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-Reference-Cited by-同舟云学术

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

Published:2018-08-16 Issue:33 Volume:23 Page:
ISSN:1560-7917
Container-title:Eurosurveillance
language:en
Short-container-title:

Author:

Ndumbi Patricia¹²,Freidl Gudrun S³²,Williams Christopher J⁴²,Mårdh Otilia⁵,Varela Carmen¹,Avellón Ana¹,Friesema Ingrid³,Vennema Harry³,Beebeejaun Kazim⁶,Ngui Siew Lin⁶,Edelstein Michael⁶,Smith-Palmer Alison⁷,Murphy Niamh⁸,Dean Jonathan⁹,Faber Mirko¹⁰,Wenzel Jürgen¹¹,Kontio Mia¹²,Müller Luise¹³,Midgley Sofie Elisabeth¹³,Sundqvist Lena¹⁴,Ederth Josefine Lundberg¹⁴,Roque-Afonso Anne-Marie¹⁵,Couturier Elisabeth¹⁶,Klamer Sofieke¹⁷,Rebolledo Javiera¹⁷,Suin Vanessa¹⁷,Aberle Stephan W.¹⁸,Schmid Daniela¹⁹,De Sousa Rita²⁰,Augusto Gonçalo Figueiredo²¹,Alfonsi Valeria²²,Del Manso Martina²²,Ciccaglione Anna Rita²²,Mellou Kassiani²³,Hadjichristodoulou Christos²⁴,Donachie Alastair²⁵²,Borg Maria-Louise²⁵,Sočan Maja²⁶,Poljak Mario²⁷,Severi Ettore⁵²⁸,

Affiliation:

1. Instituto de Salud Carlos III, CIBER Epidemiología y Salud Pública, Madrid, Spain

2. European Programme for Intervention Epidemiology Training (EPIET)| European Centre for Disease Prevention and Control, Solna, Sweden

3. National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands

4. Public Health Wales, Cardiff, United Kingdom

5. European Centre for Disease Prevention and Control, Solna, Sweden

6. Public Health England Colindale, London, United Kingdom.

7. Health Protection Scotland, Glasgow, Scotland, United Kingdom

8. Health Protection Surveillance Centre, Dublin, Ireland

9. National Virus Reference Laboratory, Dublin, Ireland

10. Robert Koch Institute, Berlin, Germany

11. University Hospital Regensburg, Regensburg, Germany

12. National Institute for Health and Welfare (THL), Helsinki, Finland

13. Statens Serum Institut, Copenhagen, Denmark

14. The Public Health Agency of Sweden, Stockholm, Sweden

15. Centre National de Référence Virus des hépatites à transmission entérique, Villejuif, France

16. Sante publique France, Saint-Maurice, France

17. Sciensano, Brussels, Belgium

18. Medical University of Vienna, Vienna, Austria

19. Austrian Agency of Health and Food Safety, Vienna, Austria

20. National Institute of Health Dr Ricardo Jorge, Lisbon, Portugal

21. Directorate-General of Health, Lisbon, Portugal

22. Instituto Superiore Di Sanita, Rome, Italy

23. Hellenic Centre for Disease Control, Athens, Greece

24. University of Thessaly, Larissa, Greece

25. Health Promotion and Disease Prevention Directorate, Msida, Malta

26. National Institute of Public Health, Ljubljana, Slovenia

27. University of Ljubljana, Ljubljana, Slovenia

28. Karolinska Institutet, Stockholm, Sweden*

Abstract

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.

Publisher

European Centre for Disease Control and Prevention (ECDC)

Subject

Virology,Public Health, Environmental and Occupational Health,Epidemiology

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