An outbreak of hepatitis a in young adults in central Italy

Stroffolini, Tommaso; Biagini, W.; Lorenzoni, Luca; Palazzesi, G. P.; Divizia, M; Frongillo, R. F.

doi:10.1007/bf00145788

Cited by 29 publications

(10 citation statements)

References 8 publications

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“…In fact, this is the largest virusassociated outbreak of food poisoning ever reported. Smaller outbreaks have been reported from the United States, Italy, and Australia [8,[9][10][11][12][13]. The fairly protracted incubation period (mean duration, 4 weeks) of HAV infection makes it very difficult to determine the association with a particular food vehicle in sporadic cases.…”

Section: Virusesmentioning

confidence: 99%

“…One of the first recognized outbreaks associated with the consumption of raw oysters was described in 1816 by the French physician J. P. A. Pasquier [2]. He described Clams, oysters, mussels [8][9][10][11][12][13] Vibrio parahaemolyticus 5 669 USA, Canada Oysters, clams [14] Vibrio cholera 4 120 Malaysia, Italy, USA "Shellfish," "bivalves," oysters [15,16] Vibrio vulnificus 1 72 USA Oysters [17] Vibrio mimicus 1 17 USA Oysters [18] Vibrio hollisae 1 2 USA Oysters [19] Salmonella species 3 98 Singapore, UK, Japan Oysters, cockles [20] Shigella flexneri 1 40 France Shrimps, mussels - Physiology. Understanding the physiology of the bivalves helps clarify why people become infected after eating raw shellfish.…”

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confidence: 99%

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Infectious Outbreaks Associated with Bivalve Shellfish Consumption: A Worldwide Perspective

Potasman¹,

Paz²,

2002

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Outbreaks of shellfish-associated infection have been reported for more than a century. Since the early 1970s, the global consumption of shellfish has increased considerably--and with it, the reports of outbreaks of infection. Most of these reports have originated from the United States, but Europe and, to a lesser extent, Asia and Australia have also been represented. The majority of outbreaks have been linked to oysters, followed by clams and mussels. Hepatitis A virus caused the largest ever shellfish-associated outbreak, but caliciviruses have caused the highest number of outbreaks; Vibrio species lead the list of bacterial pathogens. The prognosis of shellfish-associated infections is generally good, except for outbreaks of Vibrio vulnificus infection, which have a mortality rate of up to 50% in vulnerable people. Conventional and molecular techniques should be applied to better identify the causative agents, thereby enabling more-targeted control measures in growing, harvesting, and shipping bivalves.

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Section: Virusesmentioning

confidence: 99%

mentioning

confidence: 99%

Infectious Outbreaks Associated with Bivalve Shellfish Consumption: A Worldwide Perspective

Potasman¹,

Paz²,

2002

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“…In fact, this is so far the largest virus-associated outbreak of food poisoning ever reported. Smaller outbreaks have been reported worldwide (10,13,24,27,29,35,37). Several issues, such as the fact that fecal HAV excretion precedes the onset of symptoms, together with the difficulties in completely removing and/or inactivating viruses through sewage treatment (6,7), make hepatitis shellfish-borne outbreaks hard to prevent if the virus is circulating among the population.…”

mentioning

confidence: 99%

Risk Assessment in Shellfish-Borne Outbreaks of Hepatitis A

Pintó

Costafreda

Bosch

2009

Appl Environ Microbiol

235

172

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In the present work, we aimed at determining the relationship between the hepatitis A virus (HAV) numbers in imported frozen coquina clams involved in two hepatitis outbreaks, as well as the risk for human health. Due to HAV unculturability, a standardized TaqMan real-time reverse transcription-PCR controlling the virus/ nucleic acid extraction and enzyme efficiencies was employed to figure the exposure dose for clams responsible for hepatitis cases. HAV numbers were then employed to figure the risk of infection based on a dose-response model for echovirus 12. The estimated risk of infection after consumption of lightly cooked clams matched actual attack rates. Our data show that prospective monitoring of bivalve samples may fail to prevent the occurrence of outbreaks, since HAV was detected in 44% of samples directly associated with cases but was undetectable in samples that were randomly collected from the importers and belonged to the same batches. A correlation was nevertheless observed between the prevalence of hepatitis A cases in the harvesting areas and positive HAV isolation in clams, which points to the need to identify and prevent hazards rather than relying on random sampling of finished products to ensure safety. However, when evidence shows that a critical limit of viral contamination has been exceeded in the potential sources of contamination discharging into the shellfish-growing beds, quantitative virological analysis addressing quality assurance and quality control requirements should be performed with the bivalves. This work provides the first evidence of accurate HAV levels in shellfish involved in outbreaks that could be of use for risk assessment purposes.

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“…Several studies reported that the consumption of contaminated water and food are a probable source of Salmonellosis, Giardiasi, Hepatitis A and Criptosporidiosis outbreaks. (Mancini et al, 2010;Conio et al 2000;Ballone et al, 2001;Stroffolini et al 1990;Leoni et al 1998;Selvaggi et al 1996). Indicator organisms are commonly used to evaluate the microbiological quality of aquatic ecosystems (Berg 1978;Grabow 1996;EU 2006;Tyagi et al 2006).…”

Section: Microbiological Indicators and Sanitary Significance For Hummentioning

confidence: 99%