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Outbreak of hepatitis A linked to European outbreaks among men who have sex with men in Osaka, Japan, from March to July 2018
Author(s) -
Tanaka Satoshi,
Kishi Tomomi,
Ishihara Akio,
Watanabe Dai,
Uehira Tomoko,
Ishida Hisashi,
Shirasaka Takuma,
Mita Eiji
Publication year - 2019
Publication title -
hepatology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.123
H-Index - 75
eISSN - 1872-034X
pISSN - 1386-6346
DOI - 10.1111/hepr.13314
Subject(s) - outbreak , men who have sex with men , medicine , hepatitis a , viral hepatitis , hepatitis , epidemiology , vaccination , hepatitis c , pediatrics , virology , demography , human immunodeficiency virus (hiv) , syphilis , sociology
Aim Ongoing hepatitis A outbreaks among men who have sex with men (MSM) have been reported worldwide, mainly in Europe, since 2016. In Japan, there has been an increase in the number of notified hepatitis A cases since January 2018, most of which were suspected to have been transmitted through homosexual contact. In this paper, we describe the current outbreak situation of hepatitis A among MSM. Methods Between March and July 2018, 13 cases of hepatitis A were identified in our hospital. All cases were identified as MSM. Data on clinical and laboratory findings and therapies were collected from medical records. Serum or stool samples were obtained from 13 patients and subjected to sequence analysis. Results Of all patients, 12 reported to have male‐to‐male homosexual contact within 7 weeks prior to symptom onset, and 6 visited sex‐on‐premises venues in the same area. Furthermore, 12 patients were infected with HIV and consequently received antiretroviral therapy with sustained viral suppression. Ten patients received pulsed methylprednisolone therapy. Plasma exchange was additionally carried out in one patient. All patients received inpatient hospital care and were discharged alive. Sequence information, which was available in all cases, showed that the hepatitis A virus strain was identical to the EuroPride strain (RIVM‐HAV16–090). Conclusions Results of sequence analysis suggest that the ongoing hepatitis A outbreak among MSM in Japan is linked to the 2016 European outbreaks. A vaccination program is urgently required for high‐risk populations to control this ongoing outbreak.