Introduction
Hepatitis A virus (HAV), which is transmitted by the fecal-oral route and through contact with infected persons, is the most common cause of acute viral hepatitis worldwide. Ingestion of contaminated food or water is the major route of infection. Typical presenting symptoms include non-specific prodromal symptoms with variable combinations of fever, malaise, anorexia, nausea, vomiting, and other symptoms. HAV infection can cause acute liver failure and death; this risk increases with age and the presence of chronic liver disease. Because HAV is a waterborne virus, the USEPA has placed it in their CCL 3 and the Korean Ministry of Environment has placed in their list of high priority microorganisms.
Objectives
Although HAV prevalence has been extensively studied, including phylogenetic analysis of hepatitis A samples from patients in Korea, there have been few investigations of HAV contamination in surface water sources of drinking water. In the present study, we tested 265 samples of surface water from 89 locations for the presence of HAV between February 2007 and September 2010. In addition, we performed molecular characterization of the HAVs found by this surveillance.
Methods
Between February 2007 and September 2010, 265 samples were collected from 89 locations. The sampling sites were chosen from water that is used as a source of water for making treated tap water. The viruses were sampled and concentrated following USEPA guidelines. For RNA extraction and RT-PCR, a QIAamp Viral RNA Mini Kit was used. The extracted viral RNA was then used as the template for RT-PCR using HAV primers and the following conditions, which have been previously published. The newly isolated HAVs were genotyped using the partial region (VP3-VP1) of the representative HAV genotypes. The nucleotide sequences were aligned using ClustalX and evolutionary distances were calculated using the DNADIST program, based on the Kimura-two-parameter method, from the PHYLIP packa