Food authorities investigate 12 Hepatitis A cases in NSW

Twelve cases of Hepatitis A have been confirmed in the past five weeks in the Sydney area, leading to NSW health and food authorities opening an investigation into the outbreak.

Hepatitis A spreads through contaminated food or poor hygiene, and it is the most frequent cause of foodborne infection globally.

With an average of only two locally acquired cases per year, Australia is not considered a high-risk country when it comes to the spread of the infection. NSW has had between 41 and 82 cases of Hepatitis A since 2014, mostly in people returning from high-risk countries. The last serious outbreak of the virus in Australia was when 18 people became infected in Victoria after consuming Patties Food Nanna’s brand frozen berries in 2015.

However, the greatest concern to Dr Vicky Sheppeard, Director Communicable Diseases with NSW Health, is the fact that they have not been able to establish the source of these 12 recent cases.

“NSW Health is working with the NSW Food Authority to investigate the outbreak, including assessment of patterns of food distribution and any links to overseas outbreaks,” said Sheppeard.

After questioning the infected individuals, authorities believe the outbreak could be traced back to a food distributor in supermarkets or cafes as none of the patients recall eating at a common restaurant over the 6-week incubation period.

Researchers compared samples from the sick individuals to other cases of Hepatitis A in an international database, and they found the recent cases have similarities to an outbreak in Europe that is linked to lettuce. About 1500 cases have been reported in Europe since June 2016, but it is not clear whether the NSW cases are connected.

“It’s unlikely that lettuce from Europe would come here but there are a few things we’ve got to investigate,” Sheppeard stated.

With 10 out of the 12 patients contracting the disease within Australia and reporting no recent overseas travel to high-risk areas, Sheppeard must consider the possibility that the outbreak source is in Australia.

Usual symptoms include nausea, vomiting, fever and yellowing of the skin, dark urine and pale stools, but Hepatitis A can also cause infections and damage the liver. The 12 infected adults are all recovering, but three patients had to be admitted to hospital.

Sheppeard suggests a serious of precautions to follow to prevent the spread of infection, such as washing hands thoroughly after going to the toilet and before preparing or eating food, and getting vaccinated.

“Travellers to high-risk countries and anyone at higher risk of infection, including men who have sex with men, injecting drug users, sewerage workers and childcare workers, should ensure that they are vaccinated against hepatitis A.

“Two doses of vaccine prevent infection and is available through GPs,” she said.