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Pavlova A, Kocikova B, Dolinska MU, Jackova A. Hepatitis E Virus in the Role of an Emerging Food-Borne Pathogen. Microorganisms 2025; 13:885. [PMID: 40284721 PMCID: PMC12029509 DOI: 10.3390/microorganisms13040885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2025] [Revised: 04/04/2025] [Accepted: 04/07/2025] [Indexed: 04/29/2025] Open
Abstract
Viral hepatitis E represents an important global health problem caused by the hepatitis E virus (HEV). Cases of HEV infection are increasingly associated with food-borne transmissions after the consumption of raw or undercooked food products from infected animals in high-income regions. Although most cases of infection are asymptomatic, severe courses of infection have been reported in specific groups of people, predominantly among pregnant women and immunocompromised patients. The viral nucleic acid of HEV is increasingly being reported in food-producing animals and different products of an animal origin. Even though the incubation period for HEV infection is long, several direct epidemiological links between human cases and the consumption of HEV-contaminated meat and meat products have been described. In this article, we review the current knowledge on human HEV infections, HEV in different food-producing animals and products of an animal origin, as well as the accumulation and resistance to HEV in farm and slaughterhouse environments. We also provide preventive measures to help eliminate HEV from animals, the human population, and the environment.
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Affiliation(s)
| | | | | | - Anna Jackova
- Department of Epizootiology, Parasitology and Protection of One Health, University of Veterinary Medicine and Pharmacy in Kosice, Komenskeho 73, 041 81 Kosice, Slovakia; (A.P.); (B.K.); (M.U.D.)
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Virhuez-Mendoza M, Ishijima K, Tatemoto K, Kuroda Y, Inoue Y, Nishino A, Yamamoto T, Uda A, Hotta A, Kabeya H, Shimoda H, Suzuki K, Komiya T, Seto J, Iwashina Y, Hirano D, Sawada M, Yamaguchi S, Hosaka F, Maeda K. Recent Hepatitis E Virus Infection in Wild Boars and Other Ungulates in Japan. Viruses 2025; 17:524. [PMID: 40284967 PMCID: PMC12031028 DOI: 10.3390/v17040524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2025] [Revised: 04/02/2025] [Accepted: 04/02/2025] [Indexed: 04/29/2025] Open
Abstract
Hepatitis E virus (HEV) is a zoonotic pathogen with multiple hosts, posing significant public health risks, especially in regions like Japan where game meat consumption is prevalent. This study investigated HEV infection and viral shedding in wild boars, sika deer, and Japanese serows across Japan. A total of 1896 serum samples were tested for anti-HEV antibodies, 1034 for HEV RNA, and 473 fecal samples for viral shedding. Anti-HEV antibodies were detected in wild boars from all seven prefectures studied, while HEV RNA was detected in wild boars from Fukuoka, Oita, and Miyazaki in southern Japan, as well as Yamaguchi prefecture. Genetic analysis revealed subtypes 3b, 4a, and 4g, with 3b being the most prevalent. Subtype 3b exhibited distinct geographical clustering, whereas 4g persisted exclusively in Yamaguchi for over 12 years. Infectious HEV particles were confirmed in wild boar feces, highlighting the risk of environmental contamination and zoonotic transmission. Sika deer showed no evidence of HEV infection, and only one Japanese serow tested positive for antibodies without detectable RNA. These findings underscore the importance of ongoing surveillance to assess the zoonotic risks from game meat consumption and prevention of HEV transmission to humans.
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Affiliation(s)
- Milagros Virhuez-Mendoza
- Department of Veterinary Science, National Institute of Infectious Diseases (NIID), Tokyo 162-8640, Japan; (M.V.-M.)
| | - Keita Ishijima
- Department of Veterinary Science, National Institute of Infectious Diseases (NIID), Tokyo 162-8640, Japan; (M.V.-M.)
| | - Kango Tatemoto
- Department of Veterinary Science, National Institute of Infectious Diseases (NIID), Tokyo 162-8640, Japan; (M.V.-M.)
| | - Yudai Kuroda
- Department of Veterinary Science, National Institute of Infectious Diseases (NIID), Tokyo 162-8640, Japan; (M.V.-M.)
| | - Yusuke Inoue
- Department of Veterinary Science, National Institute of Infectious Diseases (NIID), Tokyo 162-8640, Japan; (M.V.-M.)
| | - Ayano Nishino
- Department of Veterinary Science, National Institute of Infectious Diseases (NIID), Tokyo 162-8640, Japan; (M.V.-M.)
- Joint Graduate School of Veterinary Medicine, Yamaguchi University, Yamaguchi 753-8515, Japan
| | - Tsukasa Yamamoto
- Department of Veterinary Science, National Institute of Infectious Diseases (NIID), Tokyo 162-8640, Japan; (M.V.-M.)
- Joint Graduate School of Veterinary Medicine, Yamaguchi University, Yamaguchi 753-8515, Japan
| | - Akihiko Uda
- Department of Veterinary Science, National Institute of Infectious Diseases (NIID), Tokyo 162-8640, Japan; (M.V.-M.)
| | - Akitoyo Hotta
- Department of Veterinary Science, National Institute of Infectious Diseases (NIID), Tokyo 162-8640, Japan; (M.V.-M.)
| | - Hidenori Kabeya
- Laboratory of Veterinary Food Hygiene, Department of Veterinary Medicine, College of Bioresource Sciences, Nihon University, Fujisawa 252-0880, Japan
| | - Hiroshi Shimoda
- Joint Graduate School of Veterinary Medicine, Yamaguchi University, Yamaguchi 753-8515, Japan
| | | | - Tomoyoshi Komiya
- Faculty of Health and Medical Sciences, Hokuriku University, Kanazawa 920-1180, Japan
| | - Junji Seto
- Department of Microbiology, Yamagata Prefectural Institute of Public Health, Yamagata 990-0031, Japan
| | - Yuki Iwashina
- Japan Wildlife Research Center, Tokyo 130-8606, Japan
| | - Daisuke Hirano
- Livestock Hygiene Department, Aomori Prefecture Livestock Association, Aomori 030-0822, Japan
| | - Mikio Sawada
- Gifu Veterinary Medical Association, Gifu 500-8385, Japan
| | - Sayuri Yamaguchi
- Kagawa Prefecture Livestock Association, Takamatsu 760-0023, Japan
| | - Fusayo Hosaka
- Gunma Prefecture Livestock Association, Maebashi 379-2147, Japan
| | - Ken Maeda
- Department of Veterinary Science, National Institute of Infectious Diseases (NIID), Tokyo 162-8640, Japan; (M.V.-M.)
- Joint Graduate School of Veterinary Medicine, Yamaguchi University, Yamaguchi 753-8515, Japan
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Rastar-Tangeten M, Mader M, Schmiedel S, Weidemann S, Chalissery S, Kempski J, Staufenberger T, Mazaheri O, Brandner JM, Addo MM, Ackermann C, Wolski A, Reucher S, Wenzel J, Lütgehetmann M, Schemmerer M, Schulze Zur Wiesch J, Pischke S. Lack of evidence for HEV infection in Baltic sea mussels (Mytilidae). BMC Infect Dis 2025; 25:355. [PMID: 40082752 PMCID: PMC11908098 DOI: 10.1186/s12879-025-10727-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2024] [Accepted: 02/27/2025] [Indexed: 03/16/2025] Open
Abstract
BACKGROUND AND AIMS Hepatitis E virus (HEV), similar to hepatitis A virus (HAV), has been linked to cases associated with mussel consumption, and several studies have detected HEV in commercially available mussels. While extensive data exists on HEV contamination in mussels from tropical regions, the Mediterranean Sea, and the North Sea, there is a lack of information regarding the potential risk posed by common mussels (Mytilidae) from the Baltic Sea. Furthermore, no experimental studies have investigated the ability of Baltic Sea mussels to be infected with HEV. MATERIAL AND METHODS Healthcare workers (n = 447) from the University Medical Center Hamburg Eppendorf, Germany, were surveyed regarding their mussel consumption habits and tested for anti-HEV IgG using a commercially available assay. Commercially sourced Baltic Sea Mytilidae, obtained from local retailers, were tested for HEV using a validated PCR method. Additionally, 50 live Mytilidae were experimentally spiked with HEV, followed by dissection and separate PCR analysis of the gastrointestinal tract, gonads, and muscle tissue. RESULTS There was no significant difference in the likelihood of anti-HEV IgG positivity between individuals who frequently consumed mussels and those who did not. None of the 40 commercial mussel samples tested were positive for HEV. HEV RNA was detected in the gastrointestinal tract of experimentally exposed Mytilidae specimen but not in their gonads or muscle tissue. It was observed that HEV RNA persisted in the gastrointestinal tract for more than 14 days but not beyond 21 days. DISCUSSION This study provides no evidence of HEV contamination in commercially sourced Baltic Sea mussels, as all tested samples were negative for HEV RNA. Moreover, no significant association was observed between mussel consumption and anti-HEV IgG positivity among healthcare workers. Experimental exposure revealed that HEV RNA can persist in the gastrointestinal tract of Baltic Sea mussels for over 16 days but less than 24 days, while no viral presence was detected in the gonad or muscle tissue. These findings suggest a minimal risk of HEV transmission through mussels from the Baltic Sea but highlight the need for further studies to understand their role in HEV ecology.
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Affiliation(s)
- M Rastar-Tangeten
- Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - M Mader
- Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- German Center for Infection Research (DZIF), Hamburg-Lübeck-Borstel-Riems Partner Site, Hamburg, Germany
| | - S Schmiedel
- Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - S Weidemann
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - S Chalissery
- Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - J Kempski
- Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | | | - O Mazaheri
- Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - J M Brandner
- Geschäftsbereich Sicherheit & Compliance, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - M M Addo
- Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- German Center for Infection Research (DZIF), Hamburg-Lübeck-Borstel-Riems Partner Site, Hamburg, Germany
| | - C Ackermann
- Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - A Wolski
- Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - S Reucher
- Institute of Medical Microbiology, Virology and Hygiene, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - J Wenzel
- National Consultant Laboratory for HAV and HEV, Institute of Clinical Microbiology and Hygiene, University Medical Center Regensburg, Regensburg, Germany
| | - M Lütgehetmann
- German Center for Infection Research (DZIF), Hamburg-Lübeck-Borstel-Riems Partner Site, Hamburg, Germany
- Institute of Medical Microbiology, Virology and Hygiene, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - M Schemmerer
- National Consultant Laboratory for HAV and HEV, Institute of Clinical Microbiology and Hygiene, University Medical Center Regensburg, Regensburg, Germany
| | - J Schulze Zur Wiesch
- Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- German Center for Infection Research (DZIF), Hamburg-Lübeck-Borstel-Riems Partner Site, Hamburg, Germany
| | - S Pischke
- Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
- German Center for Infection Research (DZIF), Hamburg-Lübeck-Borstel-Riems Partner Site, Hamburg, Germany.
