title: Hepatitis A related acute liver failure by consumption of contaminated food.
abstract: We present a patient with no medical history admitted for jaundice and dark coloured urine. Further investigations revealed hepatitis A related acute liver failure while the patient had no travel history, nor contact with infected individuals. After admission, the patient deteriorated fulfilling the King's College criteria for acute liver failure. Two days after admission, he underwent liver transplantation and recovered. Careful investigation identified imported semi-dried tomatoes as the source of the hepatitis A infection. This patient was part of a foodborne hepatitis A outbreak in the Netherlands in 2010 affecting 13 patients. Virus sequence analysis of our patient's virus showed a strain commonly found in Turkey. Hepatitis A related acute liver failure is rare, but is associated with a poor prognosis. In developed countries, the incidence of hepatitis A is low, but foodborne outbreaks are emerging. Further, we review the literature on recent foodborne hepatitis A outbreaks in developed countries, hepatitis A related acute liver failure, and hepatitis A vaccine.
authors.affiliation: Department of Gastroenterology and Hepatology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
authors.forename: Heng
authors.initials: H
authors.lastname: Chi
authors.affiliation: Department of Gastroenterology and Hepatology, University Medical Center Groningen, Groningen, The Netherlands.
authors.forename: Elizabeth B
authors.initials: EB
authors.lastname: Haagsma
authors.affiliation: Departments of Medical Microbiology, Division of Clinical Virology, University Medical Center Groningen, Groningen, The Netherlands.
authors.forename: Annelies
authors.initials: A
authors.lastname: Riezebos-Brilman
authors.affiliation: Department of Gastroenterology and Hepatology, University Medical Center Groningen, Groningen, The Netherlands.
authors.forename: Arie P
authors.initials: AP
authors.lastname: van den Berg
authors.affiliation: Department of Gastroenterology and Hepatology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
authors.forename: Herold J
authors.initials: HJ
authors.lastname: Metselaar
authors.affiliation: Department of Gastroenterology and Hepatology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands. Electronic address: r.deknegt@erasmusmc.nl.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: de Knegt
mesh_terms: D000328:Adult; D016000:Cluster Analysis; D005506:Food Contamination; D005517:Foodborne Diseases / Q000150:complications / Q000175:diagnosis* / Q000473:pathology*; D005838:Genotype; D006506:Hepatitis A / Q000150:complications* / Q000175:diagnosis*; D030041:Hepatitis A virus / Q000145:classification / Q000235:genetics / Q000302:isolation & purification; D006801:Humans; D017114:Liver Failure, Acute / Q000175:diagnosis* / Q000473:pathology* / Q000601:surgery; D016031:Liver Transplantation; D008297:Male; D008969:Molecular Sequence Data; D009426:Netherlands; D012367:RNA, Viral / Q000235:genetics; D017422:Sequence Analysis, DNA; D017385:Sequence Homology; D016896:Treatment Outcome
chemical_list: D012367:RNA, Viral
keywords: Acute viral hepatitis; Foodborne; Lycopersicon esculentum; Outbreak