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1.
Infect Dis Poverty ; 8(1): 80, 2019 Oct 03.
Artigo em Inglês | MEDLINE | ID: mdl-31578150

RESUMO

BACKGROUND: Hepatitis A (HepA) vaccination and economic transitions can change the epidemiology of HepA. China's Gross Domestic Product (GDP) per capita was known to be inversely associated with the incidence of HepA, but a deeper understanding of the epidemiology of HepA in different socio-economic regions is lacking. We compare the changing epidemiology of HepA in three socioeconomic-geographic regions of China. METHODS: We obtained data on all HepA cases reported through the National Notifiable Disease Reporting System and assessed trends and changes in age-specific incidence rates by age quartile and season. We categorized the country into three regions, the sequential years into five era, compared the incidence, quartile age, seasonal intensity and coverage of HepA of the three regions. Linear regression was performed to analyse trends in incidence of HepA and to analyse the association between coverage and incidence. RESULTS: The annual mean incidences of HepA in the eastern, central, and western regions decreased from 63.52/100 000, 50.57/100 000 and 46.39/100 000 in 1990-1992 to 1.18/100 000, 1.05/100 000 and 3.14/100 000 in 2012-2017, respectively. Decreases in incidence were seen in all age groups in the three regions; the incidence was highest (9.3/100 000) in the youngest age group (0-4 years) of the western region, while in the central region, the age group with the highest incidence changed from 0 to 9 years to adults ≥60 years old. In 2017, the median age of HepA cases was 43 years (Q1-Q3: 33-55), 47 years (Q1-Q3: 32-60) and 33 years (Q1-Q3: 9-52) in the eastern, central, and western provinces, respectively. Seasonal peaks became smaller or were nearly elimination nationwide, but seasonality persisted in some provinces. After the Expanded Program on Immunization (EPI) included HepA vaccine into the routine schedule in 2007, HepA coverage increased to > 80% in the three regions and was negatively association with the HepA incidence. CONCLUSION: The incidence of HepA decreased markedly between 1990 and 2017. A socioeconomic inequity in coverage of HepA vaccine was almost eliminated after HepA vaccine was introduced into China's EPI system, but inequity in incidence still existed in lower socio-economic developed region.


Assuntos
Vacinas contra Hepatite A/administração & dosagem , Hepatite A/epidemiologia , Programas de Imunização/estatística & dados numéricos , Fatores Socioeconômicos , Vacinação/estatística & dados numéricos , China/epidemiologia , Geografia , Hepatite A/virologia , Incidência , Estudos Longitudinais , Estações do Ano , Fatores de Tempo
2.
Food Environ Virol ; 11(4): 393-399, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31420848

RESUMO

Enteroviruses (EVs) and Hepatitis A Viruses (HAVs) are human pathogens with a wide spectrum of clinical manifestations. The monitoring of sewage samples enables to monitor the EVs and HAVs in circulation among the general population and recognize possible outbreaks. This study focused on the molecular characterization and phylogenetic analysis of the EVs and HAVs identified in 33 sewage samples collected every 15 days at the influent of a wastewater treatment plant located in Northern Italy from March to October 2016. According to the results of the molecular characterization, the most frequently identified viruses were Echovirus 6 (E-6), E-11 and HAV-IA. The phylogenetic analyses indicated the rapid genetic evolution of E-6 and E-1; noteworthy, most E-11 strains clustered with a strain isolated from a clinical sample collected in the same geographical area over the same period by our laboratory. Most of the HAV strains detected clustered with epidemic HAV-IA strains identified during the European hepatitis A outbreak that occurred in 2016-2017 affecting men who have sex with men (MSM). The detection of environmental HAV strains before and at the beginning of its spread amongst humans demonstrated that this outbreak could have been predicted by monitoring sewage samples. Moreover, conducting a genetic comparison between the HAV and EV strains identified in sewage and clinical samples may improve knowledge of viral epidemiology. EV and HAV molecular environmental surveillance may prove useful for identifying viral circulation and for issuing early warning alerts on possible outbreaks among the human population.