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Haase JA, Schlienkamp S, Ring JJ, Steinmann E. Transmission patterns of hepatitis E virus. Curr Opin Virol 2025; 70:101451. [PMID: 39892085 DOI: 10.1016/j.coviro.2025.101451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2024] [Revised: 01/10/2025] [Accepted: 01/13/2025] [Indexed: 02/03/2025]
Abstract
Hepatitis E virus (HEV) causes sporadic cases in industrialized countries and endemic outbreaks in areas with lower sanitation standards. The wide host reservoir of HEV makes it a potential source of new zoonotic transmission and dissemination in humans. Thus, the perception of HEV as a confined ailment has shifted to one of global concern. Considering HEV's environmental stability and heterogeneity in the host range of HEV's genotypes, various transmission pathways and sources for HEV infections are plausible. Here, we provide an overview on HEV's transmission routes and discuss the role of HEV as a foodborne zoonosis, as well as preventive measures and open research questions.
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Affiliation(s)
- Jil A Haase
- Department of Molecular and Medical Virology, Faculty of Medicine, Ruhr University Bochum, Bochum, Germany
| | - Sarah Schlienkamp
- Department of Molecular and Medical Virology, Faculty of Medicine, Ruhr University Bochum, Bochum, Germany
| | - Julian J Ring
- Department of Molecular and Medical Virology, Faculty of Medicine, Ruhr University Bochum, Bochum, Germany
| | - Eike Steinmann
- Department of Molecular and Medical Virology, Faculty of Medicine, Ruhr University Bochum, Bochum, Germany; German Centre for Infection Research (DZIF), External Partner Site, Bochum, Germany.
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Mor O, Na’amnih W, Shirazi R, Wax M, Gozlan Y, Kassim M, Sayid H, Omari A, Jabbor A, Muhsen K, Mari A. Hepatitis E virus (HEV) infection among the Arab population in Northern Israel: an insight into the seroepidemiology and associated risk factors. Epidemiol Infect 2025; 153:e10. [PMID: 39801356 PMCID: PMC11729521 DOI: 10.1017/s0950268824001407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Revised: 07/14/2024] [Accepted: 09/03/2024] [Indexed: 01/16/2025] Open
Abstract
Hepatitis E virus (HEV) is one of the most common causes of viral hepatitis. We examined HEV seroprevalence and associations of sociodemographic and lifestyle characteristics with HEV immunoglobulin G (IgG) seropositivity in the Arab population. A cross-sectional single-centre study was conducted among adults in the Nazareth area during 2022. Blood samples were tested using the Altona Real-Star HEV-RNA and the Wantai IgG assays. Data on sociodemographics, health status, and lifestyle were collected using structured questionnaires.Overall, 490 individuals (55.9% males) aged 18 - 96 (mean = 53.2, SD = 28.0) were enrolled. HEV IgG seropositivity was estimated at 21.4% (95% CI 17.9-25.3). No samples were HEV-RNA positive. The correlates of HEV IgG seropositivity were older age (prevalence ratio (PR) 1.07, 95% CI 1.04-1.09, P < 0.001) and consuming beef frequently (PR 2.81, 95% CI 1.40-5.63, P = 0.003). No associations were found between Arab religious groups (Muslim, Christian or Druze, representing different socioeconomic status and dietary habits) or pork consumption and HEV IgG seropositivity. In conclusion, HEV seropositivity was high in the Arab population, and assessing HEV in Ruminants, particularly cows, is warranted.
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Affiliation(s)
- Orna Mor
- Department of Epidemiology and Preventive Medicine, School of Public Health, Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
- Central Virology Laboratory, Ministry of Health, Public Health Services, The Chaim Sheba Medical Center, Tel HaShomer, Ramat-Gan, Israel
| | - Wasef Na’amnih
- Department of Epidemiology and Preventive Medicine, School of Public Health, Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Rachel Shirazi
- Central Virology Laboratory, Ministry of Health, Public Health Services, The Chaim Sheba Medical Center, Tel HaShomer, Ramat-Gan, Israel
| | - Marina Wax
- Central Virology Laboratory, Ministry of Health, Public Health Services, The Chaim Sheba Medical Center, Tel HaShomer, Ramat-Gan, Israel
| | - Yael Gozlan
- Central Virology Laboratory, Ministry of Health, Public Health Services, The Chaim Sheba Medical Center, Tel HaShomer, Ramat-Gan, Israel
| | - Marah Kassim
- Department of Epidemiology and Preventive Medicine, School of Public Health, Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Helal Sayid
- Gastroenterology Department, Nazareth Hospital EMMS, Azrieli Faculty of Medicine, Bar Ilan University, Ramat-Gan, Israel
| | - Ali Omari
- Gastroenterology Department, Nazareth Hospital EMMS, Azrieli Faculty of Medicine, Bar Ilan University, Ramat-Gan, Israel
| | - Adel Jabbor
- Medical Laboratory, Nazareth Hospital EMMS, Nazareth, Israel
| | - Khitam Muhsen
- Department of Epidemiology and Preventive Medicine, School of Public Health, Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Amir Mari
- Gastroenterology Department, Nazareth Hospital EMMS, Azrieli Faculty of Medicine, Bar Ilan University, Ramat-Gan, Israel
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Figueiredo AS, Negreiros IR, do Nascimento E Silva A, Salgado CRS, Dos Santos NL, Pinto MA, de Carvalho Neta AV, Leite JPG, Cantelli CP. Detection of Rocahepevirus ratti in Bivalve Mollusks from São Luís Island, Maranhão, Brazil: A Potential Transmission Route of an Emerging Zoonotic Pathogen? FOOD AND ENVIRONMENTAL VIROLOGY 2025; 17:11. [PMID: 39754637 DOI: 10.1007/s12560-024-09624-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2024] [Accepted: 12/03/2024] [Indexed: 01/06/2025]
Abstract
The attempt to investigate hepatitis E virus (HEV) contamination in naturally growing mangrove bivalve mollusks captured for local sale in a touristic area of Maranhão state in Brazil revealed the detection of rat hepatitis E virus (ratHEV). Using international standard protocols for processing and nucleic acid extraction, we analyzed 89 bivalve samples (Mytella falcata and Crassostrea rhizophorae) with two broadly reactive assays: heminested pan-Hepeviridae (ORF-1) and probe-based HEV-1 to HEV-4 (ORF-2/ORF-3). Heminested reactions presented 2 (2.2%) amplifications of the expected size. Nucleotide identities ranged from 86.6 to 89.0% with ratHEV isolates from wild rats, pigs, one human case and sewage reported in different countries. Regarding the phylogenetic tree, the sequences grouped with genotype HEV-C1. This first report of ratHEV detection in bivalve mollusks may be a starting point for further research on virus variability, distribution, host range and especially the possible role of contaminated shellfish as a vehicle for ratHEV transmission.
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Affiliation(s)
- Andreza Soriano Figueiredo
- Laboratory of Technological Development in Virology, Oswaldo Cruz Institute, Fiocruz, Av. Brasil 4365, Manguinhos, Rio de Janeiro, RJ, 21040-900, Brazil.
| | | | - Aldaleia do Nascimento E Silva
- Laboratory of Technological Development in Virology, Oswaldo Cruz Institute, Fiocruz, Av. Brasil 4365, Manguinhos, Rio de Janeiro, RJ, 21040-900, Brazil
| | - Caroline Roberta Soares Salgado
- Laboratory of Technological Development in Virology, Oswaldo Cruz Institute, Fiocruz, Av. Brasil 4365, Manguinhos, Rio de Janeiro, RJ, 21040-900, Brazil
| | - Natália Lourenço Dos Santos
- Laboratory of Comparative and Environmental Virology, Oswaldo Cruz Institute, Fiocruz, Rio de Janeiro, Brazil
| | - Marcelo Alves Pinto
- Laboratory of Technological Development in Virology, Oswaldo Cruz Institute, Fiocruz, Av. Brasil 4365, Manguinhos, Rio de Janeiro, RJ, 21040-900, Brazil
| | | | - José Paulo Gagliardi Leite
- Laboratory of Comparative and Environmental Virology, Oswaldo Cruz Institute, Fiocruz, Rio de Janeiro, Brazil
| | - Carina Pacheco Cantelli
- Laboratory of Comparative and Environmental Virology, Oswaldo Cruz Institute, Fiocruz, Rio de Janeiro, Brazil
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Zhou L, Chen Y, Wang F, Chen Z, Lu Y, Miao Z. Epidemiological Characteristics and Spatiotemporal Clustering of Symptomatic Hepatitis E Virus Reinfection in Zhejiang Province, 2005-2023. Viruses 2024; 16:1676. [PMID: 39599790 PMCID: PMC11599083 DOI: 10.3390/v16111676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2024] [Revised: 10/23/2024] [Accepted: 10/25/2024] [Indexed: 11/29/2024] Open
Abstract
Hepatitis E virus (HEV) reinfection is prevalent among the population, posing a significant burden on prevention and control efforts. In this study, we conducted a comprehensive analysis of data from China's Disease Prevention and Control Information System's infectious disease surveillance system to identify the epidemiological characteristics, spatiotemporal clustering, and high-risk populations of HEV reinfection. From 2005 to 2023, HEV reinfection in Zhejiang Province exhibited a fluctuating trend, peaking in 2020, with a 3-5-year lag compared to the pattern of HEV incidence. The Cox model indicated that individuals aged 40-50 and females are at higher risk of reinfection. Spatial autocorrelation was observed in reinfection cases from 2011 to 2016, with high-high clustering areas concentrated in downtown Hangzhou. Additionally, spatiotemporal scanning revealed that the clustering of reinfection cases has shifted from Hangzhou to coastal areas in recent years. Our findings suggest that targeted prevention and control measures for HEV rein fection should be implemented based on the characteristics of high-risk populations and spatiotemporal clustering patterns.
