ARTICLE
It may not be appreciated that a hepatitis A virus (HAV) outbreak investigation in several states in Australia, as described in this issue of Clinical Infectious Diseases [1], was viewed with intense interest on the other side of the world. In fact, it is considered a harbinger of hepatitis A investigations to come. This seemingly straightforward investigation—with molecular epidemiologic techniques now almost standard in any outbreak examination—may nonetheless be considered a landmark. The world is “flatter” and food and food products produced in one country (along with the pathogens they may carry) can be exported almost anywhere. We observed this in the United States when HAV infections in several states were acquired from green onions imported from northern Mexico [2, 3]. Although somewhat downplayed in the Donnan et al [1] article, molecular epidemiology from their investigation showed that samples from affected persons in both the Netherlands and Australia had sequence identity, and standard “shoe-leather” epidemiology showed large odds ratios for persons in both countries who had consumed semidried tomatoes from Turkey.
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