Assuntos
Infecções por Enterovirus/virologia , Enterovirus/genética , Vírus da Hepatite A/genética , Hepatite A/virologia , Filogenia , Esgotos/virologia , Enterovirus/classificação , Enterovirus/isolamento & purificação , Infecções por Enterovirus/epidemiologia , Hepatite A/epidemiologia , Vírus da Hepatite A/classificação , Vírus da Hepatite A/isolamento & purificação , Humanos , Itália/epidemiologia
4.
Emerg Infect Dis ; 25(8): 1594-1596, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31310213

RESUMO

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.


Assuntos
Vírus da Hepatite A/classificação , Vírus da Hepatite A/genética , Hepatite A/epidemiologia , Hepatite A/virologia , Tipagem Molecular , California/epidemiologia , Surtos de Doenças , Genótipo , Hepatite A/história , Hepatite A/transmissão , Vírus da Hepatite A/imunologia , Vírus da Hepatite A/isolamento & purificação , História do Século XXI , Humanos , Vigilância em Saúde Pública , Proteínas Virais/genética , Sequenciamento Completo do Genoma
5.
New Microbiol ; 42(3): 181-183, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31157402

RESUMO

From April to October 2017, 27 cases of Hepatitis A (HA), 22 male and 5 female, were reported in Cosenza (South Italy). The median age of cases was 32 years (range 3-49 years). Out of 21 male adults, 14 were identified as men who have sex with men (MSM). Phylogenetic analysis was conducted in 15 cases and revealed two distinct sequences of genotype IA linking to clusters recognised in MSM in other European countries in 2016; genotype IB was recognized in only 2 cases. The report confirms that HA is an emerging issue among MSM. As suggested by the WHO, in countries with low HAV circulation, vaccination programmes should be tailored on local epidemiological patterns to prevent outbreaks among high risk groups and eventual spill-over of the infection into the general population.


Assuntos
Surtos de Doenças , Hepatite A , Minorias Sexuais e de Gênero , Adolescente , Adulto , Criança , Pré-Escolar , Feminino , Genótipo , Hepatite A/epidemiologia , Hepatite A/virologia , Vírus da Hepatite A Humana/classificação , Vírus da Hepatite A Humana/genética , Humanos , Itália/epidemiologia , Masculino , Pessoa de Meia-Idade , Tipagem Molecular , Filogenia , Adulto Jovem
6.
Int J Infect Dis ; 86: 12-14, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31238154

RESUMO

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.


Assuntos
Vírus da Hepatite A/fisiologia , Hepatite A/epidemiologia , Vírus da Hepatite E/fisiologia , Hepatite E/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Animais , Doadores de Sangue/estatística & dados numéricos , Feminino , Hepatite A/sangue , Hepatite A/transmissão , Hepatite A/virologia , Vírus da Hepatite A/genética , Vírus da Hepatite A/isolamento & purificação , Anticorpos Anti-Hepatite/sangue , Hepatite E/sangue , Hepatite E/transmissão , Hepatite E/virologia , Vírus da Hepatite E/genética , Vírus da Hepatite E/isolamento & purificação , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Ruanda/epidemiologia , Estudos Soroepidemiológicos , Suínos , Doenças dos Suínos/epidemiologia , Doenças dos Suínos/virologia , Adulto Jovem , Zoonoses/sangue , Zoonoses/epidemiologia , Zoonoses/virologia
7.
BMC Infect Dis ; 19(1): 443, 2019 May 21.
Artigo em Inglês | MEDLINE | ID: mdl-31113369

