Outbreaks of Shellfish-Associated Enteric Virus Illness in the United States: Requisite for Development of Viral Guidelines

Outbreaks of hepatitis A, Norwalk illness, and nonspecific viral gastroenteritis are associated with consumption of sewage-contaminated shellfish. Over 100 outbreaks have been reported in the United States during the past 50 years. Reported cases of shellfish-associated enteric virus illness are on the increase, whereas bacterial illness from shellfish is on the decline. As yet, there are no procedures for detecting hepatitis A virus, Norwalk virus and numerous other pathogenic viruses in environmental samples, but virus extraction and assay procedures for water and shellfish are available for the more easily cultivated enteric viruses. Current standards rely on bacterial indicators as a means to evaluate the sanitary quality of shellfish and their growing waters, but the adequacy of using bacteria as indicators of possible virus contamination is questionable. The feasibility of employing enteroviruses or rotaviruses as possible viral indiators is discussed. It is proposed that easily cultivated enteroviruses, such as poliovirus, be used as an interim indicator for the possible presence of human pathogenic viruses in seafoods, with the subsequent formulation of guidelines to limit the levels of virus contamination in shellfish.

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Viral Foodborne Disease Agents of Concern

Journal of Food Protection ◽

10.4315/0362-028x-57.2.176 ◽

1994 ◽

Vol 57 (2) ◽

pp. 176-178 ◽

Cited By ~ 9

Author(s):

DEAN O. CLIVER

Keyword(s):

United States ◽

Hepatitis A ◽

Hepatitis A Virus ◽

The United States ◽

Molecular Techniques ◽

Detection Methods ◽

Foodborne Disease ◽

Norwalk Virus ◽

Routine Basis ◽

Human Enteric Viruses

Viruses transmitted to humans via foods generally emanate from the human intestines. In the United States, Norwalk virus ranked #5, hepatitis A virus #6, and “other viruses” (principally rotavirus) #10 among the top 10 causes of foodborne disease during 1983–1987. Molluscs are the most frequently reported vehicles, but any food handled by humans may transmit human enteric viruses. Some fruit and vegetable vehicles may have been contaminated in the field before or during harvesting. Viruses in foods may be inactivated before the food is eaten, and thus, not cause infection. Increasingly sensitive detection methods, largely based on “molecular” techniques, are becoming available for these viruses but are not applicable to monitoring foods on a routine basis.

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Enteric Virus Survival during Household Laundering and Impact of Disinfection with Sodium Hypochlorite

Applied and Environmental Microbiology ◽

10.1128/aem.00688-07 ◽

2007 ◽

Vol 73 (14) ◽

pp. 4425-4428 ◽

Cited By ~ 43

Author(s):

Charles P. Gerba ◽

Denise Kennedy

Keyword(s):

United States ◽

Sodium Hypochlorite ◽

Hepatitis A ◽

Hepatitis A Virus ◽

Enteric Viruses ◽

Enteric Virus ◽

The United States ◽

Cotton Cloth ◽

Organic Load ◽

Virus Survival

ABSTRACT This study was conducted to determine whether enteric viruses (adenovirus, rotavirus, and hepatitis A virus) added to cotton cloth swatches survive the wash cycle, the rinse cycle, and a 28-min permanent press drying cycle as commonly practiced in households in the United States. Detergent with and without bleach (sodium hypochlorite) was added to washing machines containing sterile and virus-inoculated 58-cm2 swatches, 3.2 kg of cotton T-shirts and underwear, and a soiled pillowcase designed to simulate the conditions (pH, organic load, etc.) encountered in soiled laundry. The most important factors for the reduction of virus in laundry were passage through the drying cycle and the addition of sodium hypochlorite. Washing with detergent alone was not found to be effective for the removal or inactivation of enteric viruses, as significant concentrations of virus were found on the swatches (reductions of 92 to 99%). It was also demonstrated that viruses are readily transferred from contaminated cloths to uncontaminated clothes. The use of sodium hypochlorite reduced the number of infectious viruses on the swatches after washing and drying by at least 99.99%. Laundering practices in common use in the United States do not eliminate enteric and respiratory viruses from clothes. The use of bleach can further reduce the numbers of enteric viruses in laundry.