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Affiliation(s)
- Lu Zhou
- Department of Epidemiology, Ministry of Education Key Laboratory of Public Health Safety, School of Public Health, Fudan University, Shanghai 200032, China; (L.Z.); (F.W.); (Z.C.)
| | - Yijuan Chen
- Department of Communicable Diseases Control and Prevention, Zhejiang Key Lab of Vaccine, Infectious Disease Prevention and Control, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China;
| | - Fengge Wang
- Department of Epidemiology, Ministry of Education Key Laboratory of Public Health Safety, School of Public Health, Fudan University, Shanghai 200032, China; (L.Z.); (F.W.); (Z.C.)
- Shanghai Institute of Infectious Disease and Biosecurity, Fudan University, Shanghai 200032, China
| | - Zixiang Chen
- Department of Epidemiology, Ministry of Education Key Laboratory of Public Health Safety, School of Public Health, Fudan University, Shanghai 200032, China; (L.Z.); (F.W.); (Z.C.)
- Shanghai Institute of Infectious Disease and Biosecurity, Fudan University, Shanghai 200032, China
| | - Yihan Lu
- Department of Epidemiology, Ministry of Education Key Laboratory of Public Health Safety, School of Public Health, Fudan University, Shanghai 200032, China; (L.Z.); (F.W.); (Z.C.)
- Shanghai Institute of Infectious Disease and Biosecurity, Fudan University, Shanghai 200032, China
| | - Ziping Miao
- Department of Communicable Diseases Control and Prevention, Zhejiang Key Lab of Vaccine, Infectious Disease Prevention and Control, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China;
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Kanda T, Li TC, Takahashi M, Nagashima S, Primadharsini PP, Kunita S, Sasaki-Tanaka R, Inoue J, Tsuchiya A, Nakamoto S, Abe R, Fujiwara K, Yokosuka O, Suzuki R, Ishii K, Yotsuyanagi H, Okamoto H. Recent advances in hepatitis E virus research and the Japanese clinical practice guidelines for hepatitis E virus infection. Hepatol Res 2024; 54:1-30. [PMID: 38874115 DOI: 10.1111/hepr.14062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Revised: 04/22/2024] [Accepted: 05/09/2024] [Indexed: 06/15/2024]
Abstract
Acute hepatitis E was considered rare until reports emerged affirming the existence of hepatitis E virus (HEV) genotypes 3 and 4 infections in Japan in the early 2000s. Extensive studies by Japanese researchers have highlighted the pivotal role of pigs and wild animals, such as wild boars and deer, as reservoirs for HEV, linking them to zoonotic infections in Japan. Currently, when hepatitis occurs subsequent to the consumption of undercooked or grilled pork, wild boar meat, or offal (including pig liver and intestines), HEV infection should be considered. Following the approval of anti-HEV immunoglobulin A antibody as a diagnostic tool for hepatitis E by Japan's Health Insurance System in 2011, the annual number of diagnosed cases of HEV infection has surged. Notably, the occurrence of post-transfusion hepatitis E promoted nationwide screening of blood products for HEV using nucleic acid amplification tests since 2020. Furthermore, chronic hepatitis E has been observed in immunosuppressed individuals. Considering the significance of hepatitis E, heightened preventive measures are essential. The Japan Agency for Medical Research and Development Hepatitis A and E viruses (HAV and HEV) Study Group, which includes special virologists and hepatologists, held a virtual meeting on February 17, 2024. Discussions encompassed pathogenesis, transmission routes, diagnosis, complications, severity factors, and ongoing and prospective vaccination or treatments for hepatitis E. Rigorous assessment of referenced studies culminated in the formulation of recommendations, which are detailed within this review. This comprehensive review presents recent advancements in HEV research and Japanese clinical practice guidelines for HEV infection.
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Affiliation(s)
- Tatsuo Kanda
- Division of Gastroenterology and Hepatology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan
- Division of Gastroenterology and Hepatology, Uonuma Institute of Community Medicine, Niigata University Medical and Dental Hospital, Minamiuonuma, Japan
- Division of Gastroenterology and Hepatology, Graduate School of Medicine and Dental Sciences, Niigata University, Niigata, Japan
| | - Tian-Cheng Li
- Department of Virology II, National Institute of Infectious Diseases, Tokyo, Japan
| | - Masaharu Takahashi
- Division of Virology, Department of Infection and Immunity, Jichi Medical University School of Medicine, Shimotsuke, Tochigi, Japan
| | - Shigeo Nagashima
- Division of Virology, Department of Infection and Immunity, Jichi Medical University School of Medicine, Shimotsuke, Tochigi, Japan
| | - Putu Prathiwi Primadharsini
- Division of Virology, Department of Infection and Immunity, Jichi Medical University School of Medicine, Shimotsuke, Tochigi, Japan
| | - Satoshi Kunita
- Center for Experimental Medicine, Jichi Medical University School of Medicine, Shimotsuke, Tochigi, Japan
| | - Reina Sasaki-Tanaka
- Division of Gastroenterology and Hepatology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan
- Division of Gastroenterology and Hepatology, Graduate School of Medicine and Dental Sciences, Niigata University, Niigata, Japan
| | - Jun Inoue
- Division of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Atsunori Tsuchiya
- Division of Gastroenterology and Hepatology, Graduate School of Medicine and Dental Sciences, Niigata University, Niigata, Japan
| | - Shingo Nakamoto
- Department of Gastroenterology, Graduate School of Medicine, Chiba University, Chuo-ku, Chiba, Japan
| | - Ryuzo Abe
- Department of Emergency Medicine, Oita University, Oita, Japan
| | - Keiichi Fujiwara
- Department of Gastroenterology, Graduate School of Medicine, Chiba University, Chuo-ku, Chiba, Japan
| | - Osamu Yokosuka
- Department of Gastroenterology, Graduate School of Medicine, Chiba University, Chuo-ku, Chiba, Japan
| | - Ryosuke Suzuki
- Department of Virology II, National Institute of Infectious Diseases, Tokyo, Japan
| | - Koji Ishii
- Department of Quality Assurance and Radiological Protection, National Institute of Infectious Diseases, Tokyo, Japan
| | - Hiroshi Yotsuyanagi
- Division of Infectious Diseases, Advanced Clinical Research Center, Institute of Medical Science, University of Tokyo, Tokyo, Japan
- Department of Infectious Diseases and Applied Immunology, Hospital of the Institute of Medical Science, University of Tokyo, Tokyo, Japan
| | - Hiroaki Okamoto
- Division of Virology, Department of Infection and Immunity, Jichi Medical University School of Medicine, Shimotsuke, Tochigi, Japan
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Tene SD, Diouara AAM, Kane A, Sané S, Coundoul S, Thiam F, Nguer CM, Diop M, Mbaye MN, Mbengue M, Lo S, Diop Ndiaye H, Toure Kane C, Ayouba A. Detection of Hepatitis E Virus (HEV) in Pork Sold in Saint-Louis, the North of Senegal. Life (Basel) 2024; 14:512. [PMID: 38672782 PMCID: PMC11050832 DOI: 10.3390/life14040512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2024] [Revised: 03/27/2024] [Accepted: 03/27/2024] [Indexed: 04/28/2024] Open
Abstract
The hepatitis E virus (HEV) is a zoonotic pathogen with various hosts, including pigs, which act as reservoirs. In industrialized countries, sporadic cases caused by genotype 3, contracted by ingesting contaminated uncooked or undercooked meat, have been reported. However, in developing countries, HEV infection is mainly dominated by genotype 2 and often associated with poor hygiene conditions and drinking water supplies. HEV infection and its circulation in domestic fauna in West Africa are poorly documented. This study aimed to assess the presence of HEV in pork sold in Saint-Louis, Senegal. Meat products (250 g samples, n = 74) were purchased in August 2022 from three locations. Then, 2 g/sample was minced to extract total nucleic acids using the Purelink™ Viral DNA/RNA kit. RT-PCR reactions were performed using the One-Taq™ One-Step RT-PCR kit targeting the HEV ORF2 genomic region. The products obtained were visualized on a 1% agarose gel. Of a total of 74 samples, divided into pork meat (n = 65) and pork liver (n = 9), 5.4% (n = 4) tested positive for HEV. In both cases, two samples were positive, representing a rate of 3.1% and 22.2% for meat and pork liver, respectively. All new viral sequences were obtained from a monophyletic group within HEV genotype 3. This study is the first to report the presence of HEV in pork sold in Senegal and the results reveal a potential circulation of HEV in the pig population. The high proportion of contamination in the pork liver samples highlights a major risk associated with their consumption.