RESUMO

BACKGROUND: Hepatitis A Virus (HAV) is one of the most common food and water borne infectious disease prevailing globally. The objective of the study was to determine sero-prevalence of HAV infection in a district of Sri Lanka. METHODS: This was a descriptive cross sectional study conducted on 1403 participants aged 1 year and above selected by multistage stratified (for age group and area of residence) cluster sampling from September 2015 to December, 2016. An interviewer-administered questionnaire was used to collect data and Anti-IgG testing was done to determine sero-positivity. The overall, the age and sex specific sero-prevalence of HAV were calculated with 95% confidence intervals (CI). RESULTS: Of the 1403 participants 1132 were anti HAV IgG positive. Therefore the overall sero-prevalence of HAV infection was 80.7% (95%CI: 78.64-82.76). There were 283 (20.2%) individuals below the age group of 14 years and below and out of them, 204 had anti HAV IgG, therefore sero-prevalence was 72.1% for that age group. The age group 15 years and aboe comprised of 1120 (79.8%) participants and of them 928 had anti HAV IgG, making sero-prevalence 82.9%. The lowest sero-prevalence (66.9%, n = 232) was observed in the age group of 11-20 years followed by 21-30 age group. From age 31 years onwards, the sero-prevalence exceeded 90%, reaching 100% after 71 years. The urban population showed a sero-prevalence of 83% (n = 195) and 80.2% (n = 937) for the rural sector while females had a sero-prevalence of 82.2% (n = 766) and it was 77.7% (n = 366) for males. Thirty-four (3.0%) participants who had sero-positive results (n = 1132) claimed that they have had HAV in the past. CONCLUSIONS: Overall, four fifth of the population was immune to HAV infection in the district of Gampaha.


Assuntos
Vírus da Hepatite A/isolamento & purificação , Hepatite A/epidemiologia , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Estudos Transversais , Feminino , Hepatite A/sangue , Hepatite A/imunologia , Hepatite A/virologia , Anticorpos Anti-Hepatite A/sangue , Anticorpos Anti-Hepatite A/imunologia , Vírus da Hepatite A/genética , Vírus da Hepatite A/imunologia , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Prevalência , População Rural/estatística & dados numéricos , Estudos Soroepidemiológicos , Sri Lanka/epidemiologia , População Urbana/estatística & dados numéricos , Adulto Jovem
8.
S Afr Med J ; 109(5): 314-318, 2019 Apr 29.
Artigo em Inglês | MEDLINE | ID: mdl-31131797

RESUMO

BACKGROUND: Hepatitis A virus (HAV) is the most common cause of viral hepatitis worldwide. Hepatitis A vaccine is not included in the Expanded Programme on Immunisation in South Africa (EPI-SA), as the country is considered to be highly endemic for hepatitis A. OBJECTIVES: To determine the seroprevalence of hepatitis A infection in Western Cape Province (WCP), South Africa. METHODS: We conducted a cross-sectional seroprevalence study in the 1 - 7-year age group in WCP. Our samples (N=482) were blood specimens left over after laboratory testing obtained from referral hospitals between August and October 2015. A Siemens enzyme immunoassay was used to test for total hepatitis A antibodies. We also analysed hepatitis A immunoglobulin G antibody results from the National Health Laboratory Service (NHLS) Disa*Lab database at Groote Schuur Hospital from 2009 to 2014, and included 2009 - 2014 acute hepatitis A (immunoglobulin M-positive) surveillance data from the National Institute for Communicable Diseases to look at trends in notified acute infections over the same period. RESULTS: Our cross-sectional study showed 44.1% seroprevalence in the 1 - 7-year age group. Hepatitis A data from the NHLS database indicated a seroprevalence of <90% up to age 10 years, indicating intermediate endemicity. The surveillance data showed that a substantial number of symptomatic hepatitis A infections occurred in the 7 - 40-year age group, suggesting that an increasing proportion of the population is susceptible to HAV infection. CONCLUSIONS: These results suggest an urgent need for detailed evidence-based considerations to introduce hepatitis A vaccine into the EPI-SA.


