Ranil Appuhamy1, Cameron Moffatt2, Stephanie Davis3, Paul Kelly4, Karina Kennedy5. 1. Health Protection Service, Australian Capital Territory Health, Canberra, Australia . 2. OzFoodNet, Communicable Disease Control Section, Health Protection Service, Australian Capital Territory, Canberra, Australia . 3. Master of Philosophy (Applied Epidemiology) Program, National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australia . 4. Population Health Division, Australian Capital Territory Health Directorate and Australian National University Medical School, Australian Capital Territory, Australia . 5. Department of Microbiology and Infectious Diseases, Canberra Hospital and Health Services, Canberra, Australia .
Abstract
OBJECTIVE: The Australian Capital Territory Health Directorate was notified of a food handler with hepatitis E virus (HEV) infection. To guide the public health response, a rapid risk assessment was undertaken to determine the risk of transmission of HEV from the infected food handler to restaurant patrons. METHOD: The literature on HEV was reviewed and expert advice sought from clinical and public health specialists. This was supplemented by results of a site investigation and a case interview. The risk rating was determined to be the product of the likelihood of transmission and the consequence of the infection. RESULTS: The food handler was likely to have been infectious at the time he was working at the restaurant. He had handled high-risk foods, and the site inspection revealed potential opportunities for transmission. HEV is not common in Australia and it was assumed that the population was non-immune and hence susceptible to the disease. Therefore, there was a low but possible likelihood of transmission of HEV. If infected, HEV has the potential for major consequences in vulnerable populations especially among women who are pregnant. The overall level of risk was considered to be very high. DISCUSSION: The general public and health practitioners were alerted to enable early identification of symptoms and prompt disease management. There were no secondary cases of HEV associated with this event. In the absence of published guidelines and limited evidence, a risk assessment framework was a useful tool to inform public health decision-making.
OBJECTIVE: The Australian Capital Territory Health Directorate was notified of a food handler with hepatitis E virus (HEV) infection. To guide the public health response, a rapid risk assessment was undertaken to determine the risk of transmission of HEV from the infected food handler to restaurant patrons. METHOD: The literature on HEV was reviewed and expert advice sought from clinical and public health specialists. This was supplemented by results of a site investigation and a case interview. The risk rating was determined to be the product of the likelihood of transmission and the consequence of the infection. RESULTS: The food handler was likely to have been infectious at the time he was working at the restaurant. He had handled high-risk foods, and the site inspection revealed potential opportunities for transmission. HEV is not common in Australia and it was assumed that the population was non-immune and hence susceptible to the disease. Therefore, there was a low but possible likelihood of transmission of HEV. If infected, HEV has the potential for major consequences in vulnerable populations especially among women who are pregnant. The overall level of risk was considered to be very high. DISCUSSION: The general public and health practitioners were alerted to enable early identification of symptoms and prompt disease management. There were no secondary cases of HEV associated with this event. In the absence of published guidelines and limited evidence, a risk assessment framework was a useful tool to inform public health decision-making.
Authors: Eyasu H Teshale; Scott P Grytdal; Christopher Howard; Vaughn Barry; Saleem Kamili; Jan Drobeniuc; Vincent R Hill; Samuel Okware; Dale J Hu; Scott D Holmberg Journal: Clin Infect Dis Date: 2010-04-01 Impact factor: 9.079
Authors: Tai Nin Chau; Sik To Lai; Cyndy Tse; Tak Keung Ng; Vincent King Sun Leung; Wilina Lim; Mun Hon Ng Journal: Am J Gastroenterol Date: 2006-02 Impact factor: 10.864
Authors: Andrea C Tricco; Ba' Pham; Bernard Duval; Gaston De Serres; Vladimir Gilca; Linda Vrbova; Andrea Anonychuk; Murray Krahn; David Moher Journal: BMC Health Serv Res Date: 2006-12-08 Impact factor: 2.655