Multistate Outbreak of Hepatitis A Associated with Frozen Strawberries

Niu, Manette T.; Polish, Louis B.; Robertson, Betty H.; Khanna, Bhawna; Woodruff, Bradley A.; Shapiro, Craig N.; Miller, Mark A.; Smith, Jacky; Gedrose, Judith K.; Alter, Miriam J.; Margolis, Harold S.

doi:10.1093/infdis/166.3.518

Cited by 221 publications

(88 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Genotypic confirmation of the virus in the food product could not be obtained, but this is consistent with other outbreaks where HAV sequencing has only occasionally been successful [10,26]. Very low viral load in the product may explain our inability to obtain genotypic confirmation and the very low number of cases in the approximately 31,000 potentially exposed households.…”

Section: Discussionsupporting

confidence: 78%

“…Epidemiological evidence (supported by identical molecular sequences among the cases) has implicated a variety of foods in outbreaks, for example, green onions, semi-dried tomatoes, blueberries and frozen strawberries [5,[7][8][9][10][11]. Laboratory confirmation of HAV contamination of vegetables and fruit is rare, in part due to low viral loads in many foods [12,13].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Hepatitis A outbreak in British Columbia, Canada: the roles of established surveillance, consumer loyalty cards and collaboration, February to May 2012

et al. 2014

View full text Add to dashboard Cite

Non-travel-related hepatitis A is rare in Canada. We describe a hepatitis A outbreak investigation in British Columbia in February to May 2012 in which exposure history was collected from nine confirmed non-travel-related cases. Suspected foods were tested for hepatitis A virus (HAV): a frozen fruit blend was identified as a common exposure for six of the nine cases using supermarket loyalty cards. Consumption of the product was confirmed in each case. Genetic analysis confirmed HAV genotype 1B in the six exposed cases. Of the three non-exposed cases, the virus could not be genotyped for two of them; the virus from the other case was found to be genotype 1A and this case was therefore not considered part of the outbreak. HAV was detected by PCR from pomegranate seeds, a component of the identified frozen fruit blend. Historically low levels of HAV infection in British Columbia triggered early recognition of the outbreak. Loyalty card histories facilitated product identification and a trace-back investigation implicated imported pomegranate seeds.

show abstract

Section: Discussionsupporting

confidence: 78%

Section: Introductionmentioning

confidence: 99%

Hepatitis A outbreak in British Columbia, Canada: the roles of established surveillance, consumer loyalty cards and collaboration, February to May 2012

et al. 2014

View full text Add to dashboard Cite

show abstract

“…Because many people may consume a batch of food or come into contact with the contaminated material, outbreaks involving large numbers infected people are common. The outbreaks of viral gastroenteritis are known to be mainly caused by norovirus (NoV) and outbreaks of viral hepatitis are caused by Hepatitis A virus (HAV) (Ramsay and Upton 1989;Reid and Robinson 1987;Calder et al 2003;Niu et al 1992;Hutin et al 1999) and, in the case of water, more rarely, Hepatitis E virus (HEV) (Jothikumar et al 1993).…”

Section: Introductionmentioning

confidence: 99%

Analytical Methods for Virus Detection in Water and Food

et al. 2010

View full text Add to dashboard Cite

Potential ways to address the issues that relate to the techniques for analyzing food and environmental samples for the presence of enteric viruses are discussed. It is not the authors' remit to produce or recommend standard or reference methods but to address specific issues in the analytical procedures. Foods of primary importance are bivalve molluscs, particularly, oysters, clams, and mussels; salad crops such as lettuce, green onions and other greens; and soft fruits such as raspberries and strawberries. All types of water, not only drinking water but also recreational water (fresh, marine, and swimming pool), river water (irrigation water), raw and treated sewage are potential vehicles for virus transmission. Well over 100 different enteric viruses could be food or water contaminants; however, with few exceptions, most well-characterized foodborne or waterborne viral outbreaks are restricted to hepatitis A virus (HAV) and calicivirus, essentially norovirus (NoV). Target viruses for analytical methods include, in addition to NoV and HAV, hepatitis E virus (HEV), enteroviruses (e.g., poliovirus), adenovirus, rotavirus, astrovirus, and any other relevant virus likely to be transmitted by food or water. A survey of the currently available methods for detection of viruses in food and environmental matrices was conducted, gathering information on protocols for extraction of viruses from various matrices and on the various specific detection techniques for each virus type.

