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Aim: The major transmission mode of hepatitis A virus (HAV) in Japan is the fecal–oral route by contaminated foods. In contrast, HAV infection is well documented as a sexually transmitted disease in Europe and North America. The present study was undertaken to determine the full‐genome sequence of HAV and trace the transmission route of HAV in Japanese men who have sex with men (MSM). Methods: In 2018, we encountered three Japanese MSM with acute hepatitis A co‐infected with HIV for 4–12 years. Serum samples obtained from these patients were used for HAV full‐genome analyses. Results: Isolated HAV strains were segregated into subgenotype IA. The three HAV strains shared 100% identity within the 481‐nucleotide partial sequence. The entire nucleotide sequence showed that the three strains were 99.97% similar to each other with only two nucleotide substitutions. At the amino acid level, the three strains differed from each other by only one or two amino acids. All three strains obtained in the present study were >99.6% identical to the 66 reported strains isolated from Taiwan and European countries during 2015–2017. In addition, these 66 strains include the RIVM‐HAV16‐090 (EuroPride) strain, which has been involved in HAV outbreaks among MSM worldwide. Conclusions: We determined for the first time the full‐genome sequence of HAV isolated from Japanese MSM with acute hepatitis A and found that the strains were identical to those from MSM worldwide. Thus, these HAV strains were imported to Japan from foreign countries through MSM. [ABSTRACT FROM AUTHOR]

Mass poisonings, called yusho and yu-cheng, occurred in western Japan in 1968 and central Taiwan in 1979, respectively. These occurrences were separately caused by ingestion of rice oils contaminated with polychlorinated biphenyls (PCBs), polychlorinated dibenzofurans (PCDFs) and polychlorinated quaterphenyls. The total intakes of PCBs and PCDFs by the patients were calculated to be, on the average, 633 and 3.4 mg for yusho, respectively, and 973 and 3.84 mg for yu-cheng, respectively, similar amounts of the causal agents being ingested in both instances. Increased eye discharge, pigmentation of nails, skin and mucous membrane, acneform eruptions and feeling of weakness were the most notable symptoms for both the poisonings. The PCB concentrations in the blood of patients were 1-30 ppb for yusho and 3-1156 ppb for yu-cheng five years and one year after the outbreaks, respectively. For the yusho patients, the clinical severity was closely related to the total amount of rice oil consumed and to the blood PCB concentration and the gas chromatographic pattern of blood PCBs.