Abstract
In March 2014, after an increase of notifications of domestically acquired hepatitis A virus infections, an outbreak investigation was launched in Norway. Sequenced-based typing results showed that these cases were associated with a strain that was identical to one causing an ongoing multinational outbreak in Europe linked to frozen mixed berries. Thirty-three confirmed cases with the outbreak strain were notified in Norway from November 2013 to June 2014. Epidemiological evidence and trace-back investigations linked the outbreak to the consumption of a berry mix cake. Identification of the hepatitis A virus outbreak strain in berries from one of the implicated cakes confirmed the cake to be the source. Subsequently, a cluster in Germany linked to the cake was also identified.
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References
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Acknowledgements
We would like to thank all colleagues that have contributed in the outbreak investigation. We would also like to thank Pawel Stefanoff from the European Programme for Intervention Epidemiology Training (EPIET) for his feedback to the manuscript. We would like to thank Dr. Oliver Kappert (Public Health Office, Freiburg, Germany) and Dr. Armin Dietz (Public Health Office, Emmendingen, Germany) for support of the outbreak investigation. First steps of this investigation were previously published here: Guzman-Herrador B, Jensvoll L, Einöder-Moreno M, Lange H, Myking S, Nygård K, Stene-Johansen K, Vold L. Ongoing hepatitis A outbreak in Europe 2013 to 2014: imported berry mix cake suspected to be the source of infection in Norway. Euro Surveill. 2014;19(15): pii = 20775. Available online: http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=20775
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Guzman-Herrador, B.R., Panning, M., Stene-Johansen, K. et al. Importance of molecular typing in confirmation of the source of a national hepatitis A virus outbreak in Norway and the detection of a related cluster in Germany. Arch Virol 160, 2823–2826 (2015). https://doi.org/10.1007/s00705-015-2531-y
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DOI: https://doi.org/10.1007/s00705-015-2531-y