Assuntos
Anticorpos Anti-Hepatite A/análise , Vírus da Hepatite A/imunologia , Hepatite A/epidemiologia , Criança , Pré-Escolar , Estudos Transversais , Feminino , Hepatite A/virologia , Humanos , Incidência , Lactente , Masculino , Estudos Retrospectivos , Fatores de Risco , Estudos Soroepidemiológicos , África do Sul/epidemiologia
9.
Am J Trop Med Hyg ; 101(1): 230-232, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31115307

RESUMO

Hepatitis E virus (HEV) infection is associated with a high fatality rate among pregnant women, and gestational complications have been reported among pregnant women infected with hepatitis A virus (HAV). The aim of this study was to determine the seroprevalence of HAV and HEV infections among pregnant women in Haiti. We stratified the population (n = 1,307) between West and non-West regions. Specimens were tested for total HAV antibody (anti-HAV), and IgM and IgG HEV antibody (anti-HEV). Overall, 96.8% pregnant women were positive for total anti-HAV, 10.3% for IgG anti-HEV, and 0.3% for IgM anti-HEV. The prevalence of IgG anti-HEV in the non-West region (12.3%) was significantly greater than that in the West region (5.3%) (P < 0.0001). Most pregnant women in Haiti had evidence of past exposure and immunity to HAV. The non-West region had a higher prevalence of HEV. Improvement in water and sanitation will help in the prevention and control of these infections in Haiti.


Assuntos
Hepatite A/epidemiologia , Hepatite E/epidemiologia , Complicações Infecciosas na Gravidez/epidemiologia , Complicações Infecciosas na Gravidez/virologia , Adolescente , Adulto , Anticorpos Antivirais/sangue , Feminino , Haiti/epidemiologia , Hepatite A/sangue , Hepatite A/virologia , Vírus da Hepatite A/imunologia , Hepatite E/sangue , Hepatite E/virologia , Vírus da Hepatite E/genética , Vírus da Hepatite E/imunologia , Humanos , Imunoglobulina G/sangue , Gravidez , Estudos Soroepidemiológicos
10.
Int J Infect Dis ; 82: 129-134, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30862519

RESUMO

OBJECTIVES: The hepatitis A vaccine (HepA) has been included in the national expanded program on immunization (EPI) in China since 2008. This study was performed to evaluate the change in dynamics of the seroepidemiology of hepatitis A virus (HAV) before and after the introduction of the program. METHODS: The trends in seroepidemiology of anti-HAV antibodies were examined in Shandong Province, China, drawing on two population-based samples of persons aged 1-59 years, one obtained in the year 2006 (n = 6682) and the other in 2014 (n = 5095). RESULTS: A dramatic increase in seroprevalence of anti-HAV antibodies from 30.76% (95% confidence interval (CI) 26.24-35.28%) to 77.46% (95% CI 74.04-80.87%) among children aged 1.5-7 years (born after HepA was recommended for routine childhood immunization), as well as an increase from 35.32% (95% CI 29.31-41.33%) to 66.69% (95% CI 55.59-77.80%) in subjects aged 8-14 years, was observed in 2014 when compared with 2006. By contrast, a decline in seroprevalence among subjects aged 15-29 years, as seen particularly in those 20-29 years of age, from 85.72% (95% CI 80.29-91.14%) to 69.24% (95% CI 62.02-76.45%), was found in this study. There was no statistically significant difference in seroprevalence between 2006 and 2014 among the subjects older than 30 years of age. CONCLUSIONS: The national HepA routine immunization program has had a positive effect, leading to an increase in anti-HAV seroprevalence among children in Shandong Province, China. More attention should be paid to young adults in the province.


