Foodborne hepatitis A outbreak associated with bakery products in northern Germany, 2012

In October 2012, a hepatitis A (HA) outbreak with 83 laboratory-confirmed cases occurred in Lower Saxony.

german.bakeryWe defined primary outbreak cases as people with laboratory-confirmed HA and symptom onset between 8 October and 12 November 2012, residing in or visiting the affected districts. Secondary outbreak cases were persons with symptom onset after 12 November 2012 and close contact with primary cases. We identified 77 primary and six secondary cases. We enrolled 50 primary cases and 52 controls matched for age and sex, and found that 82% of cases and 60% of controls had consumed products from a particular bakery (OR=3.09; 95% CI: 1.15–8.68). Cases were more likely to have eaten sweet pastries (OR=5.74; 95% CI: 1.46–22.42). Viral isolates from five selected cases and three positively tested surfaces in the bakery had identical nucleotide sequences. One additional identical isolate derived from a salesperson of the bakery suffering from a chronic disease that required immunosuppressive treatment.

Epidemiological and laboratory findings suggested that the salesperson contaminated products while packing and selling. Future risk assessment should determine whether food handlers with chronic diseases under immunosuppressive treatment could be more at risk of contaminating food and might benefit from HAV immunisation.


Further Hepatitis A case in UK school

Health officials are planning to vaccinate all children and staff at a Portsmouth school following a further case of Hepatitis A.

hepatitis.AChildren from selected classes at Devonshire Infant School were vaccinated in November after seven cases of the infection in one family.

Public Health England (PHE) said the further case suggested “transmission may have occurred within the school”.

The vaccination is now being offered to all 180 pupils and about 30 staff.

It is also being offered as a precaution to the children and staff at Fledglings pre-school.

Vaccines work: Report shows sharp decline in U.S. hepatitis A cases

A new report shows there has been a sharp decline in hepatitis A cases throughout the United States. An analysis of federal data found that hospitalization rates have fallen from 7.2 to 2.9 patients per million patients admitted to hospitals from 2002 to 2011.

berry.blend.hep.aHepatitis A cases have fallen by almost 90 percent over the past 20 years marking this increased decline as another major step forward in the fight against the potentially deadly liver disease. Vaccines like Twinrix, which protect against both Hepatitis A and B, can make a big difference.

“Hepatitis A vaccination is very important for everyone, especially travelers to high risk countries,” said Melanie Kohr, Vice-President of Clinic Operations for Passport Health. “Travel trends are on the rise, and if more people are vaccinated against this potentially deadly disease, then the likelihood of spreading it when a traveler returns greatly declines. This can play a critical role in national health in the long term and for the health of close family members no matter the situation.”

What we have here is failure to communicate: UK school criticized over handling of hepatitis A case

A Weymouth school has been criticized over its handling of a situation when a child contracted hepatitis A.

CoolHandLukeSt Andrews Primary School in Preston wrote to parents on November 26 after a pupil was found to have the infectious illness.

It is believed the child contracted the illness while abroad and did not return to school after falling ill.

But parents claim they were not told this and the letter raised concerns rather than allaying fears.

One parent, who does not wish to be named, said: “I just think that we are being kept in the dark and it’s being brushed under the carpet.

“It seems as though nothing is happening. We know absolutely nothing except that somebody at the school has hepatitis A, and that’s mainly the problem.”

Another said: “It may seem trivial to complain but communication at the school is poor and the letter was very badly worded.

“All it did was raise concerns rather than giving the full facts. It was just badly handled.”

The letter, seen by the Echo, confirms a single case of hepatitis A and lists information from Wessex Public Health England Centre about symptoms, which include fever, abdominal pain, nausea and vomiting. Hepatitis A can cause liver inflammation leading to jaundice and, in extreme cases, liver failure.

A mum criticised the advice on symptoms, saying it was so general ‘it could be anything’ and it is worrying parents.

She said: “By not giving parents enough information, it’s making us anxious.

“Two parents say they haven’t even received the letter.

“There are five children off school from illness in my son’s class and my son is experiencing abdominal pain and vomiting, but we are not sure if it’s the tail end of a bug or if it’s more serious.

“One other parent is taking their child to the doctor to see what’s going on, and another said the children need to be vaccinated.

“We need to know what the school is doing to minimise the risks.”

Vanessa Lucas, headteacher at St Andrew’s Primary School, said: “No-one has said a word to us at the school. Not all parents would receive the letter because it’s in one end of the school and it’s one child.

“The child was ill when they came back from abroad and the parents kept them off school, so it’s just a precaution.”

Cllr Francis Drake, Weymouth and Portland Borough Council’s spokesman for public health, said: “I would hope that the school is doing its utmost to make sure the situation doesn’t get any worse.

“If anybody thinks they have symptoms they should go to their doctor immediately and get advice.” 

Lost in translation? Dirty grills cause hep A and and you should wash your meat

Last week’s Consumer Food Safety Education Conference reminded me that even when folks (agencies, organizations, individuals) say that they are sharing evidence-based information with the masses, not everyone agrees on the science, or the message.

There will always be conflict (and that’s okay – harmonized messages look suspicious), what’s more important is that people share how they made their risk-based decisions.

And that’s not often done.x600

Like why does USDA suggest in their consumer messages that the danger zone for pathogen growth is between 40F and 140F, and FDA’s Model Food Code, which is well referenced says that the parameters are 41F and 135F?

ABS-CBN News story demonstrates that some folks in the Philippines are looking at different data related to risks.

According to microbiologist Dr. Windell Rivera, raw meat and poultry, the most common ingredients of grilled street food, can easily be contaminated by various bacteria.

