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Hepatitis A - Multistate (Europe) - 2013 outbreak (ECDC/CDTR, August 12 2013)

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  • Hepatitis A - Multistate (Europe) - 2013 outbreak (ECDC/CDTR, August 12 2013)

    [Source: European Centre for Disease Prevention and Control (ECDC), full PDF document: (LINK). Extract.]


    COMMUNICABLE DISEASE THREATS REPORT

    Week 32, 4-10 August 2013

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    Hepatitis A - Multistate (Europe) - 2013 outbreak

    Opening date: 9 April 2013 Latest update: 8 August 2013


    Epidemiological summary

    From 1 October 2012 until 8 August 2013, Denmark, Finland, Norway and Sweden reported 106 HAV cases due to subgenotype IB with two related sequences. None of the cases had travel history outside the EU within the period of their potential exposure.

    The source of the outbreak has not been confirmed by positive microbiological samples from berries, but epidemiological and purchase history investigations in Denmark, Norway and Sweden point towards frozen strawberries imported from North Africa as the vehicle of infection.

    On 22 May 2013, the Swedish Institute for Infectious Disease Control (SMI) published a press release indicating that frozen strawberries of non-domestic origin are likely to be the source of the Swedish outbreak. Other types of berries are no longer suspected in this outbreak.

    On 30 May 2013, the Danish Food Safety Authority confirmed that specific products with frozen strawberries packaged in Belgium and sold in Denmark, have been voluntarily recalled. Both epidemiological and product investigations point towards these specific products of frozen strawberries as the vehicle of infection for the ongoing hepatitis outbreak in the Nordic countries.

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    ECDC assessment

    The identification of closely related HAV sequences in four different countries confirms that this is a multinational food-borne outbreak. The source of the multi-country outbreak has not been confirmed, but epidemiological investigations in Denmark and Sweden point towards frozen strawberries as the vehicle of infection.

    The distribution of reported cases over time shows a marked decline in the number of cases after the implementation of the control measures. The last two cases reported in July may be due to the consumption of the implicated vehicle of infection which, although withdrawn from the market, could still be stored in some households.


    Actions

    ECDC and EFSA published a joint rapid outbreak assessment on 16 April. The latest ECDC epidemiological update was published on 6 August 2013.

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