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Australian hepatitis A case linked to date of import

Last year six people in Australia suffered an outbreak of hepatitis A from eating dates from Jordan, according to a study.

The researchers say this is the first known Hepatitis A outbreak in the region linked to the date of importation of fresh Medjool. The link to the UK outbreak was identified despite the implicated dates being months apart and from different farms.

Between June 2021 and September 2021, six genetically identical cases of hepatitis A have been reported in New South Wales and the Australian Capital Territory. All patients reported the dates of consumption during their exposure. Tested positive for hepatitis A virus (HAV) on the relevant date, according to research published in Communicable Diseases Intelligence.

Australia’s border closure in response to the COVID-19 pandemic means a common locally acquired, rather than travel acquired, origin is suspected. In addition, awareness that an outbreak of hepatitis A in the United Kingdom, which sickened at least 31 people, was also associated with date consumption enabled early hypothesis generation and investigation that may prevent further disease.

There was less than one case of Hepatitis A per month nationwide when borders were closed. All but one of the cases notified by NSW during this period until June 2021 were linked to returning citizens was due to consumption of imported frozen food previously recalled.

link to eating jujube
the first of June 2021 One patient reported consuming fresh Medjool dates during the exposure period, but the product to assist traceability could not be identified. In July, the case was found to be genetically identical to a patient sample from the UK outbreak linked to a Jordanian date. A third patient was able to report a specific brand of imported dates.

Four of the six patients reported consuming the relevant brand or consuming dates purchased from a website selling the affected product.

Five patients with genotype IB lived in New South Wales and one patient lived in the Australian Capital Territory (ACT). The median age of the cases was 26 years old, but ranged from 15 to 53 years old, and five of them were males. Four required hospital treatment.

NSW Department of Primary Industries officials collected an unopened box of suspected Medjool dates weighing 1kg from a Sydney supermarket. HAV was detected in two of 10 subsamples. Since the samples from the positive date could not be sequenced, it was not possible to genetically link the human sequence to the food in question.

In August 2021, an Australian importer issued a recall of fresh Medjool dates produced in Jordan. The importer distributes dates to New South Wales and Victoria. It is thought they may have been sent to the ACT by an unidentified third party.

The Jordanian supplier placed a hold order on the Medjool date. This means that after import into Australia, any date shipments from this supplier will be held at the border until Jordanian authorities can assure that the risk of HAV contamination has been mitigated. This order has been cancelled.

is related to the British epidemic
a report on England and Reports of a hepatitis A outbreak in Wales linked to dates from Jordan alerted Australian public health investigators to this issue and led to the addition of a date consumption question to the national hepatitis A surveillance questionnaire.

The HAV outbreak strains associated with the Australian date were the same as those in England and Wales. However, no common grower, manufacturer or importer could be identified. Jordanian authorities said batches of dates in each outbreak were picked and processed from different farms along the Jordan River, months apart.

One interpretation product of common strains in different outbreaks caused by the same food is because it represents the prevalent strains prevalent in the country of origin. Alternatively, there may be a common source of infection between farms, such as human-to-human transmission among date harvesters, the researchers said.

Scientists say more investigation is needed to understand additional risk management measures related to the possible need for fresh Medjool dates and Australian imports of such dates.

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