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First reported outbreak of locally acquired hepatitis E virus infection in Australia

Yapa, Chaturangi; Furlong, Catriona; Rosewell, Alexander; Ward, K. A.; Adamson, Sheena; Shadbolt, Craig T.; Kok, Jen; Tracy, Samantha; Bowden, Scott; Smedley, Elizabeth J.; Ferson, Mark J.; Sheppeard, V.; McAnulty, Jeremy M.

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Objective: To determine the source and extent of a locally acquired hepatitis E virus (HEV) infection outbreak. Design, setting and participants: A cluster of notified cases of HEV infection linked to a single restaurant (X) was identified in May 2014. People with laboratory-confirmed HEV infection in New South Wales between January 2013 and December 2014 were interviewed about potential risk factors for HEV infection. Co-diners at restaurant X and patients with suspected but unexplained viral...[Show more]

dc.contributor.authorYapa, Chaturangi
dc.contributor.authorFurlong, Catriona
dc.contributor.authorRosewell, Alexander
dc.contributor.authorWard, K. A.
dc.contributor.authorAdamson, Sheena
dc.contributor.authorShadbolt, Craig T.
dc.contributor.authorKok, Jen
dc.contributor.authorTracy, Samantha
dc.contributor.authorBowden, Scott
dc.contributor.authorSmedley, Elizabeth J.
dc.contributor.authorFerson, Mark J.
dc.contributor.authorSheppeard, V.
dc.contributor.authorMcAnulty, Jeremy M.
dc.date.accessioned2018-11-29T22:52:59Z
dc.date.available2018-11-29T22:52:59Z
dc.identifier.issn0025-729X
dc.identifier.urihttp://hdl.handle.net/1885/152341
dc.description.abstractObjective: To determine the source and extent of a locally acquired hepatitis E virus (HEV) infection outbreak. Design, setting and participants: A cluster of notified cases of HEV infection linked to a single restaurant (X) was identified in May 2014. People with laboratory-confirmed HEV infection in New South Wales between January 2013 and December 2014 were interviewed about potential risk factors for HEV infection. Co-diners at restaurant X and patients with suspected but unexplained viral hepatitis were retrospectively tested. Foods eaten by the infected persons were compared with those of seronegative co-diners. HEV RNA detected in sera from infected persons was sequenced and genotyped. Implicated foods were traced back to their sources. Main outcome measures: Potential sources of infection, including overseas travel and foods eaten, and origin of implicated food products. Results: In 55 serologically confirmed cases of HEV infection, 24 people had not travelled overseas during their incubation periods. Of the 24, 17 reported having eaten at restaurant X, 15 of whom could be interviewed. All reported consuming pork liver pâté, compared with only four of seven uninfected co-diners (P < 0.05). The other seven people with locally acquired infections each reported consuming a pork product during their incubation periods. HEV RNA was detected in 16 of the 24 cases; all were of genotype 3. Sequencing indicated greater than 99% homology among restaurant X isolates. HEV RNA was isolated from pork sausages from a batch implicated in one of the locally acquired infections not linked with restaurant X. The pork livers used for pâté preparation by restaurant X were traced to a single Australian farm. Conclusions: This is the first reported HEV outbreak in Australia. HEV should be considered in patients presenting with a compatible illness, even without a history of overseas travel. Pork products should be thoroughly cooked before consumption.
dc.format.mimetypeapplication/pdf
dc.publisherAustralasian Medical Association
dc.sourceMedical Journal of Australia
dc.titleFirst reported outbreak of locally acquired hepatitis E virus infection in Australia
dc.typeJournal article
local.description.notesImported from ARIES
local.identifier.citationvolume204
dc.date.issued2016
local.identifier.absfor111706 - Epidemiology
local.identifier.absfor111711 - Health Information Systems (incl. Surveillance)
local.identifier.absfor110309 - Infectious Diseases
local.identifier.ariespublicationU3488905xPUB19346
local.type.statusPublished Version
local.contributor.affiliationYapa, Chaturangi, College of Health and Medicine, ANU
local.contributor.affiliationFurlong, Catriona, NSW Health
local.contributor.affiliationRosewell, Alexander , NSW Health
local.contributor.affiliationWard, KA, NSW Health
local.contributor.affiliationAdamson, Sheena, NSW Health
local.contributor.affiliationShadbolt, Craig T, New South Wales Food Authority
local.contributor.affiliationKok, Jen, Westmead Hospital
local.contributor.affiliationTracy, Samantha, Victorian Infectious Diseases Reference Laboratory
local.contributor.affiliationBowden, Scott, Victorian Infectious Diseases Reference Laboratory
local.contributor.affiliationSmedley , Elizabeth J, Public Health Unit South Eastern Sydney Local Health District
local.contributor.affiliationFerson , Mark J , Public Health Unit South Eastern Sydney Local Health District
local.contributor.affiliationSheppeard, V, NSW Department of Health
local.contributor.affiliationMcAnulty , Jeremy.M, New South Wales Health Department
local.bibliographicCitation.issue7
local.bibliographicCitation.startpage274
local.bibliographicCitation.lastpage274
local.identifier.doi10.5694/mja15.00955
local.identifier.absseo920109 - Infectious Diseases
dc.date.updated2018-11-29T07:50:20Z
local.identifier.scopusID2-s2.0-84971623936
local.identifier.thomsonID000410547500021
dcterms.accessRightsOpen Access
CollectionsANU Research Publications

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