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Hepatitis A outbreaks in China during 2006: application of molecular epidemiology.

ABSTRACT: BACKGROUND: In China, hepatitis is a huge public health problem. Outbreaks of hepatitis A are the most frequent cause of acute hepatitis, and to date, few epidemiologic investigations or molecular surveillance studies have been performed. MATERIALS AND METHODS: In 2006, two major outbreaks of hepatitis A occurred, one in Guigang City, southern China, and the other in Hetian City, northwestern China. Field and molecular epidemiologic investigations were conducted. RESULTS: In Guigang, a single outbreak occurred in a school; 35 patients and 25 asymptomatic individuals were infected with 1 strain of hepatitis A virus (HAV). A case-control study showed that contaminated water was the likely transmission source. In Hetian, the epidemic of hepatitis A consisted of sporadic, small outbreaks involving as many as 20 wild HAV strains. A molecular epidemiology approach allowed us to identify two groups infected by individual HAV strains. Further fieldwork and a case-control study showed that ice cream was the suspected transmission source in one group. Our molecular epidemiology study showed that genetic variability between the HAV strains isolated from Guigang and Hetian and previously reported HAV strains was at least 4.3%. CONCLUSION: Contaminated water and suspected ice cream were associated with outbreaks of hepatitis A. Viral genetic analysis may advance field investigations in complex situations.

SUBMITTER: Cao J

PROVIDER: S-EPMC2716766 | biostudies-literature | 2009 Jun

REPOSITORIES: biostudies-literature

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Hepatitis A outbreaks in China during 2006: application of molecular epidemiology.

Cao Jingyuan J Wang Yue Y Song Haiyan H Meng Qingling Q Sheng Liping L Bian Tao T Mahemuti Wenqian W Yierhali Ayiguli A Omata Masao M Bi Shengli S

Hepatology international 20081219 2

<h4>Background</h4>In China, hepatitis is a huge public health problem. Outbreaks of hepatitis A are the most frequent cause of acute hepatitis, and to date, few epidemiologic investigations or molecular surveillance studies have been performed.<h4>Materials and methods</h4>In 2006, two major outbreaks of hepatitis A occurred, one in Guigang City, southern China, and the other in Hetian City, northwestern China. Field and molecular epidemiologic investigations were conducted.<h4>Results</h4>In G ...[more]

PMID: 19669361

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Project description:The 7th cholera pandemic began in 1961 in Sulawesi, Indonesia, and then spread around the world in at least three waves. However, the lack of genome sequences for Vibrio cholerae strains under long-term surveillance in East Asia, especially in China, has restricted our understanding of the dynamics of the intracountry and intercountry evolution and transmission of the 7th-pandemic clones. In this study, we obtained the genome sequences of 60 V. cholerae strains isolated in Shanghai, the largest port in the world and the largest city in China, from 1961 to 2011. Our whole-genome-based phylogeny of 7th-pandemic strains revealed that all but one fell into five "stages," most of which are single clades and share independent ancestors. Each stage dominated in succession for a period, with little overlap between them. In addition, two near-identical Shanghai strains belonging to a pre-7th-pandemic precursor and 4 nontoxigenic O1/O139 strains attributed to independent recombination events at the O-antigen loci were present. The major lineages of the 7th pandemic in Shanghai appeared to be closely related to V. cholerae strains isolated from South or Southeast Asia. Stage succession was consistently related to changes in society and human activity, implying that human-caused niche change may play a vital role in the cholera dynamics in Shanghai.IMPORTANCEV. cholerae is the causative agent of cholera, a life-threatening disease characterized by severe, watery diarrhea. The 7th pandemic started in Indonesia in 1961 and spread globally, currently infecting 1.3 million to 4 million people annually. Here, we applied whole-genome sequencing to analyze a long-term collection of V. cholerae clinical strains to reveal the phylogenetic background and evolutionary dynamics of the 7th pandemic in Shanghai, which had undergone breathtakingly rapid development in the last half-century. All but one of the Shanghai 7th-pandemic strains fell into five "stages" that were dominant in Shanghai and appeared to be closely related to 7th-pandemic strains of South or Southeast Asia. Our findings extended the understanding of the dynamics of the evolution and transmission of the 7th-pandemic clones in East Asia and the relationship between social changes and cholera epidemiology.

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Hepatitis A outbreaks in China during 2006: application of molecular epidemiology.

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Hepatitis A outbreaks in China during 2006: application of molecular epidemiology.

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