Abstract
The Taiwan Centers for Disease Control (CDC) were notified of increasing acute hepatitis A (AHA) in June 2015. Serum and/or stool from AHA patients and sewage samples were tested for hepatitis A virus (HAV). We defined outbreak cases as AHA patients with illness onset after June 2015 and with an HAV sequence less than 0.5% different from that of the TA-15 outbreak strain. We analysed characteristics and food exposures between outbreak and non-outbreak cases between January 2014 (start of enhanced surveillance) and February 2016. From June 2015 to September 2017, there were 1,563 AHA patients with a median age of 31 years (interquartile range (IQR): 26–38); the male-to-female ratio was 8.8 and 585 (37%) had human immunodeficiency virus (HIV) infection. TA-15 was detected in 82% (852/1,033) of AHA patients, and 14% (74/540) of sewage samples tested since July 2015. Infection with the TA-15 strain was associated with having HIV, sexually transmitted infections (STI), recent oral-anal sex and men who have sex with men (MSM). The Taiwan CDC implemented an HAV vaccine campaign starting from October 2016 where 62% (15,487/24,879) of people at risk were vaccinated against HAV. We recommend HAV vaccination for at-risk populations and continuous surveillance to monitor control measures.
Highlights
Acute hepatitis A (AHA) is a disease caused by hepatitis A virus (HAV) that spreads through person-to-person contact or through contaminated food or water
As highest prevalence of HAV was observed in indigenous townships because of inadequate water, sanitation and hygiene infrastructure in 1990s, Taiwan launched targeted HAV vaccination among children living in indigenous townships and surrounding areas starting in June 1995, covering 2% of the overall population [4]
Because since March 2016, only one in 10 specimens from AHA patients with human immunodeficiency virus (HIV) coinfection have been sampled for HAV sequences, only 166 patients with HAV/HIV coinfection had viral sequencing results, and 161 of those (97%) were infected with the TA-15 strain
Summary
Acute hepatitis A (AHA) is a disease caused by hepatitis A virus (HAV) that spreads through person-to-person contact or through contaminated food or water. In high-income countries where the prevalence of antiHAV antibodies is low, infection usually occurs in susceptible adults, and transmission among travellers to endemic regions, men who have sex with men (MSM) and people who inject drugs (PWID) has been reported [1]. As highest prevalence of HAV was observed in indigenous townships because of inadequate water, sanitation and hygiene infrastructure in 1990s, Taiwan launched targeted HAV vaccination among children living in indigenous townships and surrounding areas starting in June 1995, covering 2% of the overall population [4]. The highest incidence shifted from children and adolescents younger than 20 years to young adults and travellers to endemic countries; between 2010 and 2014, 96 to 139 AHA cases were reported annually, and the average maleto-female ratio was 1.3 [4,5]. The re-emergence of HAV among non-immunised populations is raising concerns as outbreaks of AHA among MSM have recently been reported in Europe and America [6,7]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callMore From: Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
