The HPA is currently investigating three cases of hepatitis A, acquired in the UK, with symptom onset dates in October 2011. The infecting hepatitis A strain is the same as one seen in two UK acquired hepatitis A cases in 2010. This hepatitis A strain has previously been identified in outbreaks of hepatitis A in the Netherlands, France and Australia where consumption of sun dried tomatoes was considered to be the source of infection through epidemiological investigations [1,2,3].
Consumption of sun-dried tomatoes is therefore one source that is currently being investigated for the recent non-travel associated cases. Local Health Protection Units have been asked to ascertain a complete recent food history during follow up of any hepatitis A cases not directly linked to travel.
Laboratories have been asked to refer samples from cases of hepatitis A not clearly linked to travel to HPA Colindale for molecular sequencing. Investigations are ongoing to inform the public health response.
1. M Petrignani et al. A possible foodborne outbreak of hepatitis A in the Netherlands, January-February 2010. Euro Surveill. 15(11), 18 March 2010.
2. M Petrignani et al. Update: A food-borne outbreak of hepatitis A in the Netherlands related to semi-dried tomatoes in oil, January-February 2010. Euro Surveill. 15(20), 20 May 2010.3. http://www.theaustralian.com.au/news/breaking