Health Professionals

Clinical Update

13 November 2009

Hepatitis A outbreak in Australia

An increase in the number of locally acquired hepatitis A cases has been reported across the State of Victoria, Australia since the start of 2009 [1-3].  As of 2 November 2009, 200 cases of hepatitis A had been notified in the State of Victoria compared to 74 cases at the same time in 2008 [2].  The outbreak is ongoing, with 23 cases notified during the week commencing 2 November [2].

Investigations into the outbreak suggest a strong link with consumption of uncooked, loose, sun-dried tomatoes. Public health advisories have been issued in the State of Victoria and as a precautionary measure, in the states of New South Wales and Western Australia, where a small number of cases, possibly linked to sun-dried tomatoes, have also been reported. [2-6].

The State of Southern Australia has also reported an increase of cases this year [7]. As of 24 October 2009, 51 cases had been reported compared to 19 cases at the same time in 2008 [7].

Advice for travellers

Hepatitis A is a viral disease that causes inflammation of the liver. The disease is transmitted through contaminated food or water, or direct contact with faeces in situations of poor hygiene or during certain sexual practices.

Hepatitis A occurs worldwide, and travellers are advised to practise strict food, water and personal hygiene precautions during travel, particularly in countries experiencing outbreaks. In addition, travellers to the States of Victoria, New South Wales and Western Australia  are advised to avoid the consumption of uncooked loose sun-dried tomatoes at present [3, 5, 6].

Hepatitis A can also be prevented by vaccination. Vaccine recommendations for Australia are available on the NaTHNaC Country Information Pages.

References

1.State Government of Victoria. Chief Health Officer Alert. Hepatitis A outbreak. 8 April 2009. [Accessed 13 November 2009]. Available at: http://www.health.vic.gov.au/chiefhealthofficer/downloads/cho_

alert_hepatitis_a.pdf

2. State Government of Victoria. Chief Health Officer Alert. Hepatitis A outbreak. 6 November 2009. [Accessed 12 November 2009]. Available at:  http://www.health.vic.gov.au/chiefhealthofficer/downloads/cho_

alert_hepatitisa_nov.pdf

3. State Government of Australia. News Release. Health warning continues on semi-dried tomatoes. 2 November 2009. [Accessed 13 November 2009]. Available at: http://www.health.vic.gov.au/chiefhealthofficer/downloads/semi-dried_toms_advisory_update.pdf

4. State Government of Victoria. Chief Health Officer advisory information: Hepatitis A outbreak – precautionary advice for cafes, restaurants, take-away outlets and caterers. 11 November 2009. [Accessed 13 November 2009]. Available at: http://www.health.vic.gov.au/chiefhealthofficer/downloads/cho_

advisory_restaurants-cafes-takeaways-caterers.pdf

5. New South Wales Government. Department of Health. Precautionary warning – semi-dried tomatoes linked to hepatitis A. 7 November 2009. [Accessed 13 November 2009]. Available at:  http://www.health.nsw.gov.au/news/2009/20091107_00.html

6. Government of Western Australia. Department of Health. Media Releases. Precautionary Warning – sun-dried tomatoes linked to hepatitis A. 10 November 2009. [Accessed 13 November 2009]. Available at: http://www.health.wa.gov.au/press/view_press.cfm?id=872

7. Government of South Australia. Department of Health. Communicable Disease Control Branch. 5 year YTD comparisons. 26 October 2009. [Accessed 13 November 2009]. Available at: http://www.dh.sa.gov.au/pehs/notifiable-diseases-summary/weekly%20report%203%20091024.pdf

Hepatitis A

NaTHNaC Health Information Sheet on hepatitis A

NaTHNaC Country Information Page for Australia

Health Protection Agency information on hepatitis A