title: Molecular confirmation of oysters as the vector for hepatitis A in a 2005 multistate outbreak.
abstract: Numerous hepatitis A outbreaks were linked to the consumption of raw molluscan shellfish in the United States between 1960 and 1989. However, there had been no major molluscan shellfish-associated hepatitis A outbreaks reported in the United States for more than a decade (1989 to 2004). Beginning in late August 2005, at least 10 clusters of hepatitis A illnesses, totaling 39 persons, occurred in four states among restaurant patrons who ate oysters. Epidemiologic data indicated that oysters were the source of the outbreak. Traceback information showed that the implicated oysters were harvested from specific Gulf Coast areas. A voluntary recall of oysters was initiated in September. Hepatitis A virus (HAV) was detected in multiple 25-g portions in one of two recalled samples, indicating that as many as 1 of every 15 oysters from this source was contaminated. Comparing 315 nucleotides within the HAV VPl-2B region, 100% homology was found among four amplicons recovered from a total of six independent experiments of the implicated oysters, and an identical HAV sequence was detected in sera from all 28 patient serum specimens tested. Ten percent heterogeneity over 315 nucleotides (31 variants) was observed between the outbreak strain (subgenotype 1A) and an HM-175 strain (subgenotype 1B) used in the laboratory where the oysters were processed. To our knowledge, this investigation is the first in the United States to identify an HAV-identical strain in persons with hepatitis A as well as in the food that was implicated as the source of their infections.
authors.affiliation: U.S. Food and Drug Administration Gulf Coast Seafood Laboratory, Dauphin Island, Alabama 36528, USA. carol.shieh@fda.hhs.gov
authors.forename: Y C
authors.initials: YC
authors.lastname: Shieh
authors.forename: Y E
authors.initials: YE
authors.lastname: Khudyakov
authors.forename: G
authors.initials: G
authors.lastname: Xia
authors.forename: L M
authors.initials: LM
authors.lastname: Ganova-Raeva
authors.forename: F M
authors.initials: FM
authors.lastname: Khambaty
authors.forename: J W
authors.initials: JW
authors.lastname: Woods
authors.forename: J E
authors.initials: JE
authors.lastname: Veazey
authors.forename: M L
authors.initials: ML
authors.lastname: Motes
authors.forename: M B
authors.initials: MB
authors.lastname: Glatzer
authors.forename: S R
authors.initials: SR
authors.lastname: Bialek
authors.forename: A E
authors.initials: AE
authors.lastname: Fiore
mesh_terms: D000818:Animals; D001483:Base Sequence; D016000:Cluster Analysis; D004196:Disease Outbreaks; D004197:Disease Reservoirs; D005506:Food Contamination / Q000032:analysis*; D006506:Hepatitis A / Q000453:epidemiology*; D030041:Hepatitis A virus / Q000235:genetics / Q000302:isolation & purification*; D006801:Humans; D008969:Molecular Sequence Data; D010125:Ostreidae / Q000821:virology*; D016133:Polymerase Chain Reaction; D020133:Reverse Transcriptase Polymerase Chain Reaction; D017385:Sequence Homology; D012758:Shellfish / Q000821:virology*; D014481:United States / Q000453:epidemiology