Hepatitis A outbreak disproportionately affecting men who have sex with men (MSM) in the European Union and European Economic Area, June 2016 to May 2017

Members Of The European Hepatitis A Outbreak Investigation Team

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Abstract

Between 1 June 2016 and 31 May 2017, 17 European Union (EU) and European Economic Area countries reported 4,096 cases associated with a multi-country hepatitis A (HA) outbreak. Molecular analysis identified three co-circulating hepatitis A virus (HAV) strains of genotype IA: VRD_521_2016, V16-25801 and RIVM-HAV16-090. We categorised cases as confirmed, probable or possible, according to the EU outbreak case definitions. Confirmed cases were infected with one of the three outbreak strains. We investigated case characteristics and strain-specific risk factors for transmission. A total of 1,400 (34%) cases were confirmed; VRD_521_2016 and RIVM-HAV16-090 accounted for 92% of these. Among confirmed cases with available epidemiological data, 92% (361/393) were unvaccinated, 43% (83/195) travelled to Spain during the incubation period and 84% (565/676) identified as men who have sex with men (MSM). Results depict an HA outbreak of multiple HAV strains, within a cross-European population, that was particularly driven by transmission between non-immune MSM engaging in high-risk sexual behaviour. The most effective preventive measure to curb this outbreak is HAV vaccination of MSM, supplemented by primary prevention campaigns that target the MSM population and promote protective sexual behaviour.

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Hepatitis A
European Union
Disease Outbreaks
Hepatitis A virus
Economics
Sexual Behavior
Health Services Needs and Demand
Primary Prevention
Risk-Taking
Spain
Vaccination
Genotype
Population

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@article{ddaaff4b8b764f7bb340434b8e003bae,
title = "Hepatitis A outbreak disproportionately affecting men who have sex with men (MSM) in the European Union and European Economic Area, June 2016 to May 2017",
abstract = "Between 1 June 2016 and 31 May 2017, 17 European Union (EU) and European Economic Area countries reported 4,096 cases associated with a multi-country hepatitis A (HA) outbreak. Molecular analysis identified three co-circulating hepatitis A virus (HAV) strains of genotype IA: VRD_521_2016, V16-25801 and RIVM-HAV16-090. We categorised cases as confirmed, probable or possible, according to the EU outbreak case definitions. Confirmed cases were infected with one of the three outbreak strains. We investigated case characteristics and strain-specific risk factors for transmission. A total of 1,400 (34{\%}) cases were confirmed; VRD_521_2016 and RIVM-HAV16-090 accounted for 92{\%} of these. Among confirmed cases with available epidemiological data, 92{\%} (361/393) were unvaccinated, 43{\%} (83/195) travelled to Spain during the incubation period and 84{\%} (565/676) identified as men who have sex with men (MSM). Results depict an HA outbreak of multiple HAV strains, within a cross-European population, that was particularly driven by transmission between non-immune MSM engaging in high-risk sexual behaviour. The most effective preventive measure to curb this outbreak is HAV vaccination of MSM, supplemented by primary prevention campaigns that target the MSM population and promote protective sexual behaviour.",
author = "{Members Of The European Hepatitis A Outbreak Investigation Team} and Patricia Ndumbi and Freidl, {Gudrun S} and Williams, {Christopher J} and Otilia M{\aa}rdh and Carmen Varela and Ana Avell{\'o}n and Ingrid Friesema and Harry Vennema and Kazim Beebeejaun and Ngui, {Siew Lin} and Michael Edelstein and Alison Smith-Palmer and Niamh Murphy and Jonathan Dean and Mirko Faber and J{\"u}rgen Wenzel and Mia Kontio and Luise M{\"u}ller and Midgley, {Sofie Elisabeth} and Lena Sundqvist and Ederth, {Josefine Lundberg} and Anne-Marie Roque-Afonso and Elisabeth Couturier and Sofieke Klamer and Javiera Rebolledo and Vanessa Suin and Aberle, {Stephan W} and Daniela Schmid and {De Sousa}, Rita and Augusto, {Gon{\cc}alo Figueiredo} and Valeria Alfonsi and {Del Manso}, Martina and Ciccaglione, {Anna Rita} and Kassiani Mellou and Christos Hadjichristodoulou and Alastair Donachie and Maria-Louise Borg and Maja Sočan and Mario Poljak and Ettore Severi",
year = "2018",
month = "8",
doi = "10.2807/1560-7917.ES.2018.23.33.1700641",
language = "English",
volume = "23",
journal = "Eurosurveillance",
issn = "1560-7917",
publisher = "European Centre for Disease Prevention and Control (ECDC)",
number = "33",

