Hepatitis A outbreak affecting men who have sex with men (MSM) in South Italy.

From April to October 2017, 27 cases of Hepatitis A (HA), 22 male and 5 female, were reported in Cosenza (South Italy). The median age of cases was 32 years (range 3-49 years). Out of 21 male adults, 14 were identified as men who have sex with men (MSM). Phylogenetic analysis was conducted in 15 cases and revealed two distinct sequences of genotype IA linking to clusters recognised in MSM in other European countries in 2016; genotype IB was recognized in only 2 cases. The report confirms that HA is an emerging issue among MSM. As suggested by the WHO, in countries with low HAV circulation, vaccination programmes should be tailored on local epidemiological patterns to prevent outbreaks among high risk groups and eventual spill-over of the infection into the general population.

[1]  H. Vennema,et al.  Usability of the international HAVNet hepatitis A virus database for geographical annotation, backtracing and outbreak detection , 2018, Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin.

[2]  M. Poljak,et al.  Hepatitis A outbreak disproportionately affecting men who have sex with men (MSM) in the European Union and European Economic Area, June 2016 to May 2017 , 2018, Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin.

[3]  M. Cusini,et al.  HEV and HAV seroprevalence in men that have sex with men (MSM): An update from Milan, Italy , 2018, Journal of medical virology.

[4]  F. Negro,et al.  EASL Clinical Practice Guidelines on hepatitis E virus infection. , 2018, Journal of hepatology.

[5]  X. Forns,et al.  Hepatitis A outbreak in Barcelona among men who have sex with men (MSM), January‐June 2017: A hospital perspective , 2018, Liver international : official journal of the International Association for the Study of the Liver.

[6]  F. Castelli,et al.  Hepatitis A outbreak in men who have sex with men (MSM) in Brescia (Northern Italy), July 2016-July 2017. , 2018, Le infezioni in medicina : rivista periodica di eziologia, epidemiologia, diagnostica, clinica e terapia delle patologie infettive.

[7]  V. Kroumova,et al.  Outbreak of severe Hepatitis A in Eastern Piedmont, Italy. , 2017, Le infezioni in medicina : rivista periodica di eziologia, epidemiologia, diagnostica, clinica e terapia delle patologie infettive.

[8]  G. Ippolito,et al.  A large ongoing outbreak of hepatitis A predominantly affecting young males in Lazio, Italy; August 2016 - March 2017 , 2017, PloS one.

[9]  L. Tavoschi,et al.  Seroprevalence and susceptibility to hepatitis A in the European Union and European Economic Area: a systematic review. , 2017, The Lancet. Infectious diseases.

[10]  D. Werber,et al.  Ongoing outbreaks of hepatitis A among men who have sex with men (MSM), Berlin, November 2016 to January 2017 – linked to other German cities and European countries , 2017, Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin.

[11]  M. Edelstein,et al.  Outbreak of hepatitis A associated with men who have sex with men (MSM), England, July 2016 to January 2017 , 2017, Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin.

[12]  M. Chironna First Outbreak of Hepatitis A Associated with SexualTransmission among Men who have Sex with Men (MSM)in Puglia, South Italy, 2017 , 2017 .

[13]  R. Bruni,et al.  A family cluster of hepatitis A virus due to an uncommon IA strain circulating in Campania (southern Italy), not associated with raw shellfish or berries: a wake-up call to implement vaccination against hepatitis A? , 2016, Le infezioni in medicina : rivista periodica di eziologia, epidemiologia, diagnostica, clinica e terapia delle patologie infettive.

[14]  C. Rizzo,et al.  Key Role of Sequencing to Trace Hepatitis A Viruses Circulating in Italy During a Large Multi-Country European Foodborne Outbreak in 2013 , 2016, PloS one.

[15]  G. Ippolito,et al.  Epidemiology of HEV in the Mediterranean basin: 10-year prevalence in Italy , 2015, BMJ Open.

[16]  G. La Rosa,et al.  Hepatitis A and E Viruses in Wastewaters, in River Waters, and in Bivalve Molluscs in Italy , 2015, Food and Environmental Virology.

[17]  P. Coursaget,et al.  Hepatitis E virus seroprevalence and risk factors for individuals in working contact with animals. , 2013, Journal of clinical virology : the official publication of the Pan American Society for Clinical Virology.

[18]  R. Tedder,et al.  Hepatitis E Virus Seroprevalence among Men Who Have Sex with Men, United Kingdom , 2013, Emerging infectious diseases.

[19]  F. Martelli,et al.  Transmission dynamics of hepatitis E virus in pigs: estimation from field data and effect of vaccination. , 2012, Epidemics.

[20]  M. Tosti,et al.  Epidemiology of acute viral hepatitis in Italy: results of the surveillance through SEIEVA (Sistema Epidemiologico Integrato dell'Epatite Virale Acuta). , 2012 .

[21]  P. Colson,et al.  Acute and chronic hepatitis E in patients infected with human immunodeficiency virus , 2011, Journal of viral hepatitis.

[22]  K. Jacobsen,et al.  Hepatitis A virus seroprevalence by age and world region, 1990 and 2005. , 2010, Vaccine.

[23]  H. Vennema,et al.  Update: a food-borne outbreak of hepatitis A in the Netherlands related to semi-dried tomatoes in oil, January-February 2010. , 2010, Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin.

[24]  R. Prato,et al.  Control of Hepatitis A by Universal Vaccination of Adolescents, Puglia, Italy , 2008, Emerging infectious diseases.

[25]  M. Massari,et al.  Epidemiological and virological characterization of a large community-wide outbreak of hepatitis A in southern Italy , 2007, Epidemiology and Infection.

[26]  S. Salmaso,et al.  Determinants of acquiring hepatitis A virus disease in a large Italian region in endemic and epidemic periods , 2005, Journal of viral hepatitis.

[27]  P. Lopalco,et al.  Outbreak of Infection with Hepatitis A Virus (HAV) Associated with a Foodhandler and Confirmed by Sequence Analysis Reveals a New HAV Genotype IB Variant , 2004, Journal of Clinical Microbiology.

[28]  J. Furesz,et al.  Safety and effectiveness of the new inactivated hepatitis A virus vaccine. , 1995, CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne.