Australian hepatitis A cases linked to imported dates

Six individuals in Australia have been a part of a hepatitis A outbreak this previous 12 months after consuming dates from Jordan, based on a examine.

Researchers mentioned it was the primary identified hepatitis A outbreak within the nation linked to imported recent Medjool dates. A connection was recognized with an outbreak in the UK regardless of implicated dates being picked months aside and coming from completely different farms. 

Between June and September 2021, six genetically equivalent hepatitis A circumstances have been reported in New South Wales and the Australian Capital Territory. All sick individuals reported the date of consumption throughout their publicity interval. Implicated dates have been constructive for hepatitis A virus (HAV), based on the examine printed in Communicable Diseases Intelligence.

Australian border closures in response to the COVID-19 pandemic meant {that a} frequent locally-acquired, and never a travel-acquired, the supply was suspected. Plus, consciousness of a hepatitis A outbreak within the UK that sickened no less than 31 individuals, additionally related to date consumption, allowed for early speculation era and investigation, probably stopping extra sicknesses.

When borders have been closed there was lower than one hepatitis A case per 30 days nationally. Till June 2021, all circumstances notified in New South Wales throughout this era have been linked to returning residents, besides one, which was because of the consumption of beforehand recalled imported frozen meals.

Hyperlink to consuming dates
The primary affected person in June 2021 reported recent Medjool date consumption throughout their publicity interval, however was unable to determine the product to help traceback. In July, it was discovered that this case was genetically equivalent to samples from sick individuals within the UK outbreak linked to dates from Jordan. The third sick particular person was in a position to report a particular model of imported dates.

4 of six sufferers reported both consuming the implicated model or consuming dates bought from a website that bought the affected product.

5 sufferers with genotype IB lived in New South Wales and one within the Australian Capital Territory (ACT). The median age of circumstances was 26 however ranged from 15 to 53 years previous and 5 have been male. 4 individuals required hospitalization.

Officers of the NSW Division of Main Industries collected a 1-kilogram unopened field of the suspected Medjool dates from a Sydney grocery store. Two of the ten subsamples had HAV detected. Because the constructive date pattern couldn’t be sequenced, human sequences couldn’t be genetically linked to the implicated meals product.

In August 2021, the Australian importer of the recent Medjool dates produced in Jordan carried out a recall. This importer distributed dates into New South Wales and Victoria. It’s thought they could have been despatched to the ACT via an unidentified third celebration.

A holding order was positioned on Medjool dates from the Jordanian provider. This meant that upon import into Australia, any consignments of dates from this provider can be held on the border till authorities in Jordan supplied assurance that the danger of HAV contamination had been mitigated. This order has since been lifted.

Connection to UK outbreak
A report on the outbreak of hepatitis A in England and Wales linked to dates from Jordan alerted Australian public well being investigators to the difficulty and led to a query about date consumption being added to the nationwide surveillance questionnaire for hepatitis A.

The HAV outbreak pressure linked to dates in Australia was equivalent to the pressure in England and Wales. Nonetheless, no frequent grower, producer, or importer may very well be recognized. Jordanian authorities mentioned the batches of dates in every outbreak had been picked and processed months aside and got here from completely different farms alongside the Jordan River.

One clarification for the frequent pressure in several outbreaks attributable to the identical meals product is that it represents an endemic, circulating pressure within the nation of origin. Or, there could also be a typical supply between the farms, resembling person-to-person transmission amongst date harvesters, mentioned researchers.

Scientists mentioned extra investigations are wanted to grasp the meals security dangers related to recent Medjool dates and extra danger administration measures in Australia on the import of such dates could also be required.

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