[Detection of a hepatitis A outbreak in Ceuta (Spain) through a microbiological surveillance system].
BACKGROUND
The Public Health Department of Ceuta informed the Spanish National Epidemiology Center of an increase in hepatitis A cases detected by the microbiological surveillance system. We conducted a study to confirm the outbreak and to initiate control measures.


METHODS
A descriptive study and a case-control study were performed. A standardized telephone questionnaire was used to collect information on demographic characteristics, symptoms, and risk factors.


RESULTS
Nineteen cases of hepatitis A were identified. Univariate analysis revealed an association between infection and eating raw vegetables (OR = 9.3; 95%CI: 1.5-57.6) or razor-shell (OR = 55; 95%CI: 4.3-703.4). In the logistic regression model, only razor-shell consumption remained a significant risk factor (OR = 36.1; 95%CI: 2.45-530.4). None of the 3 inspected restaurants had public health authorization or records of food purchase histories.


CONCLUSIONS
We confirmed a hepatitis A outbreak associated with consumption of contaminated razor-shell in homes and restaurants. The microbiological surveillance system was the main means of detecting this outbreak.
Ortega-Maján
María Teresa
MT
Programa de Epidemiología Aplicada de Campo (PEAC), Centro Nacional de Epidemiología, Madrid, España. maytortega@yahoo.es
Caffaro-Rovira
Mercedes
M
Herrera-Guibert
Dionisio José
DJ
Rivas-Pérez
Ana
A