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Two concurrent outbreaks of hepatitis A highlight the risk of infection for non-immune travellers to Morocco, January to June 2018
- Martyna Gassowski1,2,3,4 , Kai Michaelis1,5 , Jürgen J. Wenzel1,6 , Mirko Faber5 , Julie Figoni7 , Lina Mouna8 , Ingrid HM Friesema9 , Harry Vennema10 , Ana Avellon11 , Carmen Varela12 , Lena Sundqvist13 , Josefine Lundberg Ederth14 , James Plunkett15 , Koye Balogun15 , Siew Lin Ngui15 , Sofie Elisabeth Midgley16 , Sofie Gillesberg Lassen17 , Luise Müller17
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View Affiliations Hide AffiliationsAffiliations: 1 These authors contributed equally to this work 2 Department for Infectious Disease Epidemiology, Robert Koch Institute (RKI), Berlin, Germany 3 Postgraduate Training for Applied Epidemiology (PAE, German Field Epidemiology Training Programme), Robert Koch Institute, Berlin, Germany 4 European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden 5 Department for Infectious Disease Epidemiology, Unit of Gastrointestinal Infections, Zoonoses, and Tropical Infections, Robert Koch Institute (RKI), Berlin, Germany 6 National Consultant Laboratory for HAV and HEV, Institute of Clinical Microbiology and Hygiene, University Medical Centre Regensburg, Regensburg, Germany 7 Santé Publique France, French National Public Health Agency, Saint-Maurice, France 8 AP-HP, National Reference Centre for Enterically Transmitted Hepatitis Viruses, Paul Brousse hospital, Villejuif, France. 9 Centre for Infectious Diseases, Epidemiology and Surveillance, Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands 10 Centre for Infectious Diseases Research, Diagnostics and Screening, Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands 11 Hepatitis Unit, National Center of Microbiology, Instituto de Salud Carlos III, Madrid, Spain 12 National Centre of Epidemiology, Instituto de Salud Carlos III, CIBER Epidemiología y Salud Pública, Madrid, Spain 13 Department of Communicable Disease Control and Health Protection, the Public Health Agency of Sweden, Stockholm, Sweden 14 Department of Microbiology, the Public Health Agency of Sweden, Stockholm, Sweden 15 National Infection Service, Public Health England, London, United Kingdom 16 Department of Virus & Microbiological Special Diagnostics, Statens Serum Institut, Copenhagen, Denmark 17 Department of Infectious Disease Epidemiology and Prevention, Statens Serum Institut, Copenhagen, DenmarkKai MichaelisMichaelisK rki.de
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Citation style for this article: Gassowski Martyna, Michaelis Kai, Wenzel Jürgen J., Faber Mirko, Figoni Julie, Mouna Lina, Friesema Ingrid HM, Vennema Harry, Avellon Ana, Varela Carmen, Sundqvist Lena, Lundberg Ederth Josefine , Plunkett James, Balogun Koye, Ngui Siew Lin, Midgley Sofie Elisabeth, Gillesberg Lassen Sofie , Müller Luise. Two concurrent outbreaks of hepatitis A highlight the risk of infection for non-immune travellers to Morocco, January to June 2018. Euro Surveill. 2018;23(27):pii=1800329. https://doi.org/10.2807/1560-7917.ES.2018.23.27.1800329 Received: 21 Jun 2018; Accepted: 05 Jul 2018
Abstract
From January to June 2018, two ongoing hepatitis A outbreaks affected travellers returning from Morocco and cases in Europe without travel history, resulting in 163 patients in eight European countries. Most interviewed travel-related cases were unaware of the hepatitis A risk in Morocco. Molecular analysis revealed two distinct hepatitis A virus (HAV) strains (subgenotype IA DK2018_231; subgenotype IB V18–16428). Vaccination recommendations should be emphasised to increase awareness among non-immune travellers to Morocco and HAV-endemic countries.
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