TY - JOUR
T1 - Hepatitis a outbreak disproportionately affecting men who have sex with men (MSM) in the european union and european economic area, june 2016 to may 2017
AU - European Hepatitis A Outbreak Investigation Team
AU - Ndumbi, Patricia
AU - Freidl, Gudrun S.
AU - Williams, Christopher J.
AU - Mårdh, Otilia
AU - Varela, Carmen
AU - Avellón, Ana
AU - Friesema, Ingrid
AU - Vennema, Harry
AU - Beebeejaun, Kazim
AU - Ngui, Siew Lin
AU - Edelstein, Michael
AU - Smith-Palmer, Alison
AU - Murphy, Niamh
AU - Dean, Jonathan
AU - Faber, Mirko
AU - Wenzel, Jürgen
AU - Kontio, Mia
AU - Müller, Luise
AU - Midgley, Sofie Elisabeth
AU - Sundqvist, Lena
AU - Ederth, Josefine Lundberg
AU - Roque-Afonso, Anne Marie
AU - Couturier, Elisabeth
AU - Klamer, Sofieke
AU - Rebolledo, Javiera
AU - Suin, Vanessa
AU - Aberle, Stephan W.
AU - Schmid, Daniela
AU - De Sousa, Rita
AU - Augusto, Gonçalo Figueiredo
AU - Alfonsi, Valeria
AU - Del Manso, Martina
AU - Ciccaglione, Anna Rita
AU - Mellou, Kassiani
AU - Hadjichristodoulou, Christos
AU - Donachie, Alastair
AU - Borg, Maria Louise
AU - Sočan, Maja
AU - Poljak, Mario
AU - Severi, Ettore
AU - Parmentier, Sofie
AU - Laisnez, Valeska
AU - Reynaerts, Alice
AU - Mahieu, Romain
AU - Schirvel, Carole
AU - Vestergaard, Hanne Thang
AU - Nisavanh, Athinna
AU - Jessen, Heiko
AU - Michaelis, Kai
AU - Mandal, Sema
N1 - Funding Information:
We would like to acknowledge Caterina Rizzo, Maria Elena Tosti, Paulo Nogueira and Zoran Simonovi? for their contribution in this outbreak investigation. We also would like to acknowledge all the staff at local and national levels, including the personnel working in national health institutes and reference laboratories. We are grateful to Denis Coulombier and Mike Catchpole for their review of the manuscript. We are also grateful to Silviu Ionescu for his support with the case mapping and to Meghan Hamel for providing information on Canadian cases.
Publisher Copyright:
© 2018, (publisher Name). All rights reserved.
PY - 2018/8/16
Y1 - 2018/8/16
N2 - Between 1 June 2016 and 31 May 2017, 17 European Union (EU) and European Economic Area countries reported 4,096 cases associated with a multi-country hepatitis A (HA) outbreak. Molecular analysis identified three co-circulating hepatitis A virus (HAV) strains of genotype IA: VRD_521_2016, V16–25801 and RIVM-HAV16–090. We categorised cases as confirmed, probable or possible, according to the EU outbreak case definitions. Confirmed cases were infected with one of the three outbreak strains. We investigated case characteristics and strain-specific risk factors for transmission. A total of 1,400 (34%) cases were confirmed; VRD_521_2016 and RIVM-HAV16–090 accounted for 92% of these. Among confirmed cases with available epidemiological data, 92% (361/393) were unvaccinated, 43% (83/195) travelled to Spain during the incubation period and 84% (565/676) identified as men who have sex with men (MSM). Results depict an HA outbreak of multiple HAV strains, within a cross-European population, that was particularly driven by transmission between non-immune MSM engaging in high-risk sexual behaviour. The most effective preventive measure to curb this outbreak is HAV vaccination of MSM, supplemented by primary prevention campaigns that target the MSM population and promote protective sexual behaviour.
AB - Between 1 June 2016 and 31 May 2017, 17 European Union (EU) and European Economic Area countries reported 4,096 cases associated with a multi-country hepatitis A (HA) outbreak. Molecular analysis identified three co-circulating hepatitis A virus (HAV) strains of genotype IA: VRD_521_2016, V16–25801 and RIVM-HAV16–090. We categorised cases as confirmed, probable or possible, according to the EU outbreak case definitions. Confirmed cases were infected with one of the three outbreak strains. We investigated case characteristics and strain-specific risk factors for transmission. A total of 1,400 (34%) cases were confirmed; VRD_521_2016 and RIVM-HAV16–090 accounted for 92% of these. Among confirmed cases with available epidemiological data, 92% (361/393) were unvaccinated, 43% (83/195) travelled to Spain during the incubation period and 84% (565/676) identified as men who have sex with men (MSM). Results depict an HA outbreak of multiple HAV strains, within a cross-European population, that was particularly driven by transmission between non-immune MSM engaging in high-risk sexual behaviour. The most effective preventive measure to curb this outbreak is HAV vaccination of MSM, supplemented by primary prevention campaigns that target the MSM population and promote protective sexual behaviour.
UR - http://www.scopus.com/inward/record.url?scp=85053348186&partnerID=8YFLogxK
U2 - 10.2807/1560-7917.ES.2018.23.33.1700641
DO - 10.2807/1560-7917.ES.2018.23.33.1700641
M3 - Article
C2 - 30131095
AN - SCOPUS:85053348186
SN - 1025-496X
VL - 23
SP - 1
EP - 12
JO - Eurosurveillance
JF - Eurosurveillance
IS - 33
M1 - 1700641
ER -
