1887
Outbreaks Open Access

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.

Loading

Article metrics loading...

/content/10.2807/1560-7917.ES.2019.24.14.1800133
2019-04-04
2019-08-24
http://instance.metastore.ingenta.com/content/10.2807/1560-7917.ES.2019.24.14.1800133
Loading
Loading full text...

Full text loading...

/deliver/fulltext/eurosurveillance/24/14/eurosurv-24-14-5.html?itemId=/content/10.2807/1560-7917.ES.2019.24.14.1800133&mimeType=html&fmt=ahah

References

  1. Cuthbert JA. Hepatitis A: old and new. Clin Microbiol Rev. 2001;14(1):38-58.  https://doi.org/10.1128/CMR.14.1.38-58.2001  PMID: 11148002 
  2. Nainan OV, Xia G, Vaughan G, Margolis HS. Diagnosis of hepatitis a virus infection: a molecular approach. Clin Microbiol Rev. 2006;19(1):63-79.  https://doi.org/10.1128/CMR.19.1.63-79.2006  PMID: 16418523 
  3. Wu JS, Chen CH, Chiang YH, Lee YC, Lee MH, Ko YC, et al. Hepatitis A virus infection in Taiwan. Taiwan Yi Xue Hui Za Zhi. 1980;79(8):694-9. PMID: 6934257 
  4. Tsou TP, Liu CC, Huang JJ, Tsai KJ, Chang HF. Change in hepatitis A epidemiology after vaccinating high risk children in Taiwan, 1995-2008. Vaccine. 2011;29(16):2956-61.  https://doi.org/10.1016/j.vaccine.2011.02.001  PMID: 21329774 
  5. Wang CY, Su WJ, Lin CF, Huang JJ, Chou YM, Yen JJ. Epidemiological analysis and the prevention policies for the 2010-2013 epidemic of acute viral hepatitis a in Taiwan. Taiwan Epidemiology Bulletin. 2014;30(14):285-9. [Accessed: 26 Feb 2018]. Available from: https://www.cdc.gov.tw/english/info.aspx?treeid=3847719104BE0678&nowtreeid=3F54ECC1D5C5D238&tid=16A3B63F89308B8B
  6. Latash J, Dorsinville M, Del Rosso P, Antwi M, Reddy V, Waechter H, et al. Notes from the field: increase in reported hepatitis a infections among men who have sex with men - New York City, January-August 2017. MMWR Morb Mortal Wkly Rep. 2017;66(37):999-1000.  https://doi.org/10.15585/mmwr.mm6637a7  PMID: 28934181 
  7. European Centre for Disease Prevention and Control (ECDC). Rapid risk assessment: Hepatitis A outbreak in the EU/EEA mostly affecting men who have sex with men – third update, 28 June 2017. Stockholm: ECDC; 2017. Available from: https://ecdc.europa.eu/en/publications-data/rapid-risk-assessment-hepatitis-outbreak-eueea-mostly-affecting-men-who-have-sex
  8. Kuo HW, Wu HH, Chen WC, Lo YC, Liu DP. Shigellosis and acute hepatitis A infection among HIV-infected patients — Taiwan, 2015. Taiwan Epidemiology Bulletin. 2015;31(24):626-30.  https://doi.org/10.6524/EB.20151222.31(24).002.  https://doi.org/ Chinese. Available from: https://www.cdc.gov.tw/info.aspx?treeid=075874DC882A5BFD&nowtreeid=87508D1782050E1A&tid=3FDA2077C2D3C35E
  9. Oregon Food Safety Center of Excellence. Shotgun hypothesis-generating questionnaire. Corvallis: Oregon State University; 2014. Available from: https://health.oregonstate.edu/sites/health.oregonstate.edu/files/FOMES/pdf/shotgun-hypothesis-generating-questionnaire-english.pdf
  10. Lo YC, Ji DD, Hung CC. Prevalent and incident HIV diagnoses among Entamoeba histolytica-infected adult males: a changing epidemiology associated with sexual transmission--Taiwan, 2006-2013. PLoS Negl Trop Dis. 2014;8(10):e3222.  https://doi.org/10.1371/journal.pntd.0003222  PMID: 25299178 
  11. Chiou CS, Izumiya H, Kawamura M, Liao YS, Su YS, Wu HH, et al. The worldwide spread of ciprofloxacin-resistant Shigella sonnei among HIV-infected men who have sex with men, Taiwan. Clin Microbiol Infect. 2016;22(4):383.e11-6.  https://doi.org/10.1016/j.cmi.2015.12.021  PMID: 26806133 
