Daniela Loconsole1, Anna Morea1, Domenico Martinelli2, Maria Giovanna Cappelli2, Iulia Turiac3, Rosa Prato2 and Maria Chironna1*
1Department of Biomedical Sciences and Human Oncology-Hygiene Section, University of Bari, Bari, Italy
2Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
3European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
The introduction of the universal routine vaccination against hepatitis A virus in Puglia (South Italy) has significantly changed the natural history of the disease with a drastic reduction of the number of infections. In 2016, only 9 cases of acute viral hepatitis A were reported. From February 2016 to February 2017, 287 confirmed hepatitis A cases have been reported by13 European countries. In Italy, between August 2016 and February 2017, 583 cases of hepatitis A infection were reported. Most cases in Europe and Italy involved adult men who have sex with men (MSM). In Puglia region (South Italy) from January to March 2017, 33 cases of hepatitis A were reported. Of these cases, 93.9% were male aged between 26 and 52 years (median age 38 years). Fifteen subjects reported having had sexual contacts with men (MSM) in the 8 weeks preceding the onset of symptoms and 4 of these were HIV-positive. The molecular characterization was performed on 20 samples. Eight sequences were identical to the strain VRD_51_2016 and 4 to the strain RIVM-HAV16-090, which are related to the epidemic of HAV in MSM in Italy and Europe. In Puglia, as well as in Europe, anonymous sex, multiple sex partners, use of dating apps and international travel are the main risk factors for infection. Vaccination among at-risk group and specific communication strategies through social media, apps and venues seem to be the main public health strategies to contain this outbreak.
Loconsole D, Morea A, Martinelli D, Cappelli MG, Turiac I, Prato R, et al. First Outbreak of Hepatitis A Associated with Sexual Transmission among Men who have Sex with Men (MSM) in Puglia, South Italy, 2017. Ann Clin Hepatol. 2017; 1(1): 1003.