Improving preparedness to respond to cross-border hepatitis A outbreaks in the European Union/European Economic Area: towards comparable sequencing of hepatitis A virus

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Enkirch, Theresa ; Severi, Ettore ; Vennema, Harry ; Thornton, Lelia ; Dean, Jonathan ; Borg, Maria-Louise ; Ciccaglione, Anna Rita ; Bruni, Roberto ; Christova, Iva ; Ngui, Siew Lin ; Balogun, Koye ; Němeček, Vratislav ; Kontio, Mia ; Takács, Mária ; Hettmann, Andrea ; Korotinska, Rita ; Löve, Arthur ; Avellón, Ana ; Muñoz-Chimeno, Milagros ; de Sousa, Rita ; Janta, Denisa ; Epštein, Jevgenia ; Klamer, Sofieke ; Suin, Vanessa ; Aberle, Stephan W ; Holzmann, Heidemarie ; Mellou, Kassiani ; Ederth, Josefine Lundberg ; Sundqvist, Lena ; Roque-Afonso, Anne-Marie ; Filipović, Sanja Kurečić ; Poljak, Mario ; Vold, Line ; Stene-Johansen, Kathrine ; Midgley, Sofie ; Fischer, Thea Kølsen ; Faber, Mirko ; Wenzel, Jürgen J ; Takkinen, Johanna ; Leitmeyer, Katrin

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Date of publication of this fulltext: 18 Jul 2019 13:23

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Details

Item type:	Article
Journal or Publication Title:	Eurosurveillance
Volume:	24
Number of Issue or Book Chapter:	28
Date:	11 July 2019
Institutions:	Medicine > Lehrstuhl für Medizinische Mikrobiologie und Hygiene
Identification Number:	Value Type 10.2807/1560-7917.es.2019.24.28.1800397 DOI 31311618 PubMed ID
Keywords:	European Union; HAV; capacity building; foodborne diseases; hepatitis A virus; sequence analysis; surveys and questionnaires
Dewey Decimal Classification:	600 Technology > 610 Medical sciences Medicine
Status:	Published
Refereed:	Yes, this version has been refereed
Created at the University of Regensburg:	Partially
Item ID:	40545

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Abstract

Introduction: Sequence-based typing of hepatitis A virus (HAV) is important for outbreak detection, investigation and surveillance. In 2013, sequencing was central to resolving a large European Union (EU)-wide outbreak related to frozen berries. However, as the sequenced HAV genome regions were only partly comparable between countries, results were not always conclusive. Aim: The objective was to ...

Abstract

Introduction: Sequence-based typing of hepatitis A virus (HAV) is important for outbreak detection, investigation and surveillance. In 2013, sequencing was central to resolving a large European Union (EU)-wide outbreak related to frozen berries. However, as the sequenced HAV genome regions were only partly comparable between countries, results were not always conclusive. Aim: The objective was to gather information on HAV surveillance and sequencing in EU/European Economic Area (EEA) countries to find ways to harmonise their procedures, for improvement of cross-border outbreak responses.MethodsIn 2014, the European Centre for Disease Prevention and Control (ECDC) conducted a survey on HAV surveillance practices in EU/EEA countries. The survey enquired whether a referral system for confirming primary diagnostics of hepatitis A existed as well as a central collection/storage of hepatitis A cases' samples for typing. Questions on HAV sequencing procedures were also asked. Based on the results, an expert consultation proposed harmonised procedures for cross-border outbreak response, in particular regarding sequencing. In 2016, a follow-up survey assessed uptake of suggested methods. Results: Of 31 EU/EEA countries, 23 (2014) and 27 (2016) participated. Numbers of countries with central collection and storage of HAV positive samples and of those performing sequencing increased from 12 to 15 and 12 to 14 respectively in 2016, with all countries typing an overlapping fragment of 218 nt. However, variation existed in the sequenced genomic regions and their lengths. Conclusions: While HAV sequences in EU/EEA countries are comparable for surveillance, collaboration in sharing and comparing these can be further strengthened.

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