title: An outbreak of hepatitis A associated with a bakery, New York, 1994: the 1968 "West Branch, Michigan' outbreak repeated.
abstract: In a community hepatitis A outbreak in the Rochester, New York area, 64 of 79 (81%) people with anti-hepatitis A IgM-antibodies and onset of symptoms from 9 April-31 May 1994, recalled eating food obtained from a retail buyer's club. Eleven (65%) of 17 households with cases contained club members compared with 7 (21%) of 34 neighbourhood-matched control-households (matched odds ratio 8.5; 95% CI 1.7-41.6). Club employees who ate sugar-glazed baked goods were at fourfold increased risk for hepatitis. The source of infection was an IgM-positive baker who contaminated baked goods while applying sugar glaze. Computer-generated purchase lists implicated 11-12 March and 21-24 March as the most likely dates when contamination occurred. This investigation demonstrates the importance of food workers adhering to established hygiene practices. Computer-generated commercial datasets can be useful in epidemiologic investigations.
authors.affiliation: Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA, USA.
authors.forename: A C
authors.initials: AC
authors.lastname: Weltman
authors.forename: N M
authors.initials: NM
authors.lastname: Bennett
authors.forename: D A
authors.initials: DA
authors.lastname: Ackman
authors.forename: J H
authors.initials: JH
authors.lastname: Misage
authors.forename: J J
authors.initials: JJ
authors.lastname: Campana
authors.forename: L S
authors.initials: LS
authors.lastname: Fine
authors.forename: A S
authors.initials: AS
authors.lastname: Doniger
authors.forename: G J
authors.initials: GJ
authors.lastname: Balzano
authors.forename: G S
authors.initials: GS
authors.lastname: Birkhead
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001939:Bread / Q000821:virology*; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D004196:Disease Outbreaks; D005260:Female; D005511:Food Handling; D006506:Hepatitis A / Q000209:etiology* / Q000276:immunology*; D006508:Hepatitis Antibodies / Q000097:blood*; D006801:Humans; D007075:Immunoglobulin M / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009518:New York; D016017:Odds Ratio; D011159:Population Surveillance; D012307:Risk Factors; D016036:Seroepidemiologic Studies; D011795:Surveys and Questionnaires; D014504:Urban Health
chemical_list: D006508:Hepatitis Antibodies; D007075:Immunoglobulin M