Assuntos
Anticorpos Anti-Hepatite A/sangue , Vacinas contra Hepatite A/imunologia , Vírus da Hepatite A/imunologia , Hepatite A/epidemiologia , Programas de Imunização , Vacinação , Adolescente , Adulto , Criança , Pré-Escolar , China/epidemiologia , Feminino , Hepatite A/prevenção & controle , Hepatite A/virologia , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Estudos Soroepidemiológicos , Adulto Jovem
11.
Food Environ Virol ; 11(2): 149-156, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-30868371

RESUMO

Hepatitis A (HAV) is a viral infection causing a range of symptoms, sudden onset of fever, malaise, diarrhea, and jaundice. It is mostly transmitted fecal-oral through contaminated food, with immediate household and sexual contacts having a higher risk of infection. Since 2016 an increased number of HAV infections, mostly affecting men who have sex with men (MSM) have been noticed worldwide, with three main genotypes circulating. We report here on the first spillover outbreak of the MSM-associated HAV genotype RIVM-HAV16-090 in the German general population in November 2017-February 2018. In total, twelve cases could be attributed to the outbreak with the index case and a coworker in a butchers shop being the most probable source of the outbreak. The identical HAV genotype was detected in two environmental samples in the premises of the butchers shop and in nine cases. Outbreak control measures included detailed contact tracing and stool examinations, several environmental investigations, thorough cleaning, and disinfection of the premises of the butchers shop. Post-exposure vaccination was recommended to all unprotected contacts during the investigation. Furthermore, although hand-washing facilities were in accordance with the required law, additional installment of soap and disinfectant dispensers and contactless faucets has been recommended.


Assuntos
Vírus da Hepatite A/isolamento & purificação , Hepatite A/virologia , Homossexualidade Masculina/estatística & dados numéricos , Adulto , Criança , Pré-Escolar , Surtos de Doenças , Feminino , Manipulação de Alimentos , Genótipo , Alemanha , Desinfecção das Mãos , Hepatite A/epidemiologia , Vírus da Hepatite A/classificação , Vírus da Hepatite A/genética , Humanos , Masculino , Pessoa de Meia-Idade , Filogenia
12.
Food Environ Virol ; 11(2): 178-183, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-30747345

RESUMO

Although the effects of heavy metals on the behavior, including infectivity, of bacteria have been studied, little information is available about their effects on enteric viruses. We report an investigation of effects on the biosynthesis of human adenoviruses (HAdV) and hepatitis A (HAV) of waters contaminated with mineral waste following an environmental disaster in Mariana City, Minas Gerais State, Brazil. The study area was affected on November 5, 2015, by 60 million m3 of mud (containing very high concentrations of iron salts) from a mining reservoir (Fundão), reaching the Gualaxo do Norte River (sites evaluated in this study), the "Rio Doce" River and finally the Atlantic Ocean. We found substantial counts of infectious HAdV and HAV (by qPCR) in all sampled sites from Gualaxo do Norte River, indicating poor basic sanitation in this area. The effects of iron on viral infection processes were evaluated using HAdV-2 and HAV-175, as DNA and RNA enteric virus models, respectively, propagated in the laboratory and exposed to this contaminated water. Experiments in field and laboratory scales found that the numbers of plaque forming units (PFU) of HAdV and HAV were significantly higher in contaminated water with high iron concentrations than in waters with low iron concentration (< 20 µg/L of iron). These findings indicate that iron can potentiate enteric virus infectivity, posing a potential risk to human and animal health, particularly during pollution disasters such as that described here in Mariana, Brazil.


Assuntos
Adenovírus Humanos/crescimento & desenvolvimento , Vírus da Hepatite A/crescimento & desenvolvimento , Ferro/análise , Minerais/análise , Rios/virologia , Infecções por Adenovirus Humanos/virologia , Adenovírus Humanos/genética , Adenovírus Humanos/isolamento & purificação , Adenovírus Humanos/metabolismo , Brasil , Enterovirus/genética , Enterovirus/crescimento & desenvolvimento , Enterovirus/isolamento & purificação , Enterovirus/metabolismo , Monitoramento Ambiental , Hepatite A/virologia , Vírus da Hepatite A/genética , Vírus da Hepatite A/isolamento & purificação , Vírus da Hepatite A/metabolismo , Humanos , Ferro/metabolismo , Mineração , Rios/química , Poluição da Água
13.
Ann Saudi Med ; 39(1): 37-41, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30712049