According to Rivera, some cases could lead to Hepatitis A, or even kidney failure (the headline of the piece is ‘Cooking on unclean grills can cause Hepatitis-A’ – looking at the evidence in the literature, no it can’t -ben).

Rivera advised thorough washing of poultry and meat products using clean water prior to cooking, as not all bacteria can be killed by heat. Sauces must also be stored properly as they can be contaminated by bacteria if meat with saliva or microorganisms are dipped into them.

Experts added that when cooking and grilling, meat must be thoroughly cooked. Also, as much as possible, chicken must be separated from pork.

Washing meat prior to cooking is a bad idea. 

Raw and risky: Hepatitis A cluster linked to oysters and clams in Taiwan

Our friends are off to China and Indonesia at the end of the week (start of summer holidays) so we’re having them over for dinner tomorrow, where I’ll offer up a seafood pasta (I simply cannot compete with Susan’s stir-fry and other Chinese dishes).

SUN0705N-Oyster7But with the holiday season approaching, there will – like no raw egg dishes — be no raw shellfish served in this house.

The Taiwan CDC reports 30 indigenous cases of Hepatitis A from Oct. to Nov. 2014, in which more than 80 percent of the patients required hospitalization for their illness.

According to the epidemiological investigation, most patients consumed raw bivalves such as oyster and clams during the disease incubation period.

This has prompted the Taiwan CDC to remind the public to pay attention to personal dietary hygiene and consume only thoroughly cooked bivalves.

Bivalves such as oysters and clams concentrate the pathogens that are present in harvest waters.

Watch and learn Maine: NJ health officials release info about hepatitis A exposure

A food handler from a New Jersey restaurant is in hospital recovering from hepatitis A. According to, the individual worked in the back of the house of Rosa’s Restaurant and Catering in Hamilton, NJ.

Health officials warned that anyone who ate at or catered from the restaurant between Nov. 10 and Monday may be at risk for developing Hepatitis A if they have not been previously vaccinated. The township received notification from the state Department of Health Monday. Township health officer Jeff Plunkett said the employee, who worked in food preparation, has been in the hospital since last Tuesday.Unknown-17-1

“It is contagious through the oral route when you ingest food so it’s a possibility that … you could contract the virus if he was handling your food at the time,” Plunkett said.

Unvaccinated individuals who ate there should receive an injection of immune globulin or Hepatitis A vaccine. Both can prevent an infection if given within 14 days of exposure.

This information is much more useful than what health folks in Maine said a couple of weeks ago.

Over 100 exposed to hepatitis A after virus-shedding kids go to school

Getting my kids to wash their hands is a constant struggle. I’m likely not alone. There’s not a whole lot of great information on this outbreak but Heart is reporting that an outbreak of hepatitis A in Wessex (U.K.) has led to over 100 IgG shots.

According to health authorities, seven school-aged kids at a couple of schools in the U.K. have picked up hepatitis A – and the common link appears to be household-contact related.dirty-hands-medium-new

The Wessex PHE Centre has recommended that close contacts of the cases, including household, some children and staff attending the same class groups in school as some cases should receive Hepatitis A vaccination to prevent further spread of this infection.

Officials say the likelihood of spread of this infection in the school environment is very low, however as a precaution, all parents have been advised of the signs and symptoms of Hepatitis A and asked to contact their General Practitioner if they have concerns:

Dr Anand Fernandes, Consultant in Health Protection at PHE Wessex, said:

“We are working closely with colleagues in the local NHS and Portsmouth City Council Environmental Health and Public Health Departments to manage the very low risk of further spread of this illness. “No other children, staff or visitors to the schools will be offered the vaccine as the risk of exposure to them is very low.”

The News reports that Around 150 vaccinations are now being carried out at the Devonshire Infant School and Fernhurst Junior School in Southsea.


Hepatitis A in fresh vegetables a hidden health risk in Pakistan

The purpose of the current study was to evaluate fresh vegetables raised on the fecal contaminated water for the detection of Hepatitis A virus HAV by PCR method. Twenty nine samples were collected from 13 different locations of district Mardan and screened for the presence of HAV.

fieldcropworker_editVillage Bajowro near Takht Bhai was the most contaminated site having HAV in all vegetables grown over there. Water samples collected from this area proved to be contaminated with HAV.
It may be concluded that fecal contaminated water is unsafe for irrigation because of the health risk associated with such practices.

Author: Waleed KhanMuhammad IrshadGauhar RehmanAnwar Hussain
Credits/Source: SpringerPlus 2014, 3:675

Australian cafe reopened after Hepatitis A alert

Health authorities sanitized a Noosa cafe for five hours after an employee triggered a Hepatitis A alert.

beach-chalet-sunriseQueensland Health is urging anyone who dined out or used the toilet at the Beach Chalet Shop at Sunrise Beach between October 10 and November 1 to see a doctor.

People can be vaccinated within two weeks of exposure to the virus to reduce the risk of developing Hepatitis A.

Despite the highly contagious nature of the disease, Beach Chalet Shop owner Ivan Mather said the whole thing had been blown out of proportion.

“This will blow over,” he said. “Because it is just ridiculous.”

Two days ago, Mr Mather said he was advised over the phone by a state nurse that the employee had contracted Hepatitis A.

The employee no longer works at the cafe.

Mr Mather said he voluntarily closed the shop.

“I want to make that clear. I did it voluntarily,” he said.

He said Noosa Council health department staff was satisfied the cafe could be re-opened for business.

“They were here for four to five hours, supervising and sanitizing,” he said.