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Enteric Virus: Risk Assessment of Ocean Disposal of Sewage Sludge

Water Science & Technology ◽

10.2166/wst.1988.0262 ◽

1988 ◽

Vol 20 (11-12) ◽

pp. 25-31 ◽

Cited By ~ 5

Author(s):

Charles P. Gerba ◽

Sagar M. Goyal

Keyword(s):

Sewage Sludge ◽

Marine Environment ◽

Hepatitis A ◽

Hepatitis A Virus ◽

Significant Risk ◽

Enteric Virus ◽

The United States ◽

Norwalk Virus ◽

Bathing Waters ◽

Increased Risk

Densely populated coastal regions of the world generate large quantities of domestic sewage sludge which is often disposed into the marine environment. Present in these wastes are human pathogenic viruses which are capable of surviving for prolonged periods of time in the marine environment and transmitting disease to humans by a number of potential routes of which swimming and consumption of marine foods are the most significant. Hepatitis A virus and Norwalk virus outbreaks associated with shellfish consumption continue to occur in the United States. Three separate epidemiological studies have also shown an association between shellfish consumption and increased risk of hepatitis A infection in consumers. An epidemiological association between non-A and non-B hepatitis has also been demonstrated. A review of the risks of infection, clinical illness and mortality associated with enteroviruses suggests that the presence of these viruses in shellfish and bathing waters presents a significant risk to the consumer.

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Hepatitis A virus infections associated with clotting factor concentrate in the United States

Transfusion ◽

10.1046/j.1537-2995.1998.38698326337.x ◽

1998 ◽

Vol 38 (6) ◽

pp. 573-579 ◽

Cited By ~ 78

Author(s):

JM Soucie ◽

BH Robertson ◽

BP Bell ◽

KA McCaustland ◽

BL Evatt

Keyword(s):

United States ◽

Hepatitis A ◽

Hepatitis A Virus ◽

The United States ◽

Clotting Factor ◽

Virus Infections ◽

Factor Concentrate

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Viral Hepatitis A

10.2310/em.14068 ◽

2021 ◽

Author(s):

Kenrad E Nelson ◽

Brittany L Kmush

Keyword(s):

United States ◽

Acute Hepatitis ◽

Injection Drug Users ◽

Drug Users ◽

Hepatitis A ◽

Hepatitis A Virus ◽

Severe Disease ◽

The United States ◽

Childhood Immunization ◽

Effective Prevention

Epidemics of infectious jaundice have been reported throughout recorded history. However, the proof that many of these outbreaks and individual cases of acute hepatitis were caused by a viral infection, the hepatitis A virus (HAV), did not appear until the 1960s. After the transmission of infection to marmosets and humans, the epidemiologic and virologic characteristics that differed between hepatitis A and hepatitis B virus infections were defined more clearly. After the development and licensure of hepatitis A vaccines in the 1990s, it became possible to implement an effective prevention program involving routine immunization of young children in the United States and several other Western countries. However, despite the dramatic efficacy of the childhood immunization program in reducing the incidence of acute hepatitis from HAV in the population, older children and adults remained susceptible. Significant morbidity continues to occur in the United States among international travelers, injection drug users, persons with underlying liver disease, and other high-risk populations. Since HAV is a global pathogen, the prevention of increasing morbidity from hepatitis A attributable to the incidence of clinically more severe disease increases in countries transitioning from high to intermediate or low endemic status is a major public health challenge. In this review, we discuss the epidemiology, virology, clinical characteristics, and prevention of hepatitis A infections. This review contains 8 figures, 3 tables and 89 references Key words: epidemiology, global impact, hepatitis A vaccine, hepatitis A virus, prevention, reservoirs, risk factors, treatment

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Demonstration of Viral Contamination of Oysters Responsible for an Outbreak of Viral Gastroenteritis

