Abstract
A matched and serologically confirmed case-control study was carried out to investigate the source of an outbreak of acute hepatitis involving 290,000 cases in the suburbs of Shanghai, in January 1988. A total of 132 patients with acute hepatitis from six different hospitals were chosen as cases and the same number of control patients without hepatitis were matched for gender, age, admission date and area of residence. Serum specimens from both case and control patients were detected for specific anti-hepatitis A (HA) IgM antibody and a questionnaire was used to investigate probable risk factors related to the outbreak. The positive rate of anti-HA IgM was 98.48% in the case group and only 0.76% in the control, indicating that the infection was caused by HA virus. The results revealed that the source and mode of transmission were due to the consumption of contaminated and inadequately cooked clams (Anadara subcrenata lischke). There was a highly positive dose-response relationship between the odds ratio of contracting HA and the quantity or frequency of clam consumption. The odds ratios of acquiring HA from clams were up to 62.4-63.4 by both group stratification and multiple unconditional logistic regression analyses.
Full text
PDF






Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Goh K. T., Chan L., Ding J. L., Oon C. J. An epidemic of cockles-associated hepatitis A in Singapore. Bull World Health Organ. 1984;62(6):893–897. [PMC free article] [PubMed] [Google Scholar]
- Koff R. S., Sear H. S. Internal temperature of steamed clams. N Engl J Med. 1967 Mar 30;276(13):737–739. doi: 10.1056/NEJM196703302761307. [DOI] [PubMed] [Google Scholar]
- McGee D. L. A program for logistic regression on the IBM PC. Am J Epidemiol. 1986 Oct;124(4):702–705. doi: 10.1093/oxfordjournals.aje.a114444. [DOI] [PubMed] [Google Scholar]
- Mele A., Rastelli M. G., Gill O. N., di Bisceglie D., Rosmini F., Pardelli G., Valtriani C., Patriarchi P. Recurrent epidemic hepatitis A associated with consumption of raw shellfish, probably controlled through public health measures. Am J Epidemiol. 1989 Sep;130(3):540–546. doi: 10.1093/oxfordjournals.aje.a115368. [DOI] [PubMed] [Google Scholar]
- Miettinen O. Estimability and estimation in case-referent studies. Am J Epidemiol. 1976 Feb;103(2):226–235. doi: 10.1093/oxfordjournals.aje.a112220. [DOI] [PubMed] [Google Scholar]
- Millard J., Appleton H., Parry J. V. Studies on heat inactivation of hepatitis A virus with special reference to shellfish. Part 1. Procedures for infection and recovery of virus from laboratory-maintained cockles. Epidemiol Infect. 1987 Jun;98(3):397–414. doi: 10.1017/s0950268800062166. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Mitchell J. R., Presnell M. W., Akin E. W., Cummins J. M., Liu O. C. Accumulation and elimination of poliovirus by the eastern oyster. Am J Epidemiol. 1966 Jul;84(1):40–50. doi: 10.1093/oxfordjournals.aje.a120626. [DOI] [PubMed] [Google Scholar]
- Ruddy S. J., Johnson R. F., Mosley J. W., Atwater J. B., Rossetti M. A., Hart J. C. An epidemic of clam-associated hepatitis. JAMA. 1969 Apr 28;208(4):649–655. [PubMed] [Google Scholar]
