998 cases). We estimated a mean generation time of 30.2 days (95%CI: 25.2-33.0) and an effective reproduction number of about 1.63 (95% CI: 1.35-1.94). Transmissibility peaked in January 2017, shortly before targeted awareness and vaccination campaigns were put in place by health authorities; however, transmission remained above the epidemic threshold until June 2017. Within households, children (0-15) and young adults (16-30) infected preferentially individuals of the same age class, whereas transmission within older age groups was substantially homogeneous. These results suggest that the implemented interventions were able to slow down HAV transmission, but not to bring it rapidly to a halt. According to our estimates of the HAV transmissibility, about 50% of the at-risk persons should be immunized to prevent similar outbreaks in the future. Our results also indicate spillover from community transmission to household members, suggesting the opportunity of vaccinating household contacts of cases to prevent further spread of the epidemics.


Asunto(s)
Brotes de Enfermedades , Composición Familiar , Virus de la Hepatitis A , Hepatitis A/epidemiología , Hepatitis A/transmisión , Adolescente , Adulto , Anciano , Teorema de Bayes , Niño , Preescolar , Femenino , Humanos , Lactante , Recién Nacido , Italia/epidemiología , Masculino , Persona de Mediana Edad , Vacunación , Adulto Joven
13.
Emerg Infect Dis ; 25(8): 1594-1596, 2019 08.
Artículo en Inglés | MEDLINE | ID: mdl-31310213

RESUMEN

We implemented subgenomic and whole-genome sequencing to support the investigation of a large hepatitis A virus outbreak among persons experiencing homelessness, users of illicit drugs, or both in California, USA, during 2017-2018. Genotyping data helped confirm case-patients, track chains of transmission, and monitor the effectiveness of public health control measures.


Asunto(s)
Virus de la Hepatitis A/clasificación , Virus de la Hepatitis A/genética , Hepatitis A/epidemiología , Hepatitis A/virología , Tipificación Molecular , California/epidemiología , Brotes de Enfermedades , Genotipo , Hepatitis A/historia , Hepatitis A/transmisión , Virus de la Hepatitis A/inmunología , Virus de la Hepatitis A/aislamiento & purificación , Historia del Siglo XXI , Humanos , Vigilancia en Salud Pública , Proteínas Virales/genética , Secuenciación Completa del Genoma
14.
Int J Infect Dis ; 86: 12-14, 2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-31238154

RESUMEN

OBJECTIVES: To investigate the prevalence of anti-HAV and HEV markers in order to better understand spread of these two viruses among adults in Rwanda. METHODS: Samples from 1045 and 1133 blood donors, healthy adults and liver disease patients were analysed for anti-HAV IgG and HEV markers respectively. RESULTS: Anti-HAV was present in 96.9% (1013/1045), with proportions of immune persons increasing with age. HEV infection markers were detected in 11.9% (135/1133) without differences between the three categories. Seven persons had low levels of HEV RNA including four blood donors but none of the HEV strains could be sequenced. The highest prevalence of HEV markers was in farmers and persons from the Southern (17.3%) and Western regions (18.6%), which have the national highest density of pigs. This may indicate that pigs constitute an important source of HEV infection for humans in Rwanda. CONCLUSION: HAV remains highly endemic in Rwanda, but there may now be a decline of exposure during childhood. HEV is also endemic in Rwanda, but has a moderate spread and may be transmitted by blood transfusion. Based on the geographical and occupational differences in HEV prevalence, a possible zoonotic transmission from pigs should be further explored.


Asunto(s)
Virus de la Hepatitis A/fisiología , Hepatitis A/epidemiología , Virus de la Hepatitis E/fisiología , Hepatitis E/epidemiología , Adulto , Anciano , Anciano de 80 o más Años , Animales , Donantes de Sangre/estadística & datos numéricos , Femenino , Hepatitis A/sangre , Hepatitis A/transmisión , Hepatitis A/virología , Virus de la Hepatitis A/genética , Virus de la Hepatitis A/aislamiento & purificación , Anticuerpos Antihepatitis/sangre , Hepatitis E/sangre , Hepatitis E/transmisión , Hepatitis E/virología , Virus de la Hepatitis E/genética , Virus de la Hepatitis E/aislamiento & purificación , Humanos , Masculino , Persona de Mediana Edad , Prevalencia , Rwanda/epidemiología , Estudios Seroepidemiológicos , Porcinos , Enfermedades de los Porcinos/epidemiología , Enfermedades de los Porcinos/virología , Adulto Joven , Zoonosis/sangre , Zoonosis/epidemiología , Zoonosis/virología
15.
Hepatology ; 70(6): 1892-1902, 2019 12.
Artículo en Inglés | MEDLINE | ID: mdl-31100186