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Affiliation(s)
- Sophie Deli Tene
- Groupe de Recherche Biotechnologies Appliquées & Bioprocédés Environnementaux (GRBA-BE), École Supérieure Polytechnique (ESP), Université Cheikh Anta Diop, Dakar 5085, Senegal; (S.D.T.); (S.S.); (S.C.); (F.T.); (C.M.N.); (M.D.); (M.N.M.)
| | - Abou Abdallah Malick Diouara
- Groupe de Recherche Biotechnologies Appliquées & Bioprocédés Environnementaux (GRBA-BE), École Supérieure Polytechnique (ESP), Université Cheikh Anta Diop, Dakar 5085, Senegal; (S.D.T.); (S.S.); (S.C.); (F.T.); (C.M.N.); (M.D.); (M.N.M.)
| | - Alé Kane
- Laboratoire des Sciences Biologiques, Agronomiques, Alimentaires et de Modélisation des Systèmes Complexes (LABAAM), UFR S2ATA, Université Gaston Berger, Saint-Louis 234, Senegal;
| | - Sarbanding Sané
- Groupe de Recherche Biotechnologies Appliquées & Bioprocédés Environnementaux (GRBA-BE), École Supérieure Polytechnique (ESP), Université Cheikh Anta Diop, Dakar 5085, Senegal; (S.D.T.); (S.S.); (S.C.); (F.T.); (C.M.N.); (M.D.); (M.N.M.)
| | - Seynabou Coundoul
- Groupe de Recherche Biotechnologies Appliquées & Bioprocédés Environnementaux (GRBA-BE), École Supérieure Polytechnique (ESP), Université Cheikh Anta Diop, Dakar 5085, Senegal; (S.D.T.); (S.S.); (S.C.); (F.T.); (C.M.N.); (M.D.); (M.N.M.)
| | - Fatou Thiam
- Groupe de Recherche Biotechnologies Appliquées & Bioprocédés Environnementaux (GRBA-BE), École Supérieure Polytechnique (ESP), Université Cheikh Anta Diop, Dakar 5085, Senegal; (S.D.T.); (S.S.); (S.C.); (F.T.); (C.M.N.); (M.D.); (M.N.M.)
| | - Cheikh Momar Nguer
- Groupe de Recherche Biotechnologies Appliquées & Bioprocédés Environnementaux (GRBA-BE), École Supérieure Polytechnique (ESP), Université Cheikh Anta Diop, Dakar 5085, Senegal; (S.D.T.); (S.S.); (S.C.); (F.T.); (C.M.N.); (M.D.); (M.N.M.)
| | - Mamadou Diop
- Groupe de Recherche Biotechnologies Appliquées & Bioprocédés Environnementaux (GRBA-BE), École Supérieure Polytechnique (ESP), Université Cheikh Anta Diop, Dakar 5085, Senegal; (S.D.T.); (S.S.); (S.C.); (F.T.); (C.M.N.); (M.D.); (M.N.M.)
| | - Mame Ndew Mbaye
- Groupe de Recherche Biotechnologies Appliquées & Bioprocédés Environnementaux (GRBA-BE), École Supérieure Polytechnique (ESP), Université Cheikh Anta Diop, Dakar 5085, Senegal; (S.D.T.); (S.S.); (S.C.); (F.T.); (C.M.N.); (M.D.); (M.N.M.)
| | - Malick Mbengue
- Laboratoire de Microbiologie Appliquée et de Génie Industriel, École Supérieure Polytechnique (ESP), Université Cheikh Anta Diop, Dakar 5085, Senegal;
| | - Seynabou Lo
- Unité de Formation et de Recherche Science de la Santé (UFR 2S), Université Gaston Berger, Saint-Louis 234, Senegal;
| | - Halimatou Diop Ndiaye
- Laboratoire de Bactériologie Virologie CHU Aristide le Dantec, Université Cheikh Anta DIOP, Dakar 5005, Senegal;
| | - Coumba Toure Kane
- Institut de Recherche en Santé, de Surveillance Épidémiologique et de Formation (IRESSEF), Pole Urbain Diamniadio, Dakar 7325, Senegal;
- Université Sine Saloum El Hadj Ibrahima Niass (USSEIN), Kaolack 55, Senegal
| | - Ahidjo Ayouba
- Recherches Translationnelles sur le VIH et Maladies Infectieuses, Institut de Recherche pour le Développement, Université de Montpellier/INSERM U1175, 34000 Montpellier, France;
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10
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Sacristán C, Ewbank AC, Duarte-Benvenuto A, Sacristán I, Zamana-Ramblas R, Costa-Silva S, Lanes Ribeiro V, Bertozzi CP, Del Rio do Valle R, Castilho PV, Colosio AC, Marcondes MCC, Lailson-Brito J, de Freitas Azevedo A, Carvalho VL, Pessi CF, Cremer M, Esperón F, Catão-Dias JL. Survey of selected viral agents (herpesvirus, adenovirus and hepatitis E virus) in liver and lung samples of cetaceans, Brazil. Sci Rep 2024; 14:2689. [PMID: 38302481 PMCID: PMC10834590 DOI: 10.1038/s41598-023-45315-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 10/18/2023] [Indexed: 02/03/2024] Open
Abstract
Hepatic and pulmonary lesions are common in cetaceans, despite their poorly understood viral etiology. Herpesviruses (HV), adenoviruses (AdV) and hepatitis E virus (HEV) are emerging agents in cetaceans, associated with liver and/or pulmonary damage in mammals. We isolated and molecularly tested DNA for HV and AdV (n = 218 individuals; 187 liver and 108 lung samples) and RNA for HEV (n = 147 animals; 147 liver samples) from six cetacean families. All animals stranded or were bycaught in Brazil between 2001 and 2021. Positive-animals were analyzed by histopathology. Statistical analyses assessed if the prevalence of viral infection could be associated with the variables: species, family, habitat, region, sex, and age group. All samples were negative for AdV and HEV. Overall, 8.7% (19/218) of the cetaceans were HV-positive (4.8% [9/187] liver and 11.1% [12/108] lung), without HV-associated lesions. HV-prevalence was statistically significant higher in Pontoporiidae (19.2%, 10/52) when compared to Delphinidae (4.1%, 5/121), and in southeastern (17.1%, 13/76)-the most industrialized Brazilian region-when compared to the northeastern region (2.4%, 3/126). This study broadens the herpesvirus host range in cetaceans, including its description in pygmy sperm whales (Kogia breviceps) and humpback whales (Megaptera novaeangliae). Further studies must elucidate herpesvirus drivers in cetaceans.
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Affiliation(s)
- C Sacristán
- Centro de Investigación en Sanidad Animal (CISA-INIA), CSIC, Carretera Algete-El Casar de Talamanca, Km. 8,1, 28130, Valdeolmos, Madrid, Spain.
- School of Veterinary Medicine and Animal Sciences, University of São Paulo, São Paulo, SP, Brazil.
| | - A C Ewbank
- School of Veterinary Medicine and Animal Sciences, University of São Paulo, São Paulo, SP, Brazil
| | - A Duarte-Benvenuto
- School of Veterinary Medicine and Animal Sciences, University of São Paulo, São Paulo, SP, Brazil
| | - I Sacristán
- Centro de Investigación en Sanidad Animal (CISA-INIA), CSIC, Carretera Algete-El Casar de Talamanca, Km. 8,1, 28130, Valdeolmos, Madrid, Spain
| | - R Zamana-Ramblas
- School of Veterinary Medicine and Animal Sciences, University of São Paulo, São Paulo, SP, Brazil
| | - S Costa-Silva
- School of Veterinary Medicine and Animal Sciences, University of São Paulo, São Paulo, SP, Brazil
| | | | - C P Bertozzi
- São Paulo State University - UNESP, São Vicente, SP, Brazil
| | - R Del Rio do Valle
- Instituto Ecoema de Estudo e Conservação do Meio Ambiente, Peruíbe, SP, Brasil
| | - P V Castilho
- Universidade do Estado de Santa Catarina-UDESC, Laguna, SC, Brazil
| | - A C Colosio
- Instituto Baleia Jubarte, Caravelas, BA, Brazil
| | | | - J Lailson-Brito
- Laboratório de Mamíferos Aquáticos e Bioindicadores 'Profa Izabel M. G. do N. Gurgel' (MAQUA), Faculdade de Oceanografia, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - A de Freitas Azevedo
- Laboratório de Mamíferos Aquáticos e Bioindicadores 'Profa Izabel M. G. do N. Gurgel' (MAQUA), Faculdade de Oceanografia, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - V L Carvalho
- Associação de Pesquisa e Preservação de Ecossistemas Aquáticos, Caucaia, CE, Brazil
| | - C F Pessi
- Instituto de Pesquisas Cananéia (IpeC), Cananéia, SP, Brazil
| | - M Cremer
- Laboratório de Ecologia e Conservação de Tetrápodes Marinhos e Costeiros - TETRAMAR, Universidade da Região de Joinville - UNIVILLE, São Francisco Do Sul, SC, Brazil
| | - F Esperón
- Universidad Europea, Villaviciosa de Odon, Spain
| | - J L Catão-Dias
- School of Veterinary Medicine and Animal Sciences, University of São Paulo, São Paulo, SP, Brazil
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11
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Capai L, Masse S, Hozé N, Decarreaux D, Canarelli J, Simeoni MH, de Lamballerie X, Falchi A, Charrel R. Seroprevalence of anti-HEV IgG in children: very early exposure in young children in a hyperendemic region. Front Public Health 2023; 11:1293575. [PMID: 38026418 PMCID: PMC10680972 DOI: 10.3389/fpubh.2023.1293575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 10/18/2023] [Indexed: 12/01/2023] Open
Abstract
Background and objectives Hepatitis E virus (HEV) can be considered an emerging zoonotic pathogen and is an important cause of acute viral hepatitis in high-income countries. Corsica has been identified as a hyperendemic region for HEV. We aimed to characterize the prevalence of IgG among children and estimate the annual force of infection of HEV. Methods From April 2020 to June 2021, we collected 856 "residual sera" in 13 medical biology laboratories. Sera were tested using the Wantaï HEV IgG assay. Data were weighted according to the distribution by sex and age of the real Corsican population. Serocatalytic models were applied to assess the annual force of infection of HEV. Results The weighted seroprevalence was 30.33% [27.15-34.0]. The seroprevalence was only associated with increasing age (7.25-40.52%; p < 0.001). The annual probability of infection was 5.4% for adults and children above 10-year-old and 2.2% for children under 10 yo. Conclusion Our study demonstrates that in the hyperendemic island of Corsica, (i) exposure of the population to HEV is homogeneous at the spatial level with no difference between genders; (ii) HEV exposure occurs from birth, resulting in 7.4% seropositivity at the age of 4 years; and (iii) super exposure is observed after the age of 9 years. Accordingly, specific studies should be conducted to determine the breadth of the situation identified in our study. The role of the environment and its contamination by domestic or wild swine excreta should be investigated using a One Health approach.
