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An outbreak of hepatitis A associated with consumption of raw blueberries

Published online by Cambridge University Press:  23 September 2003

L. CALDER
Affiliation:
Public Health, Community Services, Auckland District Health Board, Private Bag 92065, Auckland, New Zealand
G. SIMMONS
Affiliation:
Public Health, Community Services, Auckland District Health Board, Private Bag 92065, Auckland, New Zealand
C. THORNLEY
Affiliation:
Kenepuru Science Centre, Institute of Environmental Science & Research Limited, P.O. Box 50-348, Porirua, Wellington, New Zealand
P. TAYLOR
Affiliation:
Public Health, Community Services, Auckland District Health Board, Private Bag 92065, Auckland, New Zealand
K. PRITCHARD
Affiliation:
Public Health, Community Services, Auckland District Health Board, Private Bag 92065, Auckland, New Zealand
G. GREENING
Affiliation:
Kenepuru Science Centre, Institute of Environmental Science & Research Limited, P.O. Box 50-348, Porirua, Wellington, New Zealand
J. BISHOP
Affiliation:
Ministry of Health, P.O. Box 5013, Wellington, New Zealand
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Abstract

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This report describes the epidemiology, investigation and control of a hepatitis A (HAV) outbreak in New Zealand. Descriptive and analytical epidemiology, virology, product traceback and an orchard investigation were carried out. A case–control study revealed that 56% of 39 cases had consumed raw blueberries, compared with 14% of 71 controls (odds ratio 7·6; 95% confidence intervals 2·6–22·4). Traceback of product through retailers and wholesalers implicated a single commercial orchard. Hepatitis A virus was detected by reverse transcriptase polymerase chain reaction in faecal specimens from cases as well as a blueberry product from the orchard. Presence of hepatitis A virus was confirmed by DNA hybridization and sequencing of PCR products. Sanitary audit of the orchard revealed multiple opportunities for contamination of blueberries by pickers. This outbreak highlights the need for food safety programmes in the berry fruit industry.

Type
Research Article
Copyright
© 2003 Cambridge University Press