The first cases started from a restaurant in Hungary. The ECDC launches the alert: “Human-to-human transmission has occurred and perhaps also through contaminated food”
Outbreaks of hepatitis A have been reported only in 6 countries of the European Union and the United Kingdom. As of 29 September, informs the European Center for Disease Prevention and Control, i cases identified were 303, caused by identical or closely related viral strains. The highest numbers – 161 cases, of which 139 are men and 22 women – were recorded in Hungary which is also the first country to report an outbreak. The other reported infections are distributed in Austria (7), Germany (8), the Netherlands (8), Slovenia (35), Sweden (8), and the United Kingdom (76). As for the dynamics of the contagion, the ECDC points out that “the epidemiological and microbiological data currently available suggest that Human-to-human transmission has occurred, and possibly also transmission via contaminated food».
The food-borne epidemic
The first outbreak dates back to February 15, 2022, when Hungary reported genotype Ib hepatitis Hav virus infections. The onset of the disease in the first case was in early December 2021. The presence of this strain was confirmed in all 161 Hungarian cases. Among the various hypotheses it is suspected a food-borne outbreak with a link to a Hungarian restaurant where 16 people got sick. Some patients have reported consuming a dish made from frozen berries. In the UK, no clear source of infection has been identified, but epidemiological investigations so far indicate possible food-borne infections in addition to person-to-person transmission. Germany, the Netherlands and Sweden reported a total of 9 cases infected with strains corresponding to the sequences of the British strain. Investigations into these cases have found no clear risk factors for infection such as a travel history or berry consumption, and more research is underway. “Several infected people have identified themselves as men who have sex with men (Msm), suggesting a possible transmission between sexual contacts», Highlights the ECDC. Among the patients there were several who were hospitalized.
How it is transmitted
Hepatitis A is one infectious disease caused by an RNA virus that affects the liver. Generally the contagion occurs for direct person-to-person contact or through the consumption of water or certain foods (raw or undercooked) contaminated by the virus.
Very often it runs in asymptomatic manner, especially during epidemics and in children. Hepatitis A, after a incubation period of 15-45 days from infection, is manifested by the appearance of loss of appetite, general malaise, fever and nausea. After a few days, appearsjaundicei.e. the presence of yellowish color of the skin and sclerae (the white part of the eye) and mucous membranes, due to increased concentration of bilirubin in the blood because of decreased liver function. The disease generally has a benign evolution, lasts from 2 to 10 weeksand after healing it confers apermanent immunity. It never becomes chronic.
Hepatitis A can be done prevent by respecting basic hygiene rules to defend against fecal-oral diseases and transmitted by raw food. There cooking is the only effective measure to eliminate or inactivate the hepatitis A virus therefore it is recommended not to consume raw seafood and wash fruit and vegetables thoroughly before consuming them. It is also important to take care of thepersonal hygiene, especially hands: wash your hands after using the bathroom, after changing a diaper, before preparing food, before eating, be scrupulously clean when handling food and drinks. Those traveling to countries with poor sanitation conditions should only consume cooked foods, drink bottled water, and not consume ice. Foods vehicles of infection are above all: fish and fish-based products, crustaceans, molluscs and products containing molluscs, vegetables, juices, dried tomatoes, berries and strawberries. In 2013, over 450 people fell ill with hepatitis A from consuming contaminated frozen berries.
Against hepatitis A there is a highly effective and well tolerated vaccine. Protection is achieved already 14-21 days after the first dose, so it is very important to quickly protect people who come into contact with a person with hepatitis A or people about to travel abroad to countries at risk. A second dose 6/12 months after the first prolongs its protective efficacy, providing protection for a period of 10-20 years. Vaccination is recommended in those at risk, including those who have chronic liver disease, those who travel to countries where hepatitis A is endemic, those who work in laboratories where there may be contact with the virus, male homosexuals , people who use drugs and family contacts of people with active hepatitis A.
September 30, 2022 (change September 30, 2022 | 16:51)
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