Hepatitis A Outbreak: Cases Decline as Prevention Measures Take Effect in Naples
A slight easing in the rate of new cases is offering cautious optimism as health officials in Naples, Italy, continue to grapple with a Hepatitis A outbreak linked to the consumption of raw seafood. After several days of exceeding 15 new cases per 24 hours at the Cotugno Hospital, a preliminary decrease in admissions was recorded yesterday, according to hospital officials.
“We had eight further admissions,” stated Vincenzo Di Sarno, head of the emergency department at the city’s infectious disease center, speaking at an information point set up outside the hospital. “However, many of these patients, some of whom were examined in recent days, are showing gradual signs of improvement, allowing us to discharge them for home treatment under the supervision of their general practitioners. Currently, we have 53 patients hospitalized, and their clinical condition is stable with no critical cases. We are hoping for a continued improvement in the epidemic curve, potentially reaching a peak associated with the consumption of raw shellfish during the end-of-year holidays and Carnival.”
Authorities have issued a ban on the sale of raw shellfish in the Campania region, encompassing Naples, as a preventative measure. The outbreak prompted the ban, and investigations are focused on tracing the source of the contamination. Production facilities for mussels and other shellfish are currently under increased scrutiny by the Istituto Zooprofilattico Sperimentale del Mezzogiorno.
The institute has bolstered its diagnostic capabilities, increasing the processing of biological samples and establishing a technical and scientific emergency response team available even during holidays, according to its director-general, Professor Giuseppe Iovane. Collaboration with regional authorities and local health units is focused on monitoring the entire supply chain of mussels, clams, and oysters – identified as the primary foodborne carriers of the virus.
Monitoring similarly extends to vegetables, surface water, and seawater. Facilities found to be free of contamination are permitted to continue operations, even as those with confirmed cases in Varcaturo, Nisida, and Bacoli remain under surveillance and are subject to restrictions. The Carabinieri’s NAS unit is also involved, having seized some shellfish lacking proper traceability.
Sales are currently permitted only with traceability labels and packaging that prevents direct contact with seawater. Regional authorities have reinforced their response to the epidemic through increased controls, surveillance, and vaccination efforts, as well as strengthening public health infrastructure. Epidemiological monitoring, rapid case and contact management, food chain controls, molecular investigations, and an expanded, free Hepatitis A vaccination program for at-risk groups are all underway.
The free vaccination program targets healthcare and social workers, food industry employees, individuals with underlying health conditions, children based on epidemiological risk and exposure, and those in contact with infected individuals. Hepatitis A is an acute liver infection caused by the HAV virus, transmitted through the fecal-oral route – by consuming contaminated water or food, or through close contact with an infected person. The virus can be present in stool up to seven to ten days before the onset of clinical symptoms, meaning transmission can occur before symptoms appear. The typical incubation period ranges from 15 to 50 days.
Health officials emphasize the importance of thorough handwashing with soap and water for at least 20 seconds before cooking, eating, after using the toilet, changing diapers, and after caring for a sick person. Work surfaces, knives, sinks, and other areas should be cleaned and disinfected after handling raw foods. Raw fruits and vegetables should be thoroughly washed under running water.