Abstract
Post-transfusion hepatitis A virus (HAV) infection worldwide is considered a sporadic event. An outbreak of HAV infection occurred in Latvia between the end of 2007 and throughout 2008 with more than 2,800 confirmed cases reported over a 13-month period (incidence of 123 per 100,000 population). The majority of reported HAV infection cases were in people over 18 years of age and in people living in the capitalcity, Riga. We estimated that the crude risk for HAV contamination of whole blood supplies in Riga between February and October 2008 ranged from 1.4 to 10.6 per 10,000 donated units. In people under 40 years of age, the risk of receiving an infectious blood transfusion was more than 3.0 per 10,000 recipients between August and October 2008 during the peak of the outbreak. We conclude that there is a previously under-recognised impact of HAV on blood safety during widespread outbreaks of this disease. Estimating the risk of contamination of blood supplies during an infectious disease outbreak scenario is important for fine tuning risk assessments and potentially improving public health practices.
Highlights
Hepatitis A virus (HAV) infection is an acute viral illness usually acquired through the faecal–oral route
Outbreaks have been associated with contaminated food and water supplies, and have been identified in specific communities such as injecting drug users (IDUs) and men who have sex with men (MSM)
As the majority of HAV infections in Riga were reported between February and October 2008, we divided this time into three distinct outbreak periods (Figure 1): February – April (Period 1), May – July (Period 2) and August – October (Period 3), the last being the peak of the outbreak
Summary
Hepatitis A virus (HAV) infection is an acute viral illness usually acquired through the faecal–oral route. The level of endemicity of HAV infection varies worldwide, with higher seroprevalence reported in resourcepoor countries and lower seroprevalence in developed regions such as northern Europe and Japan [1]. But with the lack of universal HAV vaccination programmes in the majority of countries, this disease remains endemic in the EU. Its epidemiology is changing: EU Member States that were considered previously highly endemic, mostly former east-European countries [3], are demonstrating moderate endemicity. Such changes in epidemiology are usually characterised by shifts in the population affected from children where HAV infection is asymptomatic or mild, to young adults, in whom the disease is more severe
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