RESUMEN

Hepatitis A virus (HAV) and hepatitis E virus (HEV) share the similar fecal-oral transmission route. During an outbreak of sexually transmitted acute hepatitis A among men who have sex with men (MSM) worldwide between 2015 and 2017, we investigated the possibility of sexual transmission and related morbidity of HEV infection among human immunodeficiency virus (HIV)-positive patients. From March 1, 2015 to August 31, 2017, anti-HEV immunoglobulin G was retrospectively determined among 3,293 HIV-positive patients, who were mainly MSM (87.6%) with a median CD4 count of 575 cells/µL. Prevalence and incidence of HEV infection were 3.7% (123 of 3,293) and 4.35 per 1,000 person-years of follow-up (PYFU), respectively, which were significantly lower compared with those of HAV infection (31.1% [996 of 3,204] and 12.61 per 1,000 PYFU, respectively). The number of patients with HEV infection did not increase with the hepatitis A epidemic. The factor associated with prevalent HEV infection was older age (per 1-year increase, adjusted odds ratio, 1.07; 95% confidence interval, 1.05-1.09), but neither sexual orientation nor acquisition of sexually transmitted infections was related to prevalent or incident HEV infection. Among 23 patients with incident HEV infection, 22 patients had viremia caused by HEV genotype 4. No patients had prolonged HEV viremia or clinical symptoms, and only a mild elevation of serum aminotransferase, ranging from 34 to 77 IU/L, was noted. Although 4 patients had hepatitis for a prolonged duration of between 8 and 17 months, no abdominal imaging revealed liver fibrosis or cirrhosis. Conclusion: HEV endemicity remained low among HIV-positive patients in Taiwan during the outbreak of acute hepatitis A. Our data suggest that sexual transmission of HEV with significant morbidity of HEV infection, if any, is rare in this population.


Asunto(s)
Infecciones por VIH/virología , Hepatitis A/epidemiología , Hepatitis E/epidemiología , Enfermedad Aguda , Adulto , Brotes de Enfermedades , Femenino , Hepatitis A/transmisión , Hepatitis E/transmisión , Humanos , Masculino , Persona de Mediana Edad , Taiwán/epidemiología
16.
Viruses ; 11(3)2019 03 20.
Artículo en Inglés | MEDLINE | ID: mdl-30897727

RESUMEN

Hepatitis A virus (HAV) outbreaks among men who have sex with men (MSM) have been reported worldwide and associated primarily with sexual transmission through oral-anal sex. Here, we provide the molecular and evolutionary description of a European strain, linked to HAV outbreaks among MSM, detected in a Brazilian homosexual couple. Bayesian analysis provided evidence that the viral isolates were introduced in Brazil from Spain between the end of 2016 and the beginning of 2017.


Asunto(s)
Brotes de Enfermedades , Virus de la Hepatitis A/genética , Hepatitis A/transmisión , Homosexualidad Masculina , Adulto , Anticuerpos Antivirales/sangre , Teorema de Bayes , Brasil , Evolución Molecular , Hepatitis A/diagnóstico , Hepatitis A/inmunología , Virus de la Hepatitis A/inmunología , Humanos , Masculino , Factores de Riesgo , España/epidemiología
17.
Epidemiol Infect ; 147: e105, 2019 01.
Artículo en Inglés | MEDLINE | ID: mdl-30869039

RESUMEN

The public health response to sporadic hepatitis A virus (HAV) infection, hepatitis A, can be complex especially when the index case is a child and no obvious source is identified. Identifying an infection source may avoid mass immunisation within schools when transmission is found to have occurred within the household. Screening of asymptomatic contacts via venepuncture can be challenging and unacceptable, as a result non-invasive methods may facilitate public health intervention. Enzyme-linked immunoassays were developed to detect HAV immunoglobulin M (IgM) and immunoglobulin G (IgG) in oral fluid (ORF). A validation panel of ORF samples from 30 confirmed acute HAV infections were all reactive for HAV IgM and IgG when tested. A panel of 40 ORF samples from persons known to have been uninfected were all unreactive. Two hundred and eighty household contacts of 72 index cases were screened by ORF to identify HAV transmission within the family and factors associated with household transmission. Almost half of households (35/72) revealed evidence of recent infection, which was significantly associated with the presence of children ⩽11 years of age (odds ratio 9.84, 95% confidence interval: 2.74-35.37). These HAV IgM and IgG immunoassays are easy to perform, rapid and sensitive and have been integrated into national guidance on the management of hepatitis A cases.