Journal of Food Protection ◽

10.4315/0362-028x-44.4.294 ◽

1981 ◽

Vol 44 (4) ◽

pp. 294-296 ◽

Cited By ~ 13

Author(s):

M. J. EYLES ◽

G. R. DAVEY ◽

E. J. HUNTLEY

Keyword(s):

Causative Agent ◽

Enteric Virus ◽

Fecal Specimen ◽

Viral Gastroenteritis ◽

Norwalk Virus ◽

Viral Contamination ◽

Virus Contamination ◽

Human Enteric Virus ◽

Viral Illness ◽

Echovirus Type

Two viruses, echovirus type 8 and a reovirus, were isolated from a batch of oysters responsible for an outbreak of gastroenteritis. Characteristics of the illness, detection of Norwalk virus in the feces of one of the victims and other factors indicated strongly that the illness was due to infection with Norwalk virus. Examination of the implicated oysters and a fecal specimen from a victim failed to provide evidence of the involvement of any other causative agent. Thus laboratory evidence of human enteric virus contamination of a batch of food responsible for a viral illness has been provided.

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Hepatitis A Virus Transmission by Blood Products in the United States

Vox Sanguinis ◽

10.1159/000462666 ◽

1994 ◽

Vol 67 (1) ◽

pp. 24-28 ◽

Cited By ~ 2

Author(s):

James W. Mosley ◽

Marek J. Nowicki ◽

Carol K. Kasper ◽

Elizabeth Donegan ◽

Louis M. Aledort ◽

...

Keyword(s):

United States ◽

Hepatitis A ◽

Hepatitis A Virus ◽

Virus Transmission ◽

The United States ◽

Blood Products

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Susceptibility to Hepatitis A Virus Infection in the United States, 2007–2016

Clinical Infectious Diseases ◽

10.1093/cid/ciaa298 ◽

2020 ◽

Vol 71 (10) ◽

pp. e571-e579 ◽

Cited By ~ 2

Author(s):

Shaoman Yin ◽

Laurie Barker ◽

Kathleen N Ly ◽

Greta Kilmer ◽

Monique A Foster ◽

...

Keyword(s):

United States ◽

Hepatitis A ◽

Hepatitis A Virus ◽

Risk Groups ◽

The United States ◽

Poverty Level ◽

Health And Nutrition ◽

National Immunization ◽

Vaccination Recommendations ◽

Sex With Men

Abstract Background Despite national immunization efforts, including universal childhood hepatitis A (HepA) vaccination recommendations in 2006, hepatitis A virus (HAV)–associated outbreaks have increased in the United States. Unvaccinated or previously uninfected persons are susceptible to HAV infection, yet the susceptibility in the US population is not well known. Methods Using National Health and Nutrition Examination Survey 2007–2016 data, we estimated HAV susceptibility prevalence (total HAV antibody negative) among persons aged ≥2 years. Among US-born adults aged ≥20 years, we examined prevalence, predictors, and age-adjusted trends of HAV susceptibility by sociodemographic characteristics. We assessed HAV susceptibility and self-reported nonvaccination to HepA among risk groups and the “immunization cohort” (those born in or after 2004). Results Among US-born adults aged ≥20 years, HAV susceptibility prevalence was 74.1% (95% confidence interval, 72.9–75.3%) during 2007–2016. Predictors of HAV susceptibility were age group 30–49 years, non-Hispanic white/black, 130% above the poverty level, and no health insurance. Prevalences of HAV susceptibility and nonvaccination to HepA, respectively, were 72.9% and 73.1% among persons who reported injection drug use, 67.5% and 65.2% among men who had sex with men, 55.2% and 75.1% among persons with hepatitis B or hepatitis C, and 22.6% and 25.9% among the immunization cohort. Susceptibility and nonvaccination decreased over time among the immunization cohort but remained stable among risk groups. Conclusions During 2007–2016, approximately three-fourths of US-born adults remained HAV susceptible. Enhanced vaccination efforts are critically needed, particularly targeting adults at highest risk for HAV infection, to mitigate the current outbreaks.

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