An outbreak of hepatitis A affecting 21 residents of an Austrian city occurred from the end of November 2007 until mid-January 2008. A case series investigation suggested the consumption of food purchased from supermarket X as the common link. A food handler employed in the delicatessen department of that supermarket had been serologically diagnosed with hepatitis A on 28th November 2007. During the infectious period of approximately 3 weeks, he worked on 11 days. Interviews with the other cluster cases revealed that the hepatitis A virus (HAV)-infected food handler did not practice appropriate hand hygiene. The investigation revealed no other possible source of infection. We hypothesize that the food of the delicatessen department contaminated by the HAV-infected food handler during his infectious period was the source of the outbreak. The district public health authority recommended the reinforcement of hygiene precautions, i.e., access to viricidal hand disinfectant and the use of disposable gloves and single-use paper towels, in the involved supermarket. The federal ministry of health recommended HAV vaccination for all food handlers in food production and gastronomy companies; this recommendation was included in the Austrian national vaccination plan 2008, even though the vaccination of food handlers is costly and its cost-effectiveness is not proven. Appropriate and regular hand hygiene, particularly after toilet visits, is the most effective measure for preventing HAV transmission.

译文

从2007年11月底到2008年1月月中旬,发生了影响奥地利城市21名居民的甲型肝炎疫情。一系列案例调查表明,从超市X购买的食物的消费是共同的环节。2007年11月28日,该超市熟食店的一名食品管理员被血清学诊断为甲型肝炎。在大约3周的传染期内,他工作了11天。对其他集群病例的采访显示,感染甲型肝炎病毒 (HAV) 的食品处理人员没有采取适当的手卫生。调查没有发现其他可能的传染源。我们假设熟食部门的食物在其感染期间被感染了HAV的食物处理者污染是爆发的源头。地区公共卫生当局建议在涉及的超市中加强卫生预防措施,即使用杀病毒的手部消毒剂,并使用一次性手套和一次性纸巾。联邦卫生部建议为食品生产和美食公司的所有食品处理者接种HAV疫苗; 该建议已被纳入奥地利国家疫苗接种计划2008,尽管食品处理者的疫苗接种成本高昂且其成本效益尚未得到证实。适当和定期的手卫生,特别是在上厕所后,是防止HAV传播的最有效措施。

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