An outbreak of foodborne hepatitis A: the value of serologic testing and matched case-control analysis.

Gustafson, Tracy L.; Hutcheson, Robert H.; Fricker, Raffael; Schaffner, William

doi:10.2105/ajph.73.10.1199

Cited by 13 publications

(8 citation statements)

References 17 publications

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“…Only active surveillance and computer integration with the hospital discharge sheets brought the cluster to light and hence enabled suitable control measures to be adopted. It should be noted that non-immune subjects in contact with the cases were immunized post-exposure, which should have prevented more cases [10,11].…”

Section: Discussionmentioning

confidence: 99%

An outbreak of hepatitis A in Southern Italy: the case for vaccinating food handlers

et al. 2005

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We report an outbreak of hepatitis A that occurred in the city of Bari (Apulian region) in June 2002. Overall, 26 cases were observed over a 4-week period. These were traced back to the index case, a food handler who prepared various food products for sale over the counter at a store in the district (OR 5.36, CI 95% 1.58-19.25). Laboratory investigations confirmed that the outbreak was due to a point source and identified a new genotype IB variant. There is a possible indication for administration of hepatitis A vaccine to food handlers, although further evidence of an acceptable cost-benefit ratio needs to be ascertained.

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Section: Discussionmentioning

confidence: 99%

An outbreak of hepatitis A in Southern Italy: the case for vaccinating food handlers

et al. 2005

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“…The high proportion of asymptomatic cases in a young population means that seroepidemiology can play an important role both in case finding to increase power and also in avoiding misclassification of cases as controls. However bleeding of young children is not always acceptable and salivary testing for IgM, a technique we hope to use in future outbreaks, is a suitable alternative in an outbreak [25][26][27].…”

Section: Discussionmentioning

confidence: 99%

Foodborne outbreaks of hepatitis A in a low endemic country: an emerging problem?

et al. 1998

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This paper describes 2 outbreaks of hepatitis A infection in Finland, a very low endemic area of hepatitis A infection, where a large proportion of the population is now susceptible to infection by hepatitis A virus (HAV). The first outbreak involved people attending several schools and day-care centres; the second employees of several bank branches in a different city. The initial investigation revealed that both were related to food distributed widely from separate central kitchens. Two separate case-control studies implicated imported salad food items as the most likely vehicle of infection. HAV was detected in the stool of cases from both outbreaks using reverse-transcriptase polymerase chain reaction; however, comparison of viral genome sequences proved that the viruses were of different origin and hence the outbreaks, although occurring simultaneously, were not linked. Foodborne outbreaks of HAV may represent an increasing problem in populations not immune to HAV.

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“…During a 6-week period in 1986, an outbreak of giardiasis occurred in residents (35) and employees (38) in a Minnesota residential home, as well as in children at a day care center (15) within the nursing home environment (96). Although there were multiple modes of transmission of Giardia lamblia within these groups, the main routes were foodborne and person to person.…”

Section: Outbreaks Involving Camps and Armed Forces Basesmentioning

confidence: 99%

“…The following two examples show how illnesses occurred at work settings but in different ways and with different agents. In April 1981, an outbreak of hepatitis A occurred among four state legislators, two lobbyists, and one senate page in Nashville, Tennessee (35). As part of a follow-up investigation, 1,079 persons received immune globulin, and 711 had blood drawn for diagnostic testing.…”

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confidence: 99%

Outbreaks Where Food Workers Have Been Implicated in the Spread of Foodborne Disease. Part 2. Description of Outbreaks by Size, Severity, and Settings

Todd

Greig

Bartleson³

et al. 2007

Journal of Food Protection

105

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This article is the second in a series of several by members of the Committee on the Control of Foodborne Illness of the International Association of Food Protection, and it continues the analysis of 816 outbreaks where food workers were implicated in the spread of foodborne disease. In this article, we discuss case morbidity and mortality and the settings where the 816 outbreaks occurred. Some of the outbreaks were very large; 11 involved more than 1,000 persons, 4 with more than 3,000 ill. The larger outbreaks tended to be extended over several days with a continuing source of infections, such as at festivals, resorts, and community events, or the contaminated product had been shipped to a large number of customers, e.g., icing on cakes or exported raspberries. There were five outbreaks with more than 100 persons hospitalized, with rates ranging from 9.9 to 100%. However, overall, the hospitalization rate was low (1.4%), and deaths were rare (0.11% of the 80,682 cases). Many of the deaths were associated with high-risk persons (i.e., those who had underlying diseases, malnutrition, or both, as in a refugee camp, or young children), but a few occurred with apparently healthy adults. An analysis of the settings for the food worker-related events showed that most of the outbreaks came from food service facilities (376 outbreaks [46.1%]), followed by catered events (126 outbreaks [15.4%]), the home (83 outbreaks [10.2%]), schools and day care centers (49 [6.0%]), and health care institutions (43 outbreaks [5.3%]). However, many cases resulted from relatively few outbreaks (< 30 each) associated with community events (9,726), processing plants (8,580), mobile/temporary service (5,367), and camps/ armed forces (5,117). The single most frequently reported setting was restaurants, with 324 outbreaks and 16,938 cases. Improper hygienic practices in homes, on picnics, or at community events accounted for 89 of the 816 outbreaks. There were 18 outbreaks associated with commercial travel in air flights, trains, and cruise ships over several decades, although only the last seems to be a major concern today. Sixteen outbreaks occurred where food, primarily produce, was harvested and shipped from one country to another. Sometimes the presence of an infected worker preparing food was only one of several factors contributing to the outbreak.

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An outbreak of foodborne hepatitis A: the value of serologic testing and matched case-control analysis.

Cited by 13 publications

References 17 publications

An outbreak of hepatitis A in Southern Italy: the case for vaccinating food handlers

An outbreak of hepatitis A in Southern Italy: the case for vaccinating food handlers

Foodborne outbreaks of hepatitis A in a low endemic country: an emerging problem?

Outbreaks Where Food Workers Have Been Implicated in the Spread of Foodborne Disease. Part 2. Description of Outbreaks by Size, Severity, and Settings

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