Foodborne outbreak of hepatitis A virus in Germany

In October 2012, a hepatitis A virus (HAV) outbreak causing 83 laboratory-confirmed cases of disease occurred in Lower Saxony, Germany. The authors identified 77 primary and six secondary cases of infection. 50 primary cases were enrolled together with 52 controls matched for age and sex. They found that 82% of the cases and 60% of the controls had consumed products from a particular bakery (odds ratio [OR] 3.09, 95%CI 1.15–8.68). The cases were also more likely to have eaten sweet pastries (OR 5.74, 95%CI 1.46–22.42). Viral isolates from five selected cases and three positively tested surfaces in the bakery were found to have identical nucleotide sequences. One additional identical isolate was found in a salesperson at the bakery that was suffering from a chronic disease necessitating immunosuppressive treatment. It is likely that this salesperson contaminated products while packing and selling. Therefore it is important to assess whether immunosuppressed food handlers are at risk of contaminating food and therefore may benefit from HAV immunisation.

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