Tel Aviv Hepatitis A Outbreak May Stem From Open-air Markets

Dan Even
Send in e-mailSend in e-mail
Send in e-mailSend in e-mail
Dan Even

Tel Aviv has recently been suffering an outbreak of Hepatitis A, and the Health Ministry believes the source may be vegetables sold in open-air markets in the south of the city.

To stem the outbreak, the ministry has decided to offer free vaccinations to high-risk populations.

According to the ministry, 69 cases of the disease have been reported in the Tel Aviv region since the start of 2012, most in the latter half of the year. That compares to just seven in 2011. Hepatitis A attacks the liver, and is transmitted via food, contaminated water or contact with someone who has it.

The ministry found that 74 percent of the reported cases are residents of south Tel Aviv and nearby Bat Yam, most of them young people aged 25 to 34. In addition, 12 of the 69 cases are drug users or homeless people.

To date, the ministry's questioning of the patients hasn't uncovered any clear common source of the problem. But it said one possible source is vegetables sold in open-air market in south Tel Aviv. Other possible transmitters that have emerged from its inquiries are homosexual sex, south Tel Aviv soup kitchens and or even certain restaurants in the city, though as yet, no one restaurant has come up repeatedly in patients' accounts.

The ministry is now trying to find the source of the suspect vegetables, in cooperation with the Agriculture Ministry.

There have been no new reported cases of Hepatitis A outside the Tel Aviv region so far this year. Last year, however, there was a rise in incidence of the disease in the Ashkelon area, though of much smaller dimensions - nine cases altogether.

In an effort to contain the current outbreak, the Health Ministry will be providing free vaccinations over the next month to high-risk groups via its district offices. The vaccine will also be available through the health maintenance organizations.

According to Prof. Itamar Grotto, head of the ministry's Public Health Services division, "High-risk groups include drug users and men who have sexual relations with other men." As a result, the ministry will launch a proactive campaign to locate and vaccinate drug users in south Tel Aviv, especially near the central bus station, which has been identified as a major center of the outbreak.

Over the last decade, Israel has actually seen a steep decline in Hepatitis A, thanks to its decision to include the vaccine in the standard package of vaccinations given to all babies. It was the first country in the world to vaccinate routinely against this disease.

Symptoms of Hepatitis A include fever, loss of appetite, nausea, throwing up and jaundice. It is a relatively prolonged disease and often causes weight loss. In rare cases, it can cause severe liver damage and be life-threatening to children under 5 or adults over 50.

Fruit and vegetables in an Israeli market.Credit: Ofer Vaknin