}

TY - JOUR

T1 - Hepatitis A outbreak disproportionately affecting men who have sex with men (MSM) in the European Union and European Economic Area, June 2016 to May 2017

AU - Members Of The European Hepatitis A Outbreak Investigation Team

AU - Ndumbi, Patricia

AU - Freidl, Gudrun S

AU - Williams, Christopher J

AU - Mårdh, Otilia

AU - Varela, Carmen

AU - Avellón, Ana

AU - Friesema, Ingrid

AU - Vennema, Harry

AU - Beebeejaun, Kazim

AU - Ngui, Siew Lin

AU - Edelstein, Michael

AU - Smith-Palmer, Alison

AU - Murphy, Niamh

AU - Dean, Jonathan

AU - Faber, Mirko

AU - Wenzel, Jürgen

AU - Kontio, Mia

AU - Müller, Luise

AU - Midgley, Sofie Elisabeth

AU - Sundqvist, Lena

AU - Ederth, Josefine Lundberg

AU - Roque-Afonso, Anne-Marie

AU - Couturier, Elisabeth

AU - Klamer, Sofieke

AU - Rebolledo, Javiera

AU - Suin, Vanessa

AU - Aberle, Stephan W

AU - Schmid, Daniela

AU - De Sousa, Rita

AU - Augusto, Gonçalo Figueiredo

AU - Alfonsi, Valeria

AU - Del Manso, Martina

AU - Ciccaglione, Anna Rita

AU - Mellou, Kassiani

AU - Hadjichristodoulou, Christos

AU - Donachie, Alastair

AU - Borg, Maria-Louise

AU - Sočan, Maja

AU - Poljak, Mario

AU - Severi, Ettore

PY - 2018/8

Y1 - 2018/8

N2 - Between 1 June 2016 and 31 May 2017, 17 European Union (EU) and European Economic Area countries reported 4,096 cases associated with a multi-country hepatitis A (HA) outbreak. Molecular analysis identified three co-circulating hepatitis A virus (HAV) strains of genotype IA: VRD_521_2016, V16-25801 and RIVM-HAV16-090. We categorised cases as confirmed, probable or possible, according to the EU outbreak case definitions. Confirmed cases were infected with one of the three outbreak strains. We investigated case characteristics and strain-specific risk factors for transmission. A total of 1,400 (34%) cases were confirmed; VRD_521_2016 and RIVM-HAV16-090 accounted for 92% of these. Among confirmed cases with available epidemiological data, 92% (361/393) were unvaccinated, 43% (83/195) travelled to Spain during the incubation period and 84% (565/676) identified as men who have sex with men (MSM). Results depict an HA outbreak of multiple HAV strains, within a cross-European population, that was particularly driven by transmission between non-immune MSM engaging in high-risk sexual behaviour. The most effective preventive measure to curb this outbreak is HAV vaccination of MSM, supplemented by primary prevention campaigns that target the MSM population and promote protective sexual behaviour.

AB - Between 1 June 2016 and 31 May 2017, 17 European Union (EU) and European Economic Area countries reported 4,096 cases associated with a multi-country hepatitis A (HA) outbreak. Molecular analysis identified three co-circulating hepatitis A virus (HAV) strains of genotype IA: VRD_521_2016, V16-25801 and RIVM-HAV16-090. We categorised cases as confirmed, probable or possible, according to the EU outbreak case definitions. Confirmed cases were infected with one of the three outbreak strains. We investigated case characteristics and strain-specific risk factors for transmission. A total of 1,400 (34%) cases were confirmed; VRD_521_2016 and RIVM-HAV16-090 accounted for 92% of these. Among confirmed cases with available epidemiological data, 92% (361/393) were unvaccinated, 43% (83/195) travelled to Spain during the incubation period and 84% (565/676) identified as men who have sex with men (MSM). Results depict an HA outbreak of multiple HAV strains, within a cross-European population, that was particularly driven by transmission between non-immune MSM engaging in high-risk sexual behaviour. The most effective preventive measure to curb this outbreak is HAV vaccination of MSM, supplemented by primary prevention campaigns that target the MSM population and promote protective sexual behaviour.

U2 - 10.2807/1560-7917.ES.2018.23.33.1700641

DO - 10.2807/1560-7917.ES.2018.23.33.1700641

M3 - Article

C2 - 30131095

VL - 23

JO - Eurosurveillance

JF - Eurosurveillance

SN - 1560-7917

IS - 33

ER -