EFSA : Tracing of food items in connection to the multinational hepatitis A virus outbreak in Europe

Hepatitis A Virus Outbreak origin

Germany reported cases of hepatitis A virus (HAV) in May 2013 in persons with a travel history. 

Italy reported a national increase in the number of HAV cases and declared an outbreak. 

Confirmed Hepatitis A Virus Cases

331 confirmed cases have been reported in Denmark, Finland, France, Germany, Ireland, Norway, the Netherlands, Poland, Sweden and the United Kingdom. HAV contamination was detected in :

• frozen mixed berries and 
• mixed berry cakes/pastries in Italy, France & Norway. 
• In Ireland, the Netherlands and Sweden, analysis of food histories and questionnaires identified suspect berries and berry products consumed by confirmed cases.

Hepatitis A Virus and Tracing

Tracing began with 38 lots/cases from Italy, Ireland and the Netherlands, an additional 5 lots/cases were added from France, Norway and Sweden in spring 2014. The tracing data were exchanged via the European Rapid Alert System for Food and Feed. The final dataset comprises 6227 transactions among 1974 food operators. 

  

The most common ingredients in the traced lots/cases were :

• Bulgarian blackberries and 
• Polish redcurrants

However, Poland is the largest producer of redcurrants in Europe, and Bulgaria is a major exporter of frozen blackberries. No single point source of contamination linking all 43 lots/cases could be identified. 

GHP, GMP, GAP and Hepatitis A Virus Outbreaks 

HAV cases/lots in five countries could be linked to seven Polish freezing processors and/or to five frozen berry suppliers in Bulgaria. This indicates that HAV contamination could be occurring at the freezing processor or in primary production of berries and therefore compliance with Good Hygiene Practice, Good Manufacturing Practice and Good Agricultural Practice is recommended for countries producing berries for freezing. 

Risk for hepatitis A Virus outbreak remains

It is possible that contaminated product related to this outbreak could still be circulating in the food chain. Hence, for the public health domain, 

1. Enhanced surveillance, 
2. Risk communication, 
3. Vaccination and 
4. Further research 

are recommended.

© European Food Safety Authority, 2014

Read the Full EFSA Report
http://www.efsa.europa.eu/en/efsajournal/pub/3821.htm

Read ECDC Report
http://www.ecdc.europa.eu/en/publications/publications/hepatitis-a-rapid-assessment-nordic-countries-april2013.pdf