Use of Molecular Epidemiology to Inform Response to a Hepatitis A Outbreak — Los Angeles County, California, October 2018–April 2019
| Autor: | Jill K. Hacker, Sarah New, Nicole M. Green, Meredith Haddix, Rachel Civen, Peera Hemarajata, Will Probert, Prabhu Gounder |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Adult
medicine.medical_specialty Health (social science) Adolescent Genotype Epidemiology Health Toxicology and Mutagenesis Disease cluster 01 natural sciences Disease Outbreaks Young Adult 03 medical and health sciences 0302 clinical medicine Health Information Management Public health surveillance Environmental health Humans Medicine Public Health Surveillance Full Report 030212 general & internal medicine 0101 mathematics Young adult Aged Molecular Epidemiology Molecular epidemiology business.industry Public health 010102 general mathematics Outbreak Hepatitis A General Medicine Middle Aged medicine.disease Los Angeles Vaccination Ill-Housed Persons business |
| Zdroj: | Morbidity and Mortality Weekly Report |
| ISSN: | 1545-861X 0149-2195 |
| DOI: | 10.15585/mmwr.mm6926a3 |
| Popis: | Los Angeles County comprises 4,058 square miles and is home to approximately 10 million residents (1), an estimated 59,000 (0.6%) of whom experience homelessness on a given night (2). In late 2018, Los Angeles County Department of Public Health (LAC DPH) was notified of a case of hepatitis A virus (HAV) infection in a person experiencing homelessness. LAC DPH conducted an investigation to determine the source of infection, identify additional cases, and identify contacts for postexposure prophylaxis (PEP). Over the next week, LAC DPH identified two additional hepatitis A cases in persons experiencing homelessness who knew one another socially and were known to congregate at a specific street intersection. To identify and respond rapidly to additional outbreak-associated cases, LAC DPH implemented enhanced surveillance procedures, including immediately obtaining specimens for molecular testing from all patients with suspected hepatitis A in the same geographic area. Enhanced surveillance identified four additional cases in persons linked to a senior living campus within two blocks of the intersection where the initial three patients reported congregating. These four cases were linked to the cluster in persons experiencing homelessness through HAV genotyping. Overall, DPH identified seven outbreak-associated hepatitis A cases during October 2018-January 2019. The DPH response to this community hepatitis A outbreak included conducting vaccination outreach to persons at risk, conducting environmental health outreach to restaurants in the outbreak area, and issuing health care provider alerts about the increased occurrence of hepatitis A. Implementation of near real-time molecular testing can improve hepatitis A outbreak responses by confirming HAV infections, linking additional cases to the outbreak, and informing the targeting of prevention efforts. |
| Databáze: | OpenAIRE |
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