Abstract
IntroductionSequence-based typing of hepatitis A virus (HAV) is important for outbreak detection, investigation and surveillance. In 2013, sequencing was central to resolving a large European Union (EU)-wide outbreak related to frozen berries. However, as the sequenced HAV genome regions were only partly comparable between countries, results were not always conclusive.AimThe objective was to gather information on HAV surveillance and sequencing in EU/European Economic Area (EEA) countries to find ways to harmonise their procedures, for improvement of cross-border outbreak responses.MethodsIn 2014, the European Centre for Disease Prevention and Control (ECDC) conducted a survey on HAV surveillance practices in EU/EEA countries. The survey enquired whether a referral system for confirming primary diagnostics of hepatitis A existed as well as a central collection/storage of hepatitis A cases’ samples for typing. Questions on HAV sequencing procedures were also asked. Based on the results, an expert consultation proposed harmonised procedures for cross-border outbreak response, in particular regarding sequencing. In 2016, a follow-up survey assessed uptake of suggested methods.ResultsOf 31 EU/EEA countries, 23 (2014) and 27 (2016) participated. Numbers of countries with central collection and storage of HAV positive samples and of those performing sequencing increased from 12 to 15 and 12 to 14 respectively in 2016, with all countries typing an overlapping fragment of 218 nt. However, variation existed in the sequenced genomic regions and their lengths.ConclusionsWhile HAV sequences in EU/EEA countries are comparable for surveillance, collaboration in sharing and comparing these can be further strengthened.
Highlights
Sequence-based typing of hepatitis A virus (HAV) is important for outbreak detection, investigation and surveillance
While HAV sequences in European Union (EU)/Economic Area (EEA) countries are comparable for surveillance, collaboration in sharing and comparing these can be further strengthened
We present a descriptive analysis of the responses to the surveys and compare the sequence-based typing practices for HAV reported by EU/EEA countries in 2014 and 2016
Summary
Sequence-based typing of hepatitis A virus (HAV) is important for outbreak detection, investigation and surveillance. Aim: The objective was to gather information on HAV surveillance and sequencing in EU/European Economic Area (EEA) countries to find ways to harmonise their procedures, for improvement of cross-border outbreak responses. The hepatitis A virus (HAV) of the Picornaviridae family affects 114 million people annually and is a common cause of food-borne infections worldwide [1,2]. It is mainly transmitted through faecal-oral route via person-to-person contact or contaminated food and water [3]. Due to suboptimal vaccination uptakes, travel to countries with high or intermediate HAV endemicity is a common risk factor for infection [8] and multi-country outbreaks have been reported since 2012 among MSM and PWID [9,10]. A large food-borne outbreak caused by berries was reported in the EU/EEA in 2013–14, with sequencing being key in identifying the vehicle of infection [19,20]
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Schedule a callMore From: Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin
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