TY - GEN T1 - Large and prolonged food-borne multistate hepatitis A outbreak in Europe associated with consumption of frozen berries, 2013 to 2014 AU - Severi, Ettore AU - Verhoef, Linda AU - Thornton, L. AU - Guzman-Herrador, B. R. AU - Faber, Mirko AU - Sundqvist, L. AU - Rimhanen-Finne, R. AU - Roque-Afonso, A. M. AU - Ngui, S. L. AU - Allerberger, Franz AU - Baumann-Popczyk, A. AU - Muller, L. AU - Parmakova, K. AU - Alfonsi, V. AU - Tavoschi, L. AU - Vennema, H. AU - Fitzgerald, M. AU - Myrmel, M. AU - Gertler, Maximilian AU - Ederth, J. AU - Kontio, M. AU - Vanbockstael, C. AU - Mandal, S. AU - Sadkowska-Todys, M. AU - Tosti, M. E. AB - In May 2013, Italy declared a national outbreak of hepatitis A, which also affected several foreign tourists who had recently visited the country. Molecular investigations identified some cases as infected with an identical strain of hepatitis A virus subgenotype IA. After additional European Union/European Economic Area (EU/EEA) countries reported locally acquired and travel-related cases associated with the same outbreak, an international outbreak investigation team was convened, a European outbreak case definition was issued and harmonisation of the national epidemiological and microbiological investigations was encouraged. From January 2013 to August 2014, 1,589 hepatitis A cases were reported associated with the multistate outbreak; 1,102 (70%) of the cases were hospitalised for a median time of six days; two related deaths were reported. Epidemiological and microbiological investigations implicated mixed frozen berries as the vehicle of infection of the outbreak. In order to control the spread of the outbreak, suspected or contaminated food batches were recalled, the public was recommended to heat-treat berries, and post-exposure prophylaxis of contacts was performed. The outbreak highlighted how large food-borne hepatitis A outbreaks may affect the increasingly susceptible EU/EEA general population and how, with the growing international food trade, frozen berries are a potential high-risk food. KW - Humans KW - Female KW - Male KW - Adolescent KW - Adult KW - Middle Aged KW - Europe/epidemiology KW - Child Preschool KW - Foodborne Diseases/diagnosis KW - Disease Outbreaks KW - European Union KW - Epidemiologic Studies KW - Foodborne Diseases/epidemiology KW - Surveys and Questionnaires KW - Hepatitis A/epidemiology KW - Hepatitis A/virology KW - Contact Tracing KW - Food Contamination KW - Foodborne Diseases/virology KW - Frozen Foods/poisoning KW - Frozen Foods/virology KW - Fruit/poisoning KW - Fruit/virology KW - Hepatitis A virus/genetics KW - Hepatitis A virus/isolation & purification KW - 610 Medizin PY - 2015 LA - eng PB - Robert Koch-Institut, Infektionsepidemiologie VL - 20 IS - 29 DO - http://dx.doi.org/10.25646/2021 ER -