show abstract

“…Strawberries in Turkey were heavily contaminated with Enterobius vermicularis 5 . Salmonella, Escherichia coli 6 , noravirus, rotavirus, swine hepatitis E virus 7 , and hepatitis A virus 8 have also been detected in strawberries in North America.…”

mentioning

confidence: 99%

Detection of intestinal parasites on field-grown strawberries in the Federal District of Brazil

Silva¹,

Maldonade

Ginani

et al. 2014

Rev. Soc. Bras. Med. Trop.

View full text Add to dashboard Cite

Introduction:This study evaluated the presence of pathogenic human parasites on fi eld-grown strawberries in the Federal District of Brazil. Methods: A total of 48 samples of strawberries and 48 soil samples from 16 properties were analyzed. Results: Contaminated strawberries were detected in 56% of the properties. Schistosoma mansoni, Ascaris lumbricoides or Ascaris suum, Balantidium coli, Endolimax nana, and Entamoeba spp. were detected. Soil was contaminated with Entamoeba spp., Entamoeba coli, Strongyloides spp., Ancylostomatidae, and Hymenolepis nana. Conclusions: Producers should be instructed on the safe handling of strawberries in order to reduce the incidence of strawberries that are contaminated with enteroparasites.Keywords: Enteroparasites. Strawberries. Transmission.Fruits and vegetables provide important nutritional value for humans, but when they are consumed raw and without being peeled, they may transmit human pathogens. Evaluating the pathogen load of fresh produce is of great importance for public health because it indicates the hygienic conditions during production, storage, transport, and handling 1 .Ascaris lumbricoides, Entamoeba coli, Entamoeba histolytica, Endolimax nana, and Giardia lamblia have been found on strawberries (Fragaria ananassa Duch) in Mexico 2 . In Costa Rica, microsporidia were detected on strawberries 3 , and in Norway, 20% of strawberries were contaminated with G. lamblia cysts 4 . Strawberries in Turkey were heavily contaminated with Enterobius vermicularis 5 . Salmonella, Escherichia coli 6 , noravirus, rotavirus, swine hepatitis E virus 7 , and hepatitis A virus 8 have also been detected in strawberries in North America.In Brazil, the cultivation of strawberries has increased in recent years. However, the contamination of Brazilian strawberries by protozoa and helminthes that pose a risk to public health has not been investigated. The Brazlândia Administrative Region of the Federal District of Brazil (FD) is the largest production center of strawberries in the CentralWest Region of Brazil. Strawberries produced there are sold in the FD and are also exported to the States of Bahia, Goiás, Pará, and Amazonas. As strawberries can carry pathogenic organisms, the aim of this study was to evaluate the presence of pathogenic human parasites on fi eld-grown strawberries in FD, Brazil.Samples of fi eld-grown strawberries were collected in the rural area of Brazlândia, FD. Brazlândia has approximately 54,000 inhabitants. It has a total area of 474.83km 2 and is 45km from Brasília (15° 47′ 56″ S, 47° 52′ 0″ W). The region includes 1,446 hectares of vegetables and fruit, of which 141 hectares produce approximately 4,700 tons of strawberries annually; they are the most commonly cultivated fruits in Brazlândia [Empresa de Assistência Técnica e Extensão Rural (EMATER)/DF].The producers included in this study were selected using registration data from EMATER. Data were collected from 16 out of 38 registered strawberry producers, during visits that occurred from June to Sep...

show abstract

Multistate Outbreak of Hepatitis A Associated with Frozen Strawberries

Cited by 221 publications

References 16 publications

Hepatitis A outbreak in British Columbia, Canada: the roles of established surveillance, consumer loyalty cards and collaboration, February to May 2012

Hepatitis A outbreak in British Columbia, Canada: the roles of established surveillance, consumer loyalty cards and collaboration, February to May 2012

Analytical Methods for Virus Detection in Water and Food

Detection of intestinal parasites on field-grown strawberries in the Federal District of Brazil

Contact Info

Product

Resources

About