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American Journal of Epidemiology Vol. 130, No. 3: 540-546
Copyright © 1989 by The Johns Hopkins University School of Hygiene and Public Health

research-article

RECURRENT EPIDEMIC HEPATITIS A ASSOCIATED WITH CONSUMPTION OF RAW SHELLFISH, PROBABLY CONTROLLED THROFGH PUBLIC HEALTH MEASURES

ALFONSO MELE1,, MARIA GRAZIA RASTELLI2, OWEN NOEL GILL3, DOMENICO DI BISCEGLIE2, FRANCESCO ROSMINI1, GIANCARLO PARDELLI4, CARLA VALTRIANI5 and PIRLUIGI PATRIARCHI5

1Laboratorio di Epidemiologia é Biostatistica, Istituto Superiore di Sanitià Vide Regina Elena 299, 00161 Rome, Italy.
2Public Health Department, USL Livorno Via F. Venuti 56, Livorno, Italy.
3Communicable Disease Surveillance Centre, 61 Colindale Avenue Avenue, London NW9 5EQ, United Kingdom.
4Infectious Disease Unit, O s w e Civile di Livorno Livorno, Italy.
5Centro Irnmuno-Trassfusionale, Ospedale Civile di Livorno Livorno, Italy.

Reprint requests to Dr. Alfonso Mele, Laboratorio di Epidemiologia e Biostatistica, Istituto Superiore di Sanitii, Vide Regina Elena 299,00161, Rome, Italy.

Between April 1984 and January 1985, in the Italian seaport of Livomo, the annual incidence of serologically confirmed acute hepatitis A doubled to 46 per 100,000 population. The exposure histories of each of 75 jaundiced subjects with serologically confirmed hepatitis A were compared with up to four, randomly chosen-, age-, sex-, and neighborhood-matched controls. Illness was strongly associated with consumption of raw mussels and clams within six weeks of onset of illness. When the two thirds of the subjects who had been exposed were classified according to the frequency with which they had recently consumed any type of raw shellfish, there was a clear dose-response relation. In February 1985, comprehensive control measures were introduced and the annual incidence of hepatitis A fell to 2.3 per 100,000 population, a 10-fold decrease from the preepidemic period.

food contamination; hepatitis A; retrospective studies; shellfish


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