Asunto(s)
Virus de la Hepatitis A/aislamiento & purificación , Hepatitis A/transmisión , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Preescolar , Composición Familiar , Femenino , Humanos , Inmunoglobulina G/análisis , Inmunoglobulina M/análisis , Lactante , Recién Nacido , Masculino , Persona de Mediana Edad , Adulto Joven
18.
Enferm Infecc Microbiol Clin ; 37(9): 569-573, 2019 Nov.
Artículo en Inglés, Español | MEDLINE | ID: mdl-30876672

RESUMEN

INTRODUCTION: The reporting of one case of hepatitis A in a food handler at a bakery and five cases in employees of a company after consuming products from the same bakery prompted an outbreak investigation. METHODS: Outbreak cases were defined as individuals with laboratory-confirmed hepatitis A (HAV) infection, with symptoms which started in June and who, during the incubation period, worked with the food handler and/or had close contact with him and/or consumed products from the bakery. Epidemiologic questionnaires were performed and blood samples were obtained to be tested for the presence of anti-hepatitis A antibodies. Molecular characterisation was carried out by PCR, sequencing of the VP1/2A region and phylogenetic analysis with the maximum likelihood estimation method, bootstrap 1000 (MEGA 7.0 software). RESULTS: A total of 14 primary hepatitis A cases were identified: eleven cases related to the consumption of products from the bakery, two cases among co-workers of the food handler, and one case was a household contact. All 12 sequenced viruses were genotype IA, matching one of the strains (RIVM-HAV16-090) responsible for the outbreaks occurring at that time in Europe, mostly affecting men who have sex with men. CONCLUSIONS: HAV vaccination of at-risk groups should be reinforced in order to prevent future outbreaks. Increasing the use of molecular typing in hepatitis A cases could improve the investigation of outbreaks, which can be expected to increase in the future because of decreasing immunity in the population.


Asunto(s)
Brotes de Enfermedades , Manipulación de Alimentos , Microbiología de Alimentos , Hepatitis A/epidemiología , Adolescente , Adulto , Trazado de Contacto , Femenino , Genotipo , Hepatitis A/transmisión , Anticuerpos de Hepatitis A/sangre , Vacunas contra la Hepatitis A , Virus de la Hepatitis A/genética , Virus de la Hepatitis A/inmunología , Virus de la Hepatitis A/aislamiento & purificación , Humanos , Control de Infecciones/métodos , Masculino , Persona de Mediana Edad , Filogenia , Estudios Seroepidemiológicos , España/epidemiología , Vacunación , Adulto Joven
19.
Top Antivir Med ; 26(4): 117-121, 2019 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-30641485

RESUMEN

The recent hepatitis A virus (HAV) outbreak in San Diego was driven by homelessness, associated sanitation conditions, and illicit drug use. As with an outbreak in Michigan, fueled by similar factors, morbidity and mortality were higher than what has been observed with post-vaccine era foodborne HAV outbreaks. Control of the outbreak in San Diego was accomplished with vaccine, sanitation, and education initiatives that targeted those at highest risk. Mass vaccination events and mobile foot teams and vans brought education and vaccine to high-risk individuals in affected areas. The homelessness crisis in San Diego and in many locales throughout the United States poses risk of increasing numbers of outbreaks of HAV and other infectious illnesses. This article summarizes an IAS-USA continuing education webinar given by Darcy A. Wooten, MD, on July 19, 2018.


Asunto(s)
Control de Enfermedades Transmisibles/métodos , Brotes de Enfermedades , Transmisión de Enfermedad Infecciosa/prevención & control , Hepatitis A/epidemiología , Terapia Conductista , California/epidemiología , Educación en Salud , Hepatitis A/mortalidad , Hepatitis A/transmisión , Vacunas contra la Hepatitis A/administración & dosificación , Humanos
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