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Outbreak of hepatitis A in two federal states of Germany: bakery products as vehicle of infection

Published online by Cambridge University Press:  02 May 2006

K. SCHENKEL ,
V. BREMER ,
C. GRABE ,
U. VAN TREECK ,
E. SCHREIER ,
M. HÖHNE ,
A. AMMON  and
K. ALPERS
K. SCHENKEL
Affiliation:
Department for Infectious Diseases Epidemiology, Robert Koch-Institut, Berlin, Germany
V. BREMER
Affiliation:
Department for Infectious Diseases Epidemiology, Robert Koch-Institut, Berlin, Germany
C. GRABE
Affiliation:
Local Health Department, Siegen, Germany
U. VAN TREECK
Affiliation:
Institute of Public Health, North Rhine-Westphalia, Münster, Germany
E. SCHREIER
Affiliation:
Unit of Molecular Epidemiology of Viral Infections, Robert Koch-Institut, Berlin, Germany
M. HÖHNE
Affiliation:
Unit of Molecular Epidemiology of Viral Infections, Robert Koch-Institut, Berlin, Germany
A. AMMON
Affiliation:
Department for Infectious Diseases Epidemiology, Robert Koch-Institut, Berlin, Germany
K. ALPERS
Affiliation:
Department for Infectious Diseases Epidemiology, Robert Koch-Institut, Berlin, Germany
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Abstract

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In April 2004, increased numbers of hepatitis A were noted in six neighbouring districts in Germany. Exploratory interviews showed that patients had consumed bakery products from company X where two employees had been diagnosed with hepatitis A in February. A case-control study of consumption of products of company X was carried out through telephone interviews. Altogether, 64 cases were identified. Fifty-two cases and 112 controls aged [ges ]16 years were included in the case-control study. In total, 46/52 cases and 37/112 controls had consumed company X products [odds ratio (OR) 15·5, 95% confidence interval (CI) 6·1–39·7]. Of these, 36/46 cases and 16/37 controls had consumed pastries (OR 4·7, 95% CI 1·8–12·3), 25/46 cases and 12/37 controls had consumed filled doughnuts (OR 2·5, 95% CI 1·0–6·1). Sequence analysis of the VP1-2A junction region indicated 100% strain homology between cases and an infected employee of company X. We recommended reinforcement of hygiene precautions, and consideration of a prolongation of compulsory work absence after post-exposure vaccination.

Type
Research Article
Information
Epidemiology & Infection , Volume 134 , Issue 6 , December 2006 , pp. 1292 - 1298
Copyright
2006 Cambridge University Press