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Affiliation(s)
- Lisandru Capai
- UR 7310, Université de Corse, Corte, France
- AG Junglen, Institute of Virology, University of Charité, Berlin, Germany
| | | | - Nathanaël Hozé
- Mathematical Modelling of Infectious Diseases Unit, Institut Pasteur, Paris, France
| | - Dorine Decarreaux
- UR 7310, Université de Corse, Corte, France
- Unité des Virus Émergents, Aix-Marseille University, Marseille, France
| | | | | | | | | | - Rémi Charrel
- Unité des Virus Émergents, Aix-Marseille University, Marseille, France
- Comité de Lutte contre les infections Nosocomiales, APHM HOPITAUX Universitaires de Marseille, Marseille, France
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12
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Zahmanova G, Takova K, Tonova V, Koynarski T, Lukov LL, Minkov I, Pishmisheva M, Kotsev S, Tsachev I, Baymakova M, Andonov AP. The Re-Emergence of Hepatitis E Virus in Europe and Vaccine Development. Viruses 2023; 15:1558. [PMID: 37515244 PMCID: PMC10383931 DOI: 10.3390/v15071558] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 07/11/2023] [Accepted: 07/13/2023] [Indexed: 07/30/2023] Open
Abstract
Hepatitis E virus (HEV) is one of the leading causes of acute viral hepatitis. Transmission of HEV mainly occurs via the fecal-oral route (ingesting contaminated water or food) or by contact with infected animals and their raw meat products. Some animals, such as pigs, wild boars, sheep, goats, rabbits, camels, rats, etc., are natural reservoirs of HEV, which places people in close contact with them at increased risk of HEV disease. Although hepatitis E is a self-limiting infection, it could also lead to severe illness, particularly among pregnant women, or chronic infection in immunocompromised people. A growing number of studies point out that HEV can be classified as a re-emerging virus in developed countries. Preventative efforts are needed to reduce the incidence of acute and chronic hepatitis E in non-endemic and endemic countries. There is a recombinant HEV vaccine, but it is approved for use and commercially available only in China and Pakistan. However, further studies are needed to demonstrate the necessity of applying a preventive vaccine and to create conditions for reducing the spread of HEV. This review emphasizes the hepatitis E virus and its importance for public health in Europe, the methods of virus transmission and treatment, and summarizes the latest studies on HEV vaccine development.
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Affiliation(s)
- Gergana Zahmanova
- Department of Plant Physiology and Molecular Biology, University of Plovdiv, 4000 Plovdiv, Bulgaria
- Department of Technology Transfer and IP Management, Center of Plant Systems Biology and Biotechnology, 4000 Plovdiv, Bulgaria
| | - Katerina Takova
- Department of Plant Physiology and Molecular Biology, University of Plovdiv, 4000 Plovdiv, Bulgaria
| | - Valeria Tonova
- Department of Plant Physiology and Molecular Biology, University of Plovdiv, 4000 Plovdiv, Bulgaria
| | - Tsvetoslav Koynarski
- Department of Animal Genetics, Faculty of Veterinary Medicine, Trakia University, 6000 Stara Zagora, Bulgaria
| | - Laura L Lukov
- Faculty of Sciences, Brigham Young University-Hawaii, Laie, HI 96762, USA
| | - Ivan Minkov
- Department of Technology Transfer and IP Management, Center of Plant Systems Biology and Biotechnology, 4000 Plovdiv, Bulgaria
- Institute of Molecular Biology and Biotechnologies, 4108 Markovo, Bulgaria
| | - Maria Pishmisheva
- Department of Infectious Diseases, Pazardzhik Multiprofile Hospital for Active Treatment, 4400 Pazardzhik, Bulgaria
| | - Stanislav Kotsev
- Department of Infectious Diseases, Pazardzhik Multiprofile Hospital for Active Treatment, 4400 Pazardzhik, Bulgaria
| | - Ilia Tsachev
- Department of Microbiology, Infectious and Parasitic Diseases, Faculty of Veterinary Medicine, Trakia University, 6000 Stara Zagora, Bulgaria
| | - Magdalena Baymakova
- Department of Infectious Diseases, Military Medical Academy, 1606 Sofia, Bulgaria
| | - Anton P Andonov
- Department of Medical Microbiology and Infectious Diseases, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB R3T 2N2, Canada
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13
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Lhomme S, Magne S, Perelle S, Vaissière E, Abravanel F, Trelon L, Hennechart-Collette C, Fraisse A, Martin-Latil S, Izopet J, Figoni J, Spaccaferri G. Clustered Cases of Waterborne Hepatitis E Virus Infection, France. Viruses 2023; 15:v15051149. [PMID: 37243235 DOI: 10.3390/v15051149] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 05/06/2023] [Accepted: 05/06/2023] [Indexed: 05/28/2023] Open
Abstract
The identification of seven cases of hepatitis E virus infection in a French rural hamlet in April 2015 led to investigations confirming the clustering and identifying the source of the infection. Laboratories and general practitioners in the area actively searched for other cases based on RT-PCR and serological tests. The environment, including water sources, was also checked for HEV RNA. Phylogenetic analyses were performed to compare HEV sequences. No other cases were found. Six of the seven patients lived in the same hamlet, and the seventh used to visit his family who lived there. All HEV strains were very similar and belonged to the HEV3f subgenotype, confirming the clustering of these cases. All the patients drank water from the public network. A break in the water supply to the hamlet was identified at the time the infection probably occurred; HEV RNA was also detected in a private water source that was connected to the public water network. The water flowing from the taps was quite turbid during the break. The private water supply containing HEV RNA was the likely source of the contamination. Private water supplies not disconnected from the public network are still frequent in rural areas, where they may contribute to public water pollution.
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Affiliation(s)
- Sébastien Lhomme
- Centre National de Référence (CNR) des Virus des Hépatites à Transmission Entériques (Hépatite A et E), Laboratoire de Virologie, CHU Toulouse, 31300 Toulouse, France
- Infinity, Université Toulouse, CNRS, Inserm, UPS, 31024 Toulouse, France
| | - Sébastien Magne
- Regional Health Agency of Auvergne-Rhône-Alpes, 15000 Aurillac, France
| | - Sylvie Perelle
- Laboratory for Food Safety, Université Paris-Est, Anses, 94700 Maisons-Alfort, France
| | - Emmanuelle Vaissière
- Santé Publique France (French National Public Health Agency), 63000 Clermont-Ferrand, France
| | - Florence Abravanel
- Centre National de Référence (CNR) des Virus des Hépatites à Transmission Entériques (Hépatite A et E), Laboratoire de Virologie, CHU Toulouse, 31300 Toulouse, France
- Infinity, Université Toulouse, CNRS, Inserm, UPS, 31024 Toulouse, France
| | - Laetitia Trelon
- Regional Health Agency of Auvergne-Rhône-Alpes, 15000 Aurillac, France
| | | | - Audrey Fraisse
- Laboratory for Food Safety, Université Paris-Est, Anses, 94700 Maisons-Alfort, France
| | - Sandra Martin-Latil
- Laboratory for Food Safety, Université Paris-Est, Anses, 94700 Maisons-Alfort, France
| | - Jacques Izopet
- Centre National de Référence (CNR) des Virus des Hépatites à Transmission Entériques (Hépatite A et E), Laboratoire de Virologie, CHU Toulouse, 31300 Toulouse, France
- Infinity, Université Toulouse, CNRS, Inserm, UPS, 31024 Toulouse, France
| | - Julie Figoni
- Santé Publique France (French National Public Health Agency), 94410 Saint-Maurice, France
| | - Guillaume Spaccaferri
- Santé Publique France (French National Public Health Agency), 63000 Clermont-Ferrand, France
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Geng Y, Shi T, Wang Y. Transmission of Hepatitis E Virus. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2023; 1417:73-92. [PMID: 37223860 DOI: 10.1007/978-981-99-1304-6_6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Transmission of hepatitis E virus (HEV) occurs predominantly by the fecal-oral route. Large epidemics of hepatitis E in the developing countries of Asia and Africa are waterborne and spread through contaminated drinking water. The reservoir of HEV in developed countries is believed to be in animals with zoonotic transmission to humans, possibly through direct contact or the consumption of undercooked contaminated meat. And HEV transmission through blood transfusion, organ transplantation, and vertical transmission has been reported.
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Affiliation(s)
- Yansheng Geng
- Key Laboratory of Public Health Safety of Hebei Province, School of Public Health, Hebei University, Baoding, China
| | - Tengfei Shi
- Key Laboratory of Public Health Safety of Hebei Province, School of Public Health, Hebei University, Baoding, China
| | - Youchun Wang
- Institute of Medical Biology, Chinese Academy of Medical Science & Peking Union Medical College, Kunming, China.
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15
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Hepatitis E Virus Seroprevalence and Associated Risk Factors in Pregnant Women Attending Antenatal Consultations in Senegal. Viruses 2022; 14:v14081742. [PMID: 36016364 PMCID: PMC9416362 DOI: 10.3390/v14081742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 08/01/2022] [Accepted: 08/05/2022] [Indexed: 11/17/2022] Open
Abstract
In West Africa, research on the hepatitis E virus (HEV) is barely covered, despite the recorded outbreaks. The low level of access to safe water and adequate sanitation is still one of the main factors of HEV spread in developing countries. HEV infection induces acute or sub-clinical liver diseases with a mortality rate ranging from 0.5 to 4%. The mortality rate is more alarming (15 to 25%) among pregnant women, especially in the last trimester of pregnancy. Herein, we conducted a multicentric socio-demographic and seroepidemiological survey of HEV in Senegal among pregnant women. A consecutive and non-redundant recruitment of participants was carried out over the period of 5 months, from March to July 2021. A total of 1227 consenting participants attending antenatal clinics responded to a standard questionnaire. Plasma samples were collected and tested for anti-HEV IgM and IgG by using the WANTAI HEV-IgM and IgG ELISA assay. The overall HEV seroprevalence was 7.8% (n = 96), with 0.5% (n = 6) and 7.4% (n = 91) for HEV IgM and HEV IgG, respectively. One of the participant samples was IgM/IgG-positive, while four were declared indeterminate to anti-HEV IgM as per the manufacturer’s instructions. From one locality to another, the seroprevalence of HEV antibodies varied from 0 to 1% for HEV IgM and from 1.5 to 10.5% for HEV IgG. The data also showed that seroprevalence varied significantly by marital status (p < 0.0001), by the regularity of income (p = 0.0043), and by access to sanitation services (p = 0.0006). These data could serve as a basis to setup national prevention strategies focused on socio-cultural, environmental, and behavioral aspects for a better management of HEV infection in Senegal.