RESUMO

BACKGROUND: Since routine immunization could change the epidemiological profile of hepatitis A virus (HAV) infection in the future, it is important to determine the baseline immunity to HAV across Turkey. OBJECTIVE: The aim of this study was to determine the seroprevalence of hepatitis A among individuals 6 years of age and older in Yozgat, Turkey. DESIGN: Cross-sectional. SETTING: Community in central region of Turkey. PATIENTS AND METHODS: Questionnaires and blood specimens were collected and the presence of hepatitis A IgG antibodies against hepatitis A virus was determined quantitatively by ELISA. MAIN OUTCOME MEASURES: The rates of hepatitis A immunity by age group. SAMPLE SIZE: 1862. RESULTS: Immunity to hepatitis A was 79.1% (n=1473). The mean (SD) age was 17.1 (14.7) years in the nonimmune group and 37.8 (19.5) years in the immune group (P less than .001), and immunity increased with age. No significant difference in immunity rate was detected between gen.ders in children and adults. The seropositivity rate for subjects ages 6-19 years was lower than in subjects aged 20-96 years (52.2% versus 93.9%; P less than .001). CONCLUSION: A catch-up vaccination program is needed for persons aged 6-19 years in Yozgat. LIMITATIONS: Single region data which can not be generalized. For this reason, a multi-centered study that can reflect the whole country is recommended. CONFLICT OF INTEREST: None.


Assuntos
Anticorpos Anti-Hepatite A/sangue , Vacinas contra Hepatite A/uso terapêutico , Vírus da Hepatite A/imunologia , Hepatite A/epidemiologia , Vacinação/estatística & dados numéricos , Adolescente , Adulto , Criança , Estudos Transversais , Ensaio de Imunoadsorção Enzimática , Feminino , Hepatite A/prevenção & controle , Hepatite A/virologia , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Soroepidemiológicos , Turquia/epidemiologia , Adulto Jovem
14.
Sex Transm Infect ; 95(1): 75-77, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-29886426

RESUMO

OBJECTIVES: Since February 2017, an increase of acute hepatitis A (AHA) cases has been notified in North of France. We aimed to report clinical and virological features of 49 cases treated in three hospitals in Lille European Metropolis (LEM). METHODS: All adult patients treated for AHA in 3 LEM hospitals between 20 February and 5 July 2017 were included. Demographic characteristics, exposure risk factors to hepatitis A virus (HAV), AHA manifestations and concomitant sexually transmitted infections (STI) were retrospectively recorded. RESULTS: Forty-nine cases of AHA were diagnosed among which 34 (69%) were hospitalised. Severe AHA occurred in 7 (14%) patients. The median age of cases was 36 years. All cases except 1 were men and 32 (65%) were identified as men having sex with men (MSM). Eleven (23%) patients were HIV-infected, 5 were under HIV pre-exposure prophylaxis (PrEP), 6 had a history of HIV postexposure prophylaxis and 19 had a history of at least one STI. Only three patients had received HAV vaccine. Proportion of patients tested for syphilis, chlamydial and gonococcal infections was 75% (18/24) in those seen by sexual health specialists and 21% (6/29) in those seen by other specialists. At least one concomitant STI was diagnosed in 13 out of 24 tested patients (54%). RT-PCR sequencing was available for 38 cases and confirmed co-circulation of 3 different strains of subgenotype IA (VRD 521 2016: n=24, RIVM-HAV16-090: n=13, V16-25801: n=1), already identified in several European countries. CONCLUSIONS: We are facing an outbreak of AHA among MSM in the North of France with a high rate of hospitalisation. Analysis of cases highlighted missed opportunities of vaccination and lack of concomitant STI screening. Awareness among healthcare providers and MSM should be increased and HAV vaccination promoted.