  12. World Health Organization (WHO). Guidelines for environmental surveillance of poliovirus circulation. Geneva: WHO; 2003. Available from: http://www.who.int/immunization/documents/WHO_VB_03.03/en/
  13. Thompson JD, Higgins DG, Gibson TJ. CLUSTAL W: improving the sensitivity of progressive multiple sequence alignment through sequence weighting, position-specific gap penalties and weight matrix choice. Nucleic Acids Res. 1994;22(22):4673-80.  https://doi.org/10.1093/nar/22.22.4673  PMID: 7984417 
  14. Fujiwara K, Yokosuka O, Fukai K, Imazeki F, Saisho H, Omata M. Analysis of full-length hepatitis A virus genome in sera from patients with fulminant and self-limited acute type A hepatitis. J Hepatol. 2001;35(1):112-9.  https://doi.org/10.1016/S0168-8278(01)00074-5  PMID: 11495028 
  15. Freidl GS, Sonder GJ, Bovée LP, Friesema IH, van Rijckevorsel GG, Ruijs WL, et al. Hepatitis A outbreak among men who have sex with men (MSM) predominantly linked with the EuroPride, the Netherlands, July 2016 to February 2017. Euro Surveill. 2017;22(8):30468.  https://doi.org/10.2807/1560-7917.ES.2017.22.8.30468  PMID: 28251892 
  16. Urbanus AT, van Houdt R, van de Laar TJ, Coutinho RA. Viral hepatitis among men who have sex with men, epidemiology and public health consequences. Euro Surveill. 2009;14(47):19421.  https://doi.org/10.2807/ese.14.47.19421-en  PMID: 19941800 
  17. Stene-Johansen K, Tjon G, Schreier E, Bremer V, Bruisten S, Ngui SL, et al. Molecular epidemiological studies show that hepatitis A virus is endemic among active homosexual men in Europe. J Med Virol. 2007;79(4):356-65.  https://doi.org/10.1002/jmv.20781  PMID: 17311331 
  18. Henning KJ, Bell E, Braun J, Barker ND. A community-wide outbreak of hepatitis A: risk factors for infection among homosexual and bisexual men. Am J Med. 1995;99(2):132-6.  https://doi.org/10.1016/S0002-9343(99)80132-6  PMID: 7625417 
  19. Leentvaar-Kuijpers A, Kool JL, Veugelers PJ, Coutinho RA, van Griensven GJ. An outbreak of hepatitis A among homosexual men in Amsterdam, 1991-1993. Int J Epidemiol. 1995;24(1):218-22.  https://doi.org/10.1093/ije/24.1.218  PMID: 7797346 
  20. Bell A, Ncube F, Hansell A, Davison KL, Young Y, Gilson R, et al. An outbreak of hepatitis A among young men associated with having sex in public venues. Commun Dis Public Health. 2001;4(3):163-70. PMID: 11732354 
  21. Beebeejaun K, Degala S, Balogun K, Simms I, Woodhall SC, Heinsbroek E, et al. Outbreak of hepatitis A associated with men who have sex with men (MSM), England, July 2016 to January 2017. Euro Surveill. 2017;22(5):30454.  https://doi.org/10.2807/1560-7917.ES.2017.22.5.30454  PMID: 28183392 
  22. Mazick A, Howitz M, Rex S, Jensen IP, Weis N, Katzenstein TL, et al. Hepatitis A outbreak among MSM linked to casual sex and gay saunas in Copenhagen, Denmark. Euro Surveill. 2005;10(5):536.  https://doi.org/10.2807/esm.10.05.00536-en 
  23. La Rosa G, Libera SD, Iaconelli M, Ciccaglione AR, Bruni R, Taffon S, et al. Surveillance of hepatitis A virus in urban sewages and comparison with cases notified in the course of an outbreak, Italy 2013. BMC Infect Dis. 2014;14(1):419.  https://doi.org/10.1186/1471-2334-14-419  PMID: 25074676 
  24. Allard R, Beauchemin J, Bédard L, Dion R, Tremblay M, Carsley J. Hepatitis A vaccination during an outbreak among gay men in Montréal, Canada, 1995-1997. J Epidemiol Community Health. 2001;55(4):251-6.  https://doi.org/10.1136/jech.55.4.251  PMID: 11238580 
  25. Centers for Disease Control and Prevention (CDC). Hepatitis A vaccination of men who have sex with men--Atlanta, Georgia, 1996-1997. MMWR Morb Mortal Wkly Rep. 1998;47(34):708-11. PMID: 9746398 