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Ahmad T, Jin H, Dhama K, Yatoo MI, Tiwari R, Bilal M, Dhawan M, Emran TB, Alestad JH, Alhani HM, BinKhalaf HK, Rabaan AA. Hepatitis E virus in pigs and the environment: An updated review of public health concerns. NARRA J 2022; 2:e78. [PMID: 38449702 PMCID: PMC10914032 DOI: 10.52225/narra.v2i2.78] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 07/22/2022] [Indexed: 09/01/2023]
Abstract
Hepatitis E virus (HEV) is an important public health problem and is responsible for both acute and chronic viral hepatitis. Public health implications of HEV are derived from its transmission route, either water-borne or food-borne, and its zoonotic potential. Not only in developing countries, but HEV cases are also found in a high number in developed countries. The spread of HEV to the environment might pollute surface waters, which could act as the source of infection for both humans and animals. Identification of the virus in animal products suggests the circulation of HEV within water and food chains. High seroprevalence and circulation of HEV in livestock, in particular pigs, as well as in environmental samples warrants further investigation into pig markets. HEV virulence in different environments and meat supply chains could shed light on the possible sources of infection in humans and the degree of occupational risk. The purpose of this review is to discuss HEV infections with an emphasis on livestock- and environment-related risk factors, and food-borne, water-borne, and zoonotic transmissions.
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Affiliation(s)
- Tauseef Ahmad
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing,Chinas
| | - Hui Jin
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing,Chinas
| | - Kuldeep Dhama
- Division of Pathology, ICAR-Indian Veterinary Research Institute, Izatnagar, Bareilly, Uttar Pradesh, India
| | - Mohd. Iqbal Yatoo
- Sher-E-Kashmir University of Agricultural Sciences and Technology of Kashmir, Shalimar, Srinagar, Jammu and Kashmir, Indias
| | - Ruchi Tiwari
- Department of Veterinary Microbiology and Immunology, College of Veterinary Sciences, Uttar Pradesh Pandit Deen Dayal Upadhyaya Pashu Chikitsa Vigyan Vishwavidyalaya Evam Go Anusandhan Sansthan (DUVASU), Mathura, India
| | - Muhammad Bilal
- School of Life Science and Food Engineering, Huaiyin Institute of Technology, Huaian, China
| | - Manish Dhawan
- Department of Microbiology, Punjab Agricultural University, Ludhiana, India
- The Trafford Group of Colleges, Manchester, United Kingdom
| | - Talha B. Emran
- Department of Pharmacy, BGC Trust University Bangladesh, Chittagong, Bangladesh
| | - Jeehan H. Alestad
- Immunology and Infectious Microbiology, Glasgow, United Kingdom
- Collage of medicine, Microbiology, Jabriya, Kuwait
- Kuwait Chair Madam in Antimicrobial Resistance Committee, Alternative Permanent Representative of Kuwait to the United Nation Agencies, Rome, Italys
| | - Hatem M. Alhani
- Department of Pediatric Infectious Disease, Maternity and Children Hospital, Dammam, Saudi Arabia
- Department of Infection Control, Maternity and Children Hospital, Dammam, Saudi Arabia
- Department of Preventive Medicine and Infection Prevention and Control, Directorate of Ministry of Health, Eastern Region, Dammam, Saudi Arabia
| | - Habib K. BinKhalaf
- Department of Molecular Laboratory, King Fahad Hospital, Hofuf, Saudi Arabia
| | - Ali A. Rabaan
- Molecular Diagnostic Laboratory, Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia
- College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
- Department of Public Health and Nutrition, The University of Haripur, Haripur, Pakistan
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17
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Ruchusatsawat K, Nuengjamnong C, Tawatsin A, Thiemsing L, Kawidam C, Somboonna N, Nuanualsuwan S. Quantitative Risk Assessments of Hepatitis A Virus and Hepatitis E Virus from Raw Oyster Consumption. RISK ANALYSIS : AN OFFICIAL PUBLICATION OF THE SOCIETY FOR RISK ANALYSIS 2022; 42:953-965. [PMID: 34601752 DOI: 10.1111/risa.13832] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 09/05/2021] [Accepted: 09/10/2021] [Indexed: 06/13/2023]
Abstract
A quantitative risk assessment of hepatitis A virus (HAV) and hepatitis E virus (HEV) from raw oyster consumption from farm and retail was evaluated over three seasons. This risk assessment comprises four steps: hazard identification, dose-response assessment, exposure assessment, and risk characterization. We used probabilistic models for prevalence, concentration, and oyster consumption. HEV dose-response (DR) model based on HEV dosing in chimpanzees and used to perform a dose-response assessment of HEV was proposed. Both HAV and HEV were simultaneously enumerated by real-time PCR to determine viral doses. The probabilistic prevalences of HAV and HEV were in the ranges of 8-20% and 8-40%, respectively. The best-fit DR model was the beta-Poisson with alpha and N50 equal to 216.9 and 3.03 × 107 , respectively. After running the Monte Carlo simulation, the annual cases of foodborne hepatitis A and hepatitis E from raw oyster consumption from farms were 9,264-17,526 and 1-604, respectively, while those at retail were 7,694-14,591 and 1-204, respectively. This study suggested that consuming farm oysters poses a significantly higher risk of hepatitis A than hepatitis E. The best-fit DR model for HEV developed in this study could determine risks of hepatitis E from raw oyster consumption in Thailand.
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Affiliation(s)
- Kriangsak Ruchusatsawat
- National Institute of Health, Department of Medical Sciences, Ministry of Public Health, Nonthaburi, Thailand
| | - Chackrit Nuengjamnong
- Department of Animal Husbandry, Faculty of Veterinary Science, Chulalongkorn University, Bangkok, Thailand
- Food Risk Hub Research Unit of Chulalongkorn University, Thailand
| | - Apiwat Tawatsin
- Medical Sciences Technical Office, Department of Medical Sciences, Ministry of Public Health, Nonthaburi, Thailand
| | - Laddawan Thiemsing
- National Institute of Health, Department of Medical Sciences, Ministry of Public Health, Nonthaburi, Thailand
| | - Chonthicha Kawidam
- National Institute of Health, Department of Medical Sciences, Ministry of Public Health, Nonthaburi, Thailand
| | - Naraporn Somboonna
- Department of Microbiology, Faculty of Science, Chulalongkorn University, Thailand
- Microbiome Research Unit for Probiotics in Food and Cosmetics, Chulalongkorn University, Thailand
| | - Suphachai Nuanualsuwan
- Department of Veterinary Public Health, Faculty of Veterinary Science, Chulalongkorn University, Bangkok, Thailand
- Food Risk Hub Research Unit of Chulalongkorn University, Thailand
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18
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Lampejo T, Curtis C, Ijaz S, Haywood B, Flores A, Sudhanva M, El Bouzidi K, Patel S, Dowling M, Zuckerman M. Nosocomial transmission of hepatitis E virus and development of chronic infection: The wider impact of COVID-19. J Clin Virol 2022; 148:105083. [PMID: 35086023 PMCID: PMC8785262 DOI: 10.1016/j.jcv.2022.105083] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Revised: 01/19/2022] [Accepted: 01/22/2022] [Indexed: 12/16/2022]
Abstract
Background Transmission of hepatitis E virus (HEV) within the healthcare setting is extremely rare. Additionally, the development of chronic HEV infection in association with severe acute respiratory syndrome coronavirus disease 2 (SARS-CoV-2) infection and/or its immunomodulatory therapy has not been reported previously. Aims To describe the investigation and management of a nosocomial HEV transmission incident during the coronavirus disease 2019 (COVID-19) pandemic. Methods Epidemiological and molecular investigation of two individuals hospitalised with COVID-19 who were both diagnosed with HEV infection. Results Findings from our investigation were consistent with transmission of HEV from one patient with a community-acquired HEV infection to another individual (identical HEV sequences were identified in the two patients), most likely due to a breach in infection control practices whilst both patients shared a bed space on the intensive care unit (ICU). Chronic HEV infection requiring treatment with ribavirin developed in one patient with prolonged lymphopaenia attributable to COVID-19 and/or the immunomodulators received for its treatment. Further investigation did not identify transmission of HEV to any other patients or to healthcare workers. Conclusions The extraordinary demands that the COVID-19 pandemic has placed on all aspects of healthcare, particularly within ICU settings, has greatly challenged the ability to consistently maintain optimal infection prevention and control practices. Under the significant pressures of the COVID-19 pandemic a highly unusual nosocomial HEV transmission incident occurred complicated further by progression to a chronic HEV infection in one patient.
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Affiliation(s)
- Temi Lampejo
- Department of Infection Sciences, King's College Hospital, London, United Kingdom.
| | - Carmel Curtis
- Department of Infection Sciences, King's College Hospital, London, United Kingdom
| | - Samreen Ijaz
- Virus Reference Department, UK Health Security Agency, London, United Kingdom
| | - Becky Haywood
- Virus Reference Department, UK Health Security Agency, London, United Kingdom
| | - Ashley Flores
- Department of Infection Prevention and Control, King's College Hospital, London, United Kingdom
| | - Malur Sudhanva
- Department of Infection Sciences, King's College Hospital, London, United Kingdom
| | - Kate El Bouzidi
- Department of Infection Sciences, King's College Hospital, London, United Kingdom
| | - Sameer Patel
- Department of Critical Care Medicine, King's College Hospital, London, United Kingdom
| | - Mick Dowling
- Department of Critical Care Medicine, King's College Hospital, London, United Kingdom
| | - Mark Zuckerman
- Department of Infection Sciences, King's College Hospital, London, United Kingdom
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19
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Gómez-López VM, Jubinville E, Rodríguez-López MI, Trudel-Ferland M, Bouchard S, Jean J. Inactivation of Foodborne Viruses by UV Light: A Review. Foods 2021; 10:foods10123141. [PMID: 34945692 PMCID: PMC8701782 DOI: 10.3390/foods10123141] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 11/29/2021] [Accepted: 12/15/2021] [Indexed: 12/13/2022] Open
Abstract
Viruses on some foods can be inactivated by exposure to ultraviolet (UV) light. This green technology has little impact on product quality and, thus, could be used to increase food safety. While its bactericidal effect has been studied extensively, little is known about the viricidal effect of UV on foods. The mechanism of viral inactivation by UV results mainly from an alteration of the genetic material (DNA or RNA) within the viral capsid and, to a lesser extent, by modifying major and minor viral proteins of the capsid. In this review, we examine the potential of UV treatment as a means of inactivating viruses on food processing surfaces and different foods. The most common foodborne viruses and their laboratory surrogates; further explanation on the inactivation mechanism and its efficacy in water, liquid foods, meat products, fruits, and vegetables; and the prospects for the commercial application of this technology are discussed. Lastly, we describe UV’s limitations and legislation surrounding its use. Based on our review of the literature, viral inactivation in water seems to be particularly effective. While consistent inactivation through turbid liquid food or the entire surface of irregular food matrices is more challenging, some treatments on different food matrices seem promising.