Assuntos
Surtos de Doenças , Hepatite A/epidemiologia , Minorias Sexuais e de Gênero , Doenças Sexualmente Transmissíveis/epidemiologia , Doença Aguda , Adulto , Infecções por Chlamydia/epidemiologia , Coinfecção/epidemiologia , França/epidemiologia , Genótipo , Gonorreia/epidemiologia , Hepatite A/fisiopatologia , Hepatite A/virologia , Vírus da Hepatite A/genética , Humanos , Masculino , Pessoa de Meia-Idade , RNA Viral/genética , Estudos Retrospectivos , Fatores de Risco , Índice de Gravidade de Doença , Sífilis/epidemiologia
15.
Jpn J Infect Dis ; 72(1): 44-48, 2019 Jan 23.
Artigo em Inglês | MEDLINE | ID: mdl-30270252

RESUMO

In a cluster of hepatitis A infections that occurred in Nagano Prefecture in 2017, hepatitis A virus (HAV) was detected in asari clams (reference food) and the patients' fecal samples. Initially, the asari clams were suspected to be the infection source. However, the exact infection route remained unknown because a patient who had not consumed an asari clam dish also developed the disease. Suspecting a secondary infection originating from the asari clams, we investigated the presence of HAV genomes in water used for washing and soaking the frozen asari clams and detected HAV in the soaking water. These results suggest that soaking water is a risk factor for secondary contamination because of the leakage of HAV accumulated in midgut gland of the asari clam. During the asari clam sand removal process, the water used to clean asari clams spread across a wide area in a concentric fashion, raising concerns that this process may aggravate contamination. In addition to HAV, diarrhea viruses, such as norovirus, have often been detected in bivalves, including asari clams. Thus, handling these foodstuffs requires adequate care.


Assuntos
Bivalves/virologia , Microbiologia de Alimentos , Vírus da Hepatite A/fisiologia , Hepatite A/transmissão , Alimentos Marinhos/virologia , Águas Residuárias/virologia , Animais , Fezes/virologia , Genoma Viral/genética , Hepatite A/diagnóstico , Hepatite A/virologia , Humanos , Japão , RNA Viral/genética , Águas Residuárias/análise
16.
EBioMedicine ; 39: 348-357, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30472089

RESUMO

BACKGROUND: A huge outbreak in the men-having-sex-with-men (MSM) has hit Europe during the years 2016-2018. Outbreak control has been hampered by vaccine shortages in many countries, and to minimize their impact, reduction of antigen doses has been implemented. However, these measures may have consequences on the evolution of hepatitis A virus (HAV), leading to the emergence of antigenic variants. Cases in vaccinated MSM patients have been detected in Barcelona, opening the possibility to study HAV evolution under immune pressure. METHODS: We performed deep-sequencing analysis of ten overlapping fragments covering the complete capsid coding region of HAV. A total of 14578255 reads were obtained and used for the analysis of virus evolution in vaccinated versus non-vaccinated patients. We estimated maximum and minimum mutation frequencies, and Shannon entropy in the quasispecies of each patient. Non-synonymous (NSyn) mutations affecting residues exposed in the capsid surface were located, with respect to epitopes, using the recently described crystal structure of HAV, as an indication of its potential role in escaping to the effect of vaccines. FINDINGS: HAV evolution at the quasispecies level, in non-vaccinated and vaccinated patients, revealed higher diversity in epitope-coding regions of the vaccinated group. Although amino acid replacements occurring in and around the epitopes were observed in both groups, their abundance was significantly higher in the quasispecies of vaccinated patients, indicating ongoing processes of fixation. INTERPRETATION: Our data suggest positive selection of antigenic variants in some vaccinated patients, raising concerns for new vaccination polices directed to the MSM group.


