A waterborne outbreak involving hepatitis A virus genotype IA at a residential facility in the Republic of Korea in 2015

J Clin Virol. 2017 Sep:94:63-66. doi: 10.1016/j.jcv.2017.07.006. Epub 2017 Jul 14.

Abstract

Background: Hepatitis A virus (HAV), a major cause of acute hepatitis, has had the highest occurrence among group 1 nationally notifiable infectious diseases in Korea since 2010.Recently,the annual increase in the HAV infection rate among young adults has become a public health concern.

Objectives: The aim of this study was to describe an outbreak of acute hepatitis in a residential facility in April 2015 and to identify potential sources of this outbreak.

Study design: Sera from all exposed residents were tested for anti-HAV IgM or IgG antibodies by ELISA. Clinical (sera and stool) and environmental samples were screened for the presence of HAV RNA using one-step RT-PCR and nested PCR. The VP3-VP1 regions of HAV were analyzed using the BLAST database and MEGA7 software.

Results: Of the 82 persons in the facility, 12 (14.6%, including 10 residents and 2 health care workers) were diagnosed with hepatitis A. Clinical symptoms were evident in 9 individuals, one of whom died, and the remaining four patients were asymptomatic. Traceback investigation revealed that HAV-RNA (genotype IA) was detected in the patients' stools and the groundwater used in the facility.

Conclusions: We described an HAV outbreak in a facility for the disabled due to using a water supply that was mixed with contaminated groundwater. Therefore, HAV vaccination and periodic water inspections in group facilities should be emphasized to prevent HAV infection.

Keywords: Genotype IA; Hepatitis A virus; Waterborne outbreak.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Disease Outbreaks / statistics & numerical data*
  • Genotype
  • Hepatitis A / epidemiology*
  • Hepatitis A / immunology
  • Hepatitis A / transmission
  • Hepatitis A Antibodies / blood
  • Hepatitis A virus / genetics*
  • Hepatitis A virus / immunology
  • Humans
  • Immunoglobulin G / blood
  • Immunoglobulin M / blood
  • Phylogeny
  • Republic of Korea / epidemiology
  • Water Microbiology*
  • Water Supply
  • Young Adult

Substances

  • Hepatitis A Antibodies
  • Immunoglobulin G
  • Immunoglobulin M