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Affiliation(s)
- Vicente M. Gómez-López
- Catedra Alimentos para la Salud, Universidad Católica San Antonio de Murcia, Campus de los Jerónimos, E-30107 Murcia, Spain;
| | - Eric Jubinville
- Institute of Nutraceuticals and Functional Foods, Département des Sciences des Aliments, Université Laval, Québec, QC G1V 0A6, Canada; (E.J.); (M.T.-F.); (S.B.)
| | - María Isabel Rodríguez-López
- Departamento de Tecnología de la Alimentación y Nutrición, Universidad Católica San Antonio de Murcia, Campus de los Jerónimos, E-30107 Murcia, Spain;
| | - Mathilde Trudel-Ferland
- Institute of Nutraceuticals and Functional Foods, Département des Sciences des Aliments, Université Laval, Québec, QC G1V 0A6, Canada; (E.J.); (M.T.-F.); (S.B.)
| | - Simon Bouchard
- Institute of Nutraceuticals and Functional Foods, Département des Sciences des Aliments, Université Laval, Québec, QC G1V 0A6, Canada; (E.J.); (M.T.-F.); (S.B.)
| | - Julie Jean
- Institute of Nutraceuticals and Functional Foods, Département des Sciences des Aliments, Université Laval, Québec, QC G1V 0A6, Canada; (E.J.); (M.T.-F.); (S.B.)
- Correspondence: ; Tel.: +1-418-656-2131 (ext. 413849)
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20
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Kupke P, Werner JM. Hepatitis E Virus Infection-Immune Responses to an Underestimated Global Threat. Cells 2021; 10:cells10092281. [PMID: 34571931 PMCID: PMC8468229 DOI: 10.3390/cells10092281] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 08/23/2021] [Accepted: 08/30/2021] [Indexed: 12/19/2022] Open
Abstract
Infection with the hepatitis E virus (HEV) is one of the main ubiquitous causes for developing an acute hepatitis. Moreover, chronification plays a predominant role in immunocompromised patients such as transplant recipients with more frequent severe courses. Unfortunately, besides reduction of immunosuppression and off-label use of ribavirin or pegylated interferon alfa, there is currently no specific anti-viral treatment to prevent disease progression. So far, research on involved immune mechanisms induced by HEV is limited. It is very difficult to collect clinical samples especially from the early phase of infection since this is often asymptomatic. Nevertheless, it is certain that the outcome of HEV-infected patients correlates with the strength of the proceeding immune response. Several lymphoid cells have been identified in contributing either to disease progression or achieving sustained virologic response. In particular, a sufficient immune control by both CD4+ and CD8+ T cells is necessary to prevent chronic viral replication. Especially the mechanisms underlying fulminant courses are poorly understood. However, liver biopsies indicate the involvement of cytotoxic T cells in liver damage. In this review, we aimed to highlight different parts of the lymphoid immune response against HEV and point out questions that remain unanswered regarding this underestimated global threat.
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21
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Hriskova K, Marosevic D, Belting A, Wenzel JJ, Carl A, Katz K. Epidemiology of Hepatitis E in 2017 in Bavaria, Germany. FOOD AND ENVIRONMENTAL VIROLOGY 2021; 13:337-346. [PMID: 33900549 PMCID: PMC8379136 DOI: 10.1007/s12560-021-09474-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 04/03/2021] [Indexed: 05/04/2023]
Abstract
In the last decade, the number of reported hepatitis E virus (HEV) infections in Germany, including Bavaria, has continued to rise. In order to identify risk factors associated with HEV infection, we investigated notified hepatitis E cases from Bavaria during 2017. The project "Intensified Hepatitis E Surveillance in Bavaria" included interviews with questionnaires, collection and genotyping of stool, serum and food samples. In addition, certain risk factors were examined in a sample comparison with healthy population using univariable analysis and logistic regression. In total, 135 hepatitis E cases from Bavaria were included in the analysis. Mean age for women was 46 (range 20-74) years and 47.5 (range 20-85) for men. 56 of the cases (41.5%) were asymptomatic. Among the symptomatic cases, both men and women were equally affected with symptoms like fever (16.3%), jaundice (18.8%) and upper abdominal pain (28.2%). 145 human samples (serum, stool) and 6 food samples were collected. 15.9% of the human samples (n = 23) were positive for HEV RNA by reverse-transcription quantitative real-time PCR (RT-qPCR). Identified risk factors significantly associated with hepatitis E were sausage consumption with odds ratio 9.6 (CI 1.3-70.1), fish with OR 2.2 (CI 1.1-4.4) and cat ownership with OR 1.9 (CI 1.3-3.0) in multivariable analyses. Further investigation is needed to confirm the role of fish in HEV transmission. Autochthonous HEV genotype 3 is prevalent in Bavaria and there could be more transmission routes contributing to the spread of HEV than previously known. Undercooked meat, offal, sausages, fish, shellfish and contact with animals and pets are possible sources for infection.
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Affiliation(s)
- K Hriskova
- Institute for Medical Information Processing, Biometry and Epidemiology - IBE, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany.
- Pettenkofer School of Public Health, Munich, Germany.
| | - D Marosevic
- Bavarian Public Health and Food Safety Authority (LGL), Veterinärstraße 2, 85764, Oberschleißheim, Germany
| | - A Belting
- Bavarian Public Health and Food Safety Authority (LGL), Veterinärstraße 2, 85764, Oberschleißheim, Germany
| | - J J Wenzel
- National Consultant Laboratory for HAV and HEV, Institute of Clinical Microbiology and Hygiene, University Medical Centre Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany
| | - A Carl
- Bavarian Public Health and Food Safety Authority (LGL), Veterinärstraße 2, 85764, Oberschleißheim, Germany
| | - K Katz
- Bavarian Public Health and Food Safety Authority (LGL), Veterinärstraße 2, 85764, Oberschleißheim, Germany
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22
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Moraes DFDSD, Mesquita JR, Dutra V, Nascimento MSJ. Systematic Review of Hepatitis E Virus in Brazil: A One-Health Approach of the Human-Animal-Environment Triad. Animals (Basel) 2021; 11:2290. [PMID: 34438747 PMCID: PMC8388429 DOI: 10.3390/ani11082290] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 07/28/2021] [Accepted: 07/29/2021] [Indexed: 12/11/2022] Open
Abstract
Brazil is the fifth largest country in the world with diverse socioeconomic and sanitary conditions, also being the fourth largest pig producer in the world. The aim of the present systematic review was to collect and summarize all HEV published data from Brazil (from 1995 to October 2020) performed in humans, animals, and the environment, in a One Health perspective. A total of 2173 papers were retrieved from five search databases (LILACs, Mendeley, PubMed, Scopus, and Web of Science) resulting in 71 eligible papers after application of exclusion/inclusion criteria. Data shows that HEV genotype 3 (HEV-3) was the only retrieved genotype in humans, animals, and environment in Brazil. The South region showed the highest human seroprevalence and also the highest pig density and industry, suggesting a zoonotic link. HEV-1 and 2 were not detected in Brazil, despite the low sanitary conditions of some regions. From the present review we infer that HEV epidemiology in Brazil is similar to that of industrialized countries (only HEV-3, swine reservoirs, no waterborne transmission, no association with low sanitary conditions). Hence, we alert for the implementation of HEV surveillance systems in swine and for the consideration of HEV in the diagnostic routine of acute and chronic hepatitis in humans.
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Affiliation(s)
- Danny Franciele da Silva Dias Moraes
- Faculty of Veterinary Medicine, Federal University of Mato Grosso, Cuiabá 78060-900, Brazil; (D.F.d.S.D.M.); (V.D.)
- Secretaria de Estado do Meio Ambiente de Mato Grosso (SEMA), Cuiabá 78050-970, Brazil
- Abel Salazar Institute of Biomedical Sciences (ICBAS), University of Porto, 4050-313 Porto, Portugal
| | - João R. Mesquita
- Abel Salazar Institute of Biomedical Sciences (ICBAS), University of Porto, 4050-313 Porto, Portugal
- Epidemiology Research Unit (EPIUnit), Instituto de Saúde Pública da Universidade do Porto, 4050-600 Porto, Portugal
| | - Valéria Dutra
- Faculty of Veterinary Medicine, Federal University of Mato Grosso, Cuiabá 78060-900, Brazil; (D.F.d.S.D.M.); (V.D.)
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Occurrence of Human Enteric Viruses in Shellfish along the Production and Distribution Chain in Sicily, Italy. Foods 2021; 10:foods10061384. [PMID: 34203938 PMCID: PMC8232761 DOI: 10.3390/foods10061384] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 06/09/2021] [Accepted: 06/10/2021] [Indexed: 12/11/2022] Open
Abstract
Contamination of bivalve mollusks with human pathogenic viruses represents a recognized food safety risk. Thus, monitoring programs for shellfish quality along the entire food chain could help to finally preserve the health of consumers. The aim of the present study was to provide up-to-date data on the prevalence of enteric virus contamination along the shellfish production and distribution chain in Sicily. To this end, 162 batches of mollusks were collected between 2017 and 2019 from harvesting areas, depuration and dispatch centers (n = 63), restaurants (n = 6) and retail stores (n = 93) distributed all over the island. Samples were processed according to ISO 15216 standard method, and the presence of genogroup GI and GII norovirus (NoV), hepatitis A and E viruses (HAV, HEV), rotavirus and adenovirus was investigated by real-time reverse transcription polymerase chain reaction (real-time-RT PCR), nested (RT)-PCR and molecular genotyping. Our findings show that 5.56% of samples were contaminated with at least one NoV, HAV and/or HEV. Contaminated shellfish were sampled at production sites and retail stores and their origin was traced back to Spain and several municipalities in Italy. In conclusion, our study highlights the need to implement routine monitoring programs along the whole food chain as an effective measure to prevent foodborne transmission of enteric viruses.