Assuntos
Proteínas do Capsídeo/genética , Vírus da Hepatite A/imunologia , Hepatite A/epidemiologia , Sequenciamento de Nucleotídeos em Larga Escala/métodos , Mutação , Adulto , Proteínas do Capsídeo/imunologia , Surtos de Doenças , Europa (Continente)/epidemiologia , Evolução Molecular , Hepatite A/imunologia , Hepatite A/virologia , Antígenos da Hepatite A/genética , Antígenos da Hepatite A/metabolismo , Vírus da Hepatite A/genética , Homossexualidade Masculina , Humanos , Masculino , Pessoa de Meia-Idade , Quase-Espécies , Análise de Sequência de RNA/métodos , Vacinação
17.
19.
Saudi J Kidney Dis Transpl ; 29(6): 1498-1501, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30588986

RESUMO

Hepatitis A is usually a benign self-limiting disease with few or no extrahepatic manifestations. Acute hepatitis A causing severe renal dysfunction is not very common, although described. Patients developing renal dysfunction post hepatitis A infection usually have prerenal acute kidney injury (AKI) or acute tubular necrosis due to vomiting, diarrhea, and poor fluid replacement. However, if renal dysfunction persists, other causes need to be evaluated. The term cholemic nephrosis or more specifically bile cast nephropathy has been described in the setting of cholestatic jaundice and decompensated liver failure where bilirubin levels reach above 20 mg/dL. Herein, we describe the clinical course of a patient who developed acute hepatitis A with severe liver dysfunction and subsequently AKI which persisted for six weeks. Renal biopsy showed the evidence of bile cast nephropathy. After six weeks of hemodialysis, urine output improved. He slowly recovered both hepatic and renal functions.


Assuntos
Lesão Renal Aguda/etiologia , Bile/metabolismo , Hepatite A/complicações , Icterícia/etiologia , Insuficiência Renal/etiologia , Doença Aguda , Lesão Renal Aguda/diagnóstico , Lesão Renal Aguda/metabolismo , Lesão Renal Aguda/terapia , Adulto , Biópsia , Hepatite A/diagnóstico , Hepatite A/virologia , Humanos , Icterícia/diagnóstico , Icterícia/metabolismo , Icterícia/terapia , Masculino , Insuficiência Renal/diagnóstico , Insuficiência Renal/metabolismo , Insuficiência Renal/terapia , Resultado do Tratamento
20.
Ann Agric Environ Med ; 25(4): 708-713, 2018 Dec 20.
Artigo em Inglês | MEDLINE | ID: mdl-30586962

RESUMO

INTRODUCTION: Molecular studies have confirmed the silent circulation of enterovirus (EntV) and hepatitis A virus in the environment, even in the absence of clinical manifestation. Viral pathogens are among the major causes of disease outbreaks, particularly in the bigger cities and both in the developed and underdeveloped nations. MATERIAL AND METHODS: Between June 2016 - June 2017, 97 samples of drinking water, river water polluted with sewage and blood were selected and obtained from high risk communities in Pakistan. Negatively charged membrane filters were used to concentrate the virus, followed by the use of specific PCR primers set for quick identification of the waterborne viruses. RESULTS: Enteroviruses were recovered from 40%, 28.57% and 33.33% of river water polluted with sewage samples in Lahore, Islamabad and Rawalpindi, respectively, while the presence of 13.13% and 11.76% of viral load was also confirmed in the drinking water of Lahore and Rawalpindi, respectively. A high prevalence of HAV (12.5% and 21.05%) was also verified in the clinical samples. Phylogenetic analysis indicated close resemblance of HAV isolates with the Indian strains. This study is the first ever comparative analysis of the EntV and HAV isolated from environmental samples and clinical specimen on a molecular level. CONCLUSIONS: The parallel surveillance of EntV and HAV in the river water polluted with sewage, and clinical samples is quite helpful for controlling and reducing the disease burden of the waterborne illnesses.


Assuntos
Infecções por Enterovirus/virologia , Enterovirus/isolamento & purificação , Água Doce/virologia , Vírus da Hepatite A/isolamento & purificação , Hepatite A/virologia , Cidades/estatística & dados numéricos , Enterovirus/classificação , Enterovirus/genética , Vírus da Hepatite A/classificação , Vírus da Hepatite A/genética , Humanos , Paquistão , Filogenia , Reação em Cadeia da Polimerase , Esgotos/virologia , Poluição da Água/análise
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