title: Two years' prospective collection of molecular and epidemiological data shows limited spread of hepatitis A virus outside risk groups in Amsterdam, 2000-2002.
abstract: We performed a viral sequencing study on samples representing all reported primary cases of acute hepatitis A virus (HAV) infection reported for 2 years in Amsterdam. Two regions of HAV RNA were amplified, sequenced, and used for phylogenetic analysis. Of 156 cases, strains of 104 isolates (66.6%) clustered into 3 genotypes: 1A, 1B, and 3. Two separate transmission circles occurred, without mutual interrelation. In genotype 1A, 4 clusters occurred in men having sex with men (MSM), and the fifth cluster was related to a virus from Morocco. In genotype 1B, 6 small clusters were directly related to the Moroccan virus. In genotype 3, strains were related to a virus from Pakistan. Our analysis indicates that, to stop transmission of HAV in Amsterdam, the entire MSM population and travelers to countries where HAV is endemic, especially children, should be vaccinated. Prevention strategies need not include the vaccination of all children living in Amsterdam.
authors.affiliation: Division of Public Health, Gemeentelijke Geneeskundige en Gezondheidsdienst Amsterdam, The Netherlands. Jvansteenbergen.LCI@ggd.nl
authors.forename: Jim E
authors.initials: JE
authors.lastname: van Steenbergen
authors.forename: Grace
authors.initials: G
authors.lastname: Tjon
authors.forename: Anneke
authors.initials: A
authors.lastname: van den Hoek
authors.forename: Alex
authors.initials: A
authors.lastname: Koek
authors.forename: Roel A
authors.initials: RA
authors.lastname: Coutinho
authors.forename: Sylvia M
authors.initials: SM
authors.lastname: Bruisten
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D018562:Disease Transmission, Infectious; D005260:Female; D005838:Genotype; D006506:Hepatitis A / Q000453:epidemiology* / Q000635:transmission*; D017957:Hepatitis A Virus, Human / Q000235:genetics* / Q000302:isolation & purification; D018451:Homosexuality, Male; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D017720:Molecular Epidemiology; D008969:Molecular Sequence Data; D009018:Morocco / Q000453:epidemiology; D009426:Netherlands / Q000453:epidemiology; D010154:Pakistan / Q000453:epidemiology; D010802:Phylogeny; D011446:Prospective Studies; D012367:RNA, Viral / Q000235:genetics; D014195:Travel
chemical_list: D012367:RNA, Viral