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Published Date: 2012-09-05 20:25:08
Subject: PRO/EDR> Hepatitis A - France, Philippines: food establishments susp.
Archive Number: 20120905.1282537

HEPATITIS A - FRANCE, PHILIPPINES: FOOD ESTABLISHMENTS SUSPECTED
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In this report:
[1] France - restaurant associated
[2] Philippines - school canteen associated

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[1] France
Date: Tue 4 Sep 2012
Source: Ouestfrance.fr [in French, trans. edited]
http://www.ouest-france.fr/region/paysdelaloire_detail_-Douze-cas-d-hepatite-A-en-Sarthe-les-medecins-alertes_40807-2109754_actu.Htm

The Regional Health Agency of the Pays de la Loire has recently posted a warning of an outbreak of acute hepatitis A virus infection to all physicians and laboratories in the Le Mans region.

On 30 Aug 2012, the Regional Health Agency issued a statement warning that: "12 cases of acute hepatitis A had been reported, including a group of 7 cases in the same locality in the city of Le Mans. Investigations in progress suggest a restaurant as the source of the outbreak. The actual mode of transmission of infection has yet to be established."

Previously, in 2011, 17 cases of hepatitis A were reported in the department of Sarthe (42 cases in the whole region).

This form of hepatitis (hepatitis A) causes fever, nausea, abdominal pain, and fatigue. It is necessary to consult a doctor if these symptoms develop.

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[2] Philippines - school canteen associated
Date: Wed 5 Sep 2012
Source: Philippine Information Agency [edited]
http://www.pia.gov.ph/news/index.php?article=41346743591

The Provincial Health Office [PHO] of Apayao has declared an outbreak of hepatitis A in the municipality of Kabugao after 19 cases, mostly students, were reported in one week. PHO Surveillance Officer Dr. Mary Ann Canonizado said that the cases were reported from 19-26 Aug 2012. Most of the students were from the Lourdes High School in Barangay Poblacion.

Canonizado said that, based on the surveillance they conducted, they traced the source of the virus to a canteen at the school. The canteen was ordered closed, and screen testing was done on the students to detect and prevent further spread of the virus. Doctors treated the victims and continue to monitor their condition. They were also given liver aid supplements and other vitamins.

The PHO and the municipal government of Kabugao also conducted information, education, and communication campaigns on food handling directed toward canteen personnel, school teachers, officials, parents, and students. They also alerted rural health units in the municipality and nearby areas. An educator's forum and barangay and purok assembly were also conducted. A group from the National Epidemiology Center from Manila is set to arrive in Kabugao to conduct further surveillance and other screening tests.

From February to August 2012, the PHO recorded 21 cases of hepatitis A, but there was no recorded mortality.

[Byline: Redjie Melvic M. Cawis]

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[Hepatitis A is a liver disease caused by hepatitis A virus. The virus is primarily spread when an uninfected (and unvaccinated) person ingests food or water that is contaminated with the faeces of an infected person. The disease is closely associated with a lack of safe water, inadequate sanitation and poor personal hygiene. Waterborne outbreaks, though infrequent, are usually associated with sewage-contaminated or inadequately treated water.

The virus can also be transmitted through close physical contact with an infectious person, although casual contact among people does not spread the virus. The incubation period of hepatitis A is usually 14-28 days. Symptoms of hepatitis A range from mild to severe and can include fever, malaise, loss of appetite, diarrhoea, nausea, abdominal discomfort, dark-coloured urine and jaundice (a yellowing of the skin and whites of the eyes). Adults have signs and symptoms of illness more often than children, and the severity of disease and mortality increases in older age groups. Infected children under 6 years of age do not usually experience noticeable symptoms, and only 10 percent develop jaundice. Among older children and adults, infection usually causes more severe symptoms, with jaundice occurring in more than 70 percent of cases.

The actual vehicle of transmission of hepatitis A virus infection has not been identified in either of the 2 incidents described above in France or the Philippines.

Le Mans is a city in France located on the Sarthe River. Traditionally the capital of the province of Maine, it is now the capital of the Sarthe department. Le Mans is a part of the Pays de la Loire region. Le Mans can be found in the interactive HealthMap at: http://healthmap.org/r/3khW.

The City of Baguio is a highly urbanized city located in the province of Benguet in the northern Luzon island of the Philippines. Luzon island can be found in the interactive HealthMap at: http://healthmap.org/r/00dc. - Mod.CP]

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