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Wageningen, Netherlands

Boxman I.L.,Laboratory for Feed and Food Safety | Verhoef L.,National Institute of Public Health and the Environment RIVM | Vennema H.,National Institute of Public Health and the Environment RIVM | Ngui S.,Public Health England | And 4 more authors.
Eurosurveillance | Year: 2016

This report describes an outbreak investigation starting with two closely related suspected food-borne clusters of Dutch hepatitis A cases, nine primary cases in total, with an unknown source in the Netherlands. The hepatitis A virus (HAV) genotype IA sequences of both clusters were highly similar (459/460 nt) and were not reported earlier. Food questionnaires and a case–control study revealed an association with consumption of mussels. Analysis of mussel supply chains identified the most likely production area. International enquiries led to identification of a cluster of patients near this production area with identical HAV sequences with onsets predating the first Dutch cluster of cases. The most likely source for this cluster was a case who returned from an endemic area in Central America, and a subsequent household cluster from which treated domestic sewage was discharged into the suspected mussel production area. Notably, mussels from this area were also consumed by a separate case in the United Kingdom sharing an identical strain with the second Dutch cluster. In conclusion, a small number of patients in a non-endemic area led to geographically dispersed hepatitis A outbreaks with food as vehicle. This link would have gone unnoticed without sequence analyses and international collaboration. © 2016, European Centre for Disease Prevention and Control (ECDC). All rights reserved. Source


Boxman I.L.A.,Laboratory for Feed and Food Safety | Verhoef L.,National Institute of Public Health and the Environment RIVM | Hagele G.,Laboratory for Feed and Food Safety | Klunder K.,Laboratory for Feed and Food Safety | And 4 more authors.
Food Control | Year: 2015

Noroviruses (NoV) are among the most common causes of viral gastroenteritis (GE) worldwide and can be transmitted from person-to-person, via food or contaminated surfaces. The present study aimed to examine the prevalence of NoV RNA on surfaces in food preparation and sanitary areas in different health care settings and to compare the outcomes with the prevalence in nearby located catering companies, mainly restaurants, for general public, as sentinels. For this purpose, 1087 environmental swabs were taken for NoV analyses from surfaces in 241 institutional departments and 123 catering companies in The Netherlands without a recently reported outbreak of gastro-enteritis in high NoV season only. NoV RNA was detected in 15.1% of the 73 non-hospital health care institutions, 11.1% of the 54 hospital central kitchen departments, 14.9% of the 114 decentralized hospital kitchens (in-patient units) and 4.1% of the 123 nearby located catering companies. Twenty-five of the 49 positive environmental samples were genotyped by sequence analyses. In 7% of the investigated hospitals (4/58), NoV was detected in two or more departments. NoV prevalence was significantly lower in food preparation areas than in sanitary facilities (p<0.05), but only in hospital central kitchen departments and non-hospital health care settings, and not in de-centralized hospital kitchens in in-patient units or in catering companies for the general public. This data suggests that there is a need for education on risks of NoV transmission by food handling of healthcare workers using in ward kitchen facilities. © 2014. Source


Boxman I.L.,Laboratory for Feed and Food Safety | Verhoef L.,Laboratory for Feed and Food Safety | Vennema H.,Laboratory for Feed and Food Safety | Ngui S.-L.,Laboratory for Feed and Food Safety | And 4 more authors.
Euro surveillance : bulletin Européen sur les maladies transmissibles = European communicable disease bulletin | Year: 2016

This report describes an outbreak investigation starting with two closely related suspected food-borne clusters of Dutch hepatitis A cases, nine primary cases in total, with an unknown source in the Netherlands. The hepatitis A virus (HAV) genotype IA sequences of both clusters were highly similar (459/460 nt) and were not reported earlier. Food questionnaires and a case-control study revealed an association with consumption of mussels. Analysis of mussel supply chains identified the most likely production area. International enquiries led to identification of a cluster of patients near this production area with identical HAV sequences with onsets predating the first Dutch cluster of cases. The most likely source for this cluster was a case who returned from an endemic area in Central America, and a subsequent household cluster from which treated domestic sewage was discharged into the suspected mussel production area. Notably, mussels from this area were also consumed by a separate case in the United Kingdom sharing an identical strain with the second Dutch cluster. In conclusion, a small number of patients in a non-endemic area led to geographically dispersed hepatitis A outbreaks with food as vehicle. This link would have gone unnoticed without sequence analyses and international collaboration. Source

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