A large ongoing outbreak of hepatitis A predominantly affecting young males in Lazio, Italy; August 2016 - March 2017

The hepatitis A virus (HAV) is mainly transmitted through the faecal-oral route. In industrialized countries HAV infection generally occurs as either sporadic cases in travelers from endemic areas, local outbreak within closed/semi-closed population and as foodborne community outbreak. Recently, an...

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Bibliographic Details
Published in:PloS one 2017-11, Vol.12 (11), p.e0185428-e0185428
Main Authors: Lanini, Simone, Minosse, Claudia, Vairo, Francesco, Garbuglia, Annarosa, Di Bari, Virginia, Agresta, Alessandro, Rezza, Giovanni, Puro, Vincenzo, Pendenza, Alessio, Loffredo, Maria Rosaria, Scognamiglio, Paola, Zumla, Alimuddin, Panella, Vincenzo, Ippolito, Giuseppe, Capobianchi, Maria Rosaria
Format: Article
Language:English
Subjects:
Adult
Biology and life sciences
Clusters
Computer and Information Sciences
Development and progression
Disease Outbreaks
Disease prevention
Disease transmission
Distribution
Epidemiology
Female
Health risks
Hepatitis
Hepatitis A
Hepatitis A - epidemiology
Homosexuality, Male
Humans
Infections
Infectious diseases
Italy - epidemiology
Male
Males
Medicine and health sciences
Outbreaks
People and Places
Population Surveillance
Risk factors
Risk groups
Surveillance
Vaccination
Viruses
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Summary:The hepatitis A virus (HAV) is mainly transmitted through the faecal-oral route. In industrialized countries HAV infection generally occurs as either sporadic cases in travelers from endemic areas, local outbreak within closed/semi-closed population and as foodborne community outbreak. Recently, an increasing number of HAV infection clusters have been reported among young men-who-have-sex-with-men (MSM). The Lazio Regional Service for the epidemiology and control for infectious diseases (SeRESMI) has noticed an increase of acute hepatitis A (AHA) since September 2016. Temporal analysis carried out with a discrete Poisson model using surveillance data between January 2016 and March 2017 evidenced an ongoing outbreak of AHA that started at the end of August. Molecular investigation carried out on 130 out of 513 cases AHA reported until March 2017 suggests that this outbreak is mainly supported by an HAV variant which is currently spreading within MSM communities across Europe (VRD_521_2016). The report confirms that AHA is an emerging issue among MSM. In addition through the integration of standard (case based) surveillance with molecular investigation we could discriminate, temporally concomitant but epidemiologically unrelated, clusters due to different HAV variants. As suggested by the WHO, in countries with low HAV circulation, vaccination programmes should be tailored on the local epidemiological patterns to prevent outbreaks among high risk groups and eventual spillover of the infection in the general population.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0185428