title: An outbreak of hepatitis A associated with consumption of raw blueberries.
abstract: This report describes the epidemiology, investigation and control of a hepatitis A (HAV) outbreak in New Zealand. Descriptive and analytical epidemiology, virology, product traceback and an orchard investigation were carried out. A case-control study revealed that 56% of 39 cases had consumed raw blueberries, compared with 14% of 71 controls (odds ratio 7.6; 95% confidence intervals 2.6-22.4). Traceback of product through retailers and wholesalers implicated a single commercial orchard. Hepatitis A virus was detected by reverse transcriptase polymerase chain reaction in faecal specimens from cases as well as a blueberry product from the orchard. Presence of hepatitis A virus was confirmed by DNA hybridization and sequencing of PCR products. Sanitary audit of the orchard revealed multiple opportunities for contamination of blueberries by pickers. This outbreak highlights the need for food safety programmes in the berry fruit industry.
authors.affiliation: Public Health Community Services, Auckland District Health Board, Private Bag 92065, Auckland, New Zealand.
authors.forename: L
authors.initials: L
authors.lastname: Calder
authors.forename: G
authors.initials: G
authors.lastname: Simmons
authors.forename: C
authors.initials: C
authors.lastname: Thornley
authors.forename: P
authors.initials: P
authors.lastname: Taylor
authors.forename: K
authors.initials: K
authors.lastname: Pritchard
authors.forename: G
authors.initials: G
authors.lastname: Greening
authors.forename: J
authors.initials: J
authors.lastname: Bishop
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000383:Agriculture; D029798:Blueberry Plants; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D004279:DNA, Viral / Q000032:analysis; D004196:Disease Outbreaks; D005243:Feces / Q000821:virology; D005260:Female; D005506:Food Contamination; D005638:Fruit / Q000821:virology*; D006506:Hepatitis A / Q000453:epidemiology* / Q000635:transmission*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009520:New Zealand / Q000453:epidemiology; D016017:Odds Ratio; D020133:Reverse Transcriptase Polymerase Chain Reaction; D012449:Safety
chemical_list: D004279:DNA, Viral