  26. Tortajada C, de Olalla PG, Pinto RM, Bosch A, Caylà J. Outbreak of hepatitis A among men who have sex with men in Barcelona, Spain, September 2008-March 2009. Euro Surveill. 2009;14(15):19175. PMID: 19371516 
  27. Tortajada C, de Olalla PG, Diez E, Pinto RM, Bosch A, Perez U, et al. Saunas Working Group. Hepatitis A among men who have sex with men in Barcelona, 1989-2010: insufficient control and need for new approaches. BMC Infect Dis. 2012;12(1):11.  https://doi.org/10.1186/1471-2334-12-11  PMID: 22264382 
  28. Tseng YT, Sun HY, Chang SY, Wu CH, Liu WC, Wu PY, et al. Seroprevalence of hepatitis virus infection in men who have sex with men aged 18-40 years in Taiwan. J Formos Med Assoc. 2012;111(8):431-8.  https://doi.org/10.1016/j.jfma.2011.06.022  PMID: 22939661 
  29. Lee YL, Lin KY, Cheng CY, Li CW, Yang CJ, Tsai MS, et al. Taiwan HIV Study Group. Evolution of hepatitis A virus seroprevalence among HIV-positive adults in Taiwan. PLoS One. 2017;12(10):e0186338.  https://doi.org/10.1371/journal.pone.0186338  PMID: 29036227 
  30. Cheng CY, Wu HH, Zou H, Lo YC. Epidemiological characteristics and associated factors of acute hepatitis A outbreak among HIV-coinfected men who have sex with men in Taiwan, June 2015-December 2016. J Viral Hepat. 2018;25(10):1208-15.  https://doi.org/10.1111/jvh.12926  PMID: 29741291 
  31. Chen GJ, Lin KY, Sun HY, Sheng WH, Hsieh SM, Huang YC, et al. Incidence of acute hepatitis A among HIV-positive patients during an outbreak among MSM in Taiwan: Impact of HAV vaccination. Liver Int. 2018;38(4):594-601. https://doi.org/10.1111/liv.13468  PMID: 28482131 
  32. Weerakoon AP, Chen MY, Read TR, Bradshaw C, Fairley CK. Immunity to hepatitis A when outbreaks of infection in men who have sex with men (MSM) are rare. Vaccine. 2012;30(23):3430-4.  https://doi.org/10.1016/j.vaccine.2012.03.024  PMID: 22449421 
  33. Regan DG, Wood JG, Benevent C, Ali H, Smith LW, Robertson PW, et al. Estimating the critical immunity threshold for preventing hepatitis A outbreaks in men who have sex with men. Epidemiol Infect. 2016;144(7):1528-37.  https://doi.org/10.1017/S0950268815002605  PMID: 26566273 
  34. Crane HM, Dhanireddy S, Kim HN, Ramers C, Dellit TH, Kitahata MM, et al. Hepatitis A vaccination among human immuno- deficiency virus (HIV)-infected adults: Current evidence and unanswered questions. J AIDS HIV Res. 2013;5(3):90-100.
  35. Kernéis S, Launay O, Turbelin C, Batteux F, Hanslik T, Boëlle PY. Long-term immune responses to vaccination in HIV-infected patients: a systematic review and meta-analysis. Clin Infect Dis. 2014;58(8):1130-9.  https://doi.org/10.1093/cid/cit937  PMID: 24415637 
  36. Kernéis S, Desaint C, Brichler S, Rey D, Belarbi L, Gordien E, et al. Long-term persistence of humoral immunity after hepatitis A vaccination in HIV-infected adults. J Acquir Immune Defic Syndr. 2011;57(3):e63-6.  https://doi.org/10.1097/QAI.0b013e31821fdec3  PMID: 21860353 
  37. Tseng YT, Chang SY, Liu WC, Sun HY, Wu CH, Wu PY, et al. Comparative effectiveness of two doses versus three doses of hepatitis A vaccine in human immunodeficiency virus-infected and -uninfected men who have sex with men. Hepatology. 2013;57(5):1734-41.  https://doi.org/10.1002/hep.26210  PMID: 23258666 
/content/10.2807/1560-7917.ES.2019.24.14.1800133
Loading

Data & Media loading...

Supplementary data

Comment has been disabled for this content
Submit comment
Close
Comment moderation successfully completed
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error