Abstract
An outbreak of hepatitis A is described involving thirteen cases in a town in central-northern Italy. The consumption of infected clams, caught in a polluted coastal area of the Adriatic Sea, caused hepatitis A in all five members of a family consisting of mother, father and children, two of whom attended primary school. The epidemic subsequently spread to the primary school with a secondary attack rate of 7.9%, 0 for female pupils and 18.9% for males. The epidemiological and environmental investigations showed that the critical exposure took place in the boys' toilet in the primary school (OR: 32.79, 95% CI: 6.83–157.45). To prevent the spreading of contagion, extra disinfection was carried out in the whole school and health education campaigns were mounted. The good basic hygienic conditions of the homes, together with the cooperation of school staff in surveillance and providing information, allowed the epidemic to be controlled.
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References
ISTAT. Annuari Statistici Italiani. Istituto Superiore di Statistica, Roma 1986–1995.
Barbuti S, Germinario C, Lopalco PL, Quarto M. Epatite A in Puglia: L'epidemia del 1996. Vaccinazione 1996; 8 (12): 3–4.
Divizia M, De Filippis P, Di Napoli A, et al. Isolation of wild-type hepatitis A virus from the environment. Wat Res 1989a; 23: 1155–1160.
Mele A, Rastelli MG, Gill ON, et al. Recurrent epidemic hepatitis A associated with consumption of raw shellfish, probably controlled through public measures. Am J Epidemiol 1989; 130: 540–546.
Squarcione S, Troiano T, D' Amato S, Carbini R. An epidemic of viral hepatitis A in Apulia. Ann Ig 1995, 7: 431–437.
Mele A, Catapano R, Cialdea R, et al. Outbreak of hepatitis A in Trieste, Italy. J Public Health Med 1994; 16: 242–243.
Mele A, Rosmini F, Zampieri A, Gill ON. Integrated epidemiological system for acute viral hepatitis A in Italy (SEIEVA): Description and preliminary results. Eur J Epidemiol 1986; 2: 300–304.
Koff RS, Sear MD. Internal temperature of steamed clams. New England J Med 1967; 276: 737–739.
Niu MT, Polish LB, Robetson BH, et al. Multistate outbreak of hepatitis A associated with frozen strawberies. J Infect Dis 1992; 166: 518–524.
Conzelmann Auer C, Ackermann Liebrich U, Herzog C, Bachlin A. Hepatitis A outbreak in a kindergarten. Schweiz Med Wochenschr 1992; 122: 1559–1566.
Desenclos JCA, MacLafferty L. Community wide outbreak of hepatitis A linked to children in day care centres and with increased transmission in young adult men in Florida 1988–1989. J Epidemiol Comm Health 1993; 47: 269–273.
Sinlaparatsamee S, Nuniem J, Kankao J, Theamboonlers A. An outbreak of hepatitis A in school children at Nakhon Si Thammarat, southern Thailand. Southeast Asian J Trop Med Public Health 1995; 26: 104–108.
Rajaratnam G, Patel M, Parry JV, Perry KR, Palmer SR. An outbreak of hepatitis A: School toilets as a source of transmission. J Public Health Med 1992; 14: 72–77.
MMWR. Recommendations for protection against viral hepatitis. Morbidity and Mortality Weekly Report 1985; 34: 313–337.
Majeed FA, Stuart JM, Cartwright AV, et al. An outbreak of hepatitis A in Gloucester, UK. Epidemiol Inf 1992; 109: 167–173.
Desenclos JCA, Klontz KC, Wilder MH, et al. A multistate outbreak of hepatitis A caused by the consumption of raw oysters. Am J Public Health 1991; 81: 1268–1272.
Halliday ML, Kang LY, Zhou TK, et al. An epidemic of hepatitis A attributable to the ingestion of raw clams in Shanghai, China. J Infec Dis 1991; 164: 852–859.
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Leoni, E., Bevini, C., Esposti, S.D. et al. An outbreak of intrafamiliar hepatitis A associated with clam consumption: Epidemic transmission to a school community. Eur J Epidemiol 14, 187–192 (1998). https://doi.org/10.1023/A:1007441106534
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DOI: https://doi.org/10.1023/A:1007441106534