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24
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Treagus S, Wright C, Baker-Austin C, Longdon B, Lowther J. The Foodborne Transmission of Hepatitis E Virus to Humans. FOOD AND ENVIRONMENTAL VIROLOGY 2021; 13:127-145. [PMID: 33738770 PMCID: PMC8116281 DOI: 10.1007/s12560-021-09461-5] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 01/16/2021] [Indexed: 05/04/2023]
Abstract
Globally, Hepatitis E virus (HEV) causes over 20 million cases worldwide. HEV is an emerging and endemic pathogen within economically developed countries, chiefly resulting from infections with genotype 3 (G3) HEV. G3 HEV is known to be a zoonotic pathogen, with a broad host range. The primary source of HEV within more economically developed countries is considered to be pigs, and consumption of pork products is a significant risk factor and known transmission route for the virus to humans. However, other foods have also been implicated in the transmission of HEV to humans. This review consolidates the information available regarding transmission of HEV and looks to identify gaps where further research is required to better understand how HEV is transmitted to humans through food.
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Affiliation(s)
- Samantha Treagus
- Biosciences, College of Life and Environmental Sciences, University of Exeter, Penryn Campus, Penryn, Cornwall, UK.
- Centre for Environment Fisheries and Aquaculture Science, Barrack Road, Weymouth, Dorset, DT4 8UB, UK.
| | | | - Craig Baker-Austin
- Centre for Environment Fisheries and Aquaculture Science, Barrack Road, Weymouth, Dorset, DT4 8UB, UK
| | - Ben Longdon
- Biosciences, College of Life and Environmental Sciences, University of Exeter, Penryn Campus, Penryn, Cornwall, UK
| | - James Lowther
- Centre for Environment Fisheries and Aquaculture Science, Barrack Road, Weymouth, Dorset, DT4 8UB, UK
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25
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Di Cola G, Fantilli AC, Pisano MB, Ré VE. Foodborne transmission of hepatitis A and hepatitis E viruses: A literature review. Int J Food Microbiol 2021; 338:108986. [PMID: 33257099 DOI: 10.1016/j.ijfoodmicro.2020.108986] [Citation(s) in RCA: 67] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 11/04/2020] [Accepted: 11/05/2020] [Indexed: 12/19/2022]
Abstract
Foodborne viruses have been recognized as a growing concern to the food industry and a serious public health problem. Hepatitis A virus (HAV) is responsible for the majority of viral outbreaks of food origin worldwide, while hepatitis E virus (HEV) has also been gaining prominence as a foodborne viral agent in the last years, due to its zoonotic transmission through the consumption of uncooked or undercooked infected meat or derivatives. However, there is a lack of scientific reports that gather all the updated information about HAV and HEV as foodborne viruses. A search of all scientific articles about HAV and HEV in food until March 2020 was carried out, using the keywords "HAV", "HEV", "foodborne", "outbreak" and "detection in food". Foodborne outbreaks due to HAV have been reported since 1956, mainly in the USA, and in Europe in recent years, where the number of outbreaks has been increasing throughout time, and nowadays it has become the continent with the highest foodborne HAV outbreak report. Investigation and detection of HAV in food is more recent, and the first detections were performed in the 1990s decade, most of them carried out on seafood, first, and frozen food, later. On the other hand, HEV has been mainly looked for and detected in food derived from reservoir animals, such as meat, sausages and pate of pigs and wild boars. For this virus, only isolated cases and small outbreaks of foodborne transmission have been recorded, most of them in industrialized countries, due to HEV genotype 3 or 4. Virus detection in food matrices requires special processing of the food matrix, followed by RNA detection by molecular techniques. For HAV, a real-time PCR has been agreed as the standard method for virus detection in food; in the case of HEV, a consensus assay for its detection in food has not been reached yet. Our investigation shows that there is still little data about HAV and HEV prevalence and frequency of contamination in food, prevalent viral strains, and sources of contamination, mainly in developing countries, where there is no research and legislation in this regard. Studies on these issues are needed to get a better understanding of foodborne viruses, their maintenance and their potential to cause diseases.
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Affiliation(s)
- Guadalupe Di Cola
- Instituto de Virología "Dr. J. M. Vanella", Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Enfermera Gordillo Gomez s/n, CP: 5016 Córdoba, Argentina; Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Argentina.
| | - Anabella C Fantilli
- Instituto de Virología "Dr. J. M. Vanella", Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Enfermera Gordillo Gomez s/n, CP: 5016 Córdoba, Argentina; Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Argentina
| | - María Belén Pisano
- Instituto de Virología "Dr. J. M. Vanella", Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Enfermera Gordillo Gomez s/n, CP: 5016 Córdoba, Argentina; Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Argentina
| | - Viviana E Ré
- Instituto de Virología "Dr. J. M. Vanella", Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Enfermera Gordillo Gomez s/n, CP: 5016 Córdoba, Argentina; Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Argentina
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Battistini R, Listorti V, Squadrone S, Pederiva S, Abete MC, Mua R, Ciccotelli V, Suffredini E, Maurella C, Baioni E, Orlandi M, Ercolini C, Serracca L. Occurrence and persistence of enteric viruses, arsenic and biotoxins in Pacific oysters farmed in an Italian production site. MARINE POLLUTION BULLETIN 2021; 162:111843. [PMID: 33223135 DOI: 10.1016/j.marpolbul.2020.111843] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 10/07/2020] [Accepted: 11/11/2020] [Indexed: 06/11/2023]
Abstract
The presence of Norovirus (NoV) and Hepatitis E virus (HEV) in non-depurated and depurated oysters raised in the north-west Italian coast was investigated by quantitative real-time RT-PCR. Total and inorganic arsenic (As) and the presence of marine biotoxins (DSP, ASP, PSP) by LC-MS were also investigated. NoV was detected through all the sampling period in non depurated and depurated oysters with highest levels during wintertime (>104 genome copies per gram, gc/g) and minimum values in summer below the LOQ (<130/140 gc/g). HEV has never been found as well as biotoxins. Total As concentration was found in oysters in the range 0.45-3.0 mg/kg, while inorganic As was found in all samples in concentrations below the LOQ (<0.020 mg/kg). The study highlights how the 24 h depuration process didn't reduce significantly NoV levels and therefore the high concentration of NoV in oysters could represent a risk for consumers especially during winter and spring months.
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Affiliation(s)
- Roberta Battistini
- Istituto Zooprofilattico Sperimentale del Piemonte, Liguria e Valle d'Aosta, Turin, Italy.
| | - Valeria Listorti
- Istituto Zooprofilattico Sperimentale del Piemonte, Liguria e Valle d'Aosta, Turin, Italy
| | - Stefania Squadrone
- Istituto Zooprofilattico Sperimentale del Piemonte, Liguria e Valle d'Aosta, Turin, Italy
| | - Sabina Pederiva
- Istituto Zooprofilattico Sperimentale del Piemonte, Liguria e Valle d'Aosta, Turin, Italy
| | - Maria Cesarina Abete
- Istituto Zooprofilattico Sperimentale del Piemonte, Liguria e Valle d'Aosta, Turin, Italy
| | - Roberto Mua
- Istituto Zooprofilattico Sperimentale del Piemonte, Liguria e Valle d'Aosta, Turin, Italy
| | - Valentina Ciccotelli
- Istituto Zooprofilattico Sperimentale del Piemonte, Liguria e Valle d'Aosta, Turin, Italy
| | - Elisabetta Suffredini
- Department of Food Safety, Nutrition and Veterinary Public Health, Istituto Superiore di Sanità, Rome, Italy
| | - Cristiana Maurella
- Istituto Zooprofilattico Sperimentale del Piemonte, Liguria e Valle d'Aosta, Turin, Italy
| | - Elisa Baioni
- Istituto Zooprofilattico Sperimentale del Piemonte, Liguria e Valle d'Aosta, Turin, Italy
| | - Mino Orlandi
- Liguria Local Health Unit-ASL 5, Complex Unit of Hygiene of Foods and Animal Origin, La Spezia, Italy
| | - Carlo Ercolini
- Istituto Zooprofilattico Sperimentale del Piemonte, Liguria e Valle d'Aosta, Turin, Italy
| | - Laura Serracca
- Istituto Zooprofilattico Sperimentale del Piemonte, Liguria e Valle d'Aosta, Turin, Italy
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Abi Nader E, Girard M, Leruez-Ville M, Sissaoui S, Lacaille F, Roque-Afonso AM, Debray D. Seroprevalence of Hepatitis E virus infection in children after liver transplantation: A single-center experience in France. Clin Res Hepatol Gastroenterol 2020; 44:174-180. [PMID: 31266724 DOI: 10.1016/j.clinre.2019.06.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2018] [Revised: 05/26/2019] [Accepted: 06/05/2019] [Indexed: 02/04/2023]
Abstract
INTRODUCTION Hepatitis E virus (HEV) is a major cause of acute viral hepatitis worldwide, usually asymptomatic in children. However, a growing number of publications over the last decade have documented cases of chronic hepatitis related to HEV-genotype 3 infection, and progressing to cirrhosis in immuno-compromised patients, particularly in adult kidney transplant recipients. The aim of our study was to evaluate the prevalence and severity of HEV infection among pediatric liver transplant (PLT) recipients managed in our center. MATERIAL AND METHODS Between November 1st 2014 and January 1st 2016, PLT recipients (less than 18 years-old) were screened for HEV infection [determined by HEV serology, HEV- immunoglobulin M (IgM) and immunoglobulin G (IgG), and HEV-ribonucleic acid (RNA) by reverse transcriptase polymerase chain reaction] at their annual follow-up visit. RESULTS Eighty children were tested for HEV infection a mean of 5.4±5.3 years after liver transplantation (LT). The main indication for LT was biliary atresia (n=47, 59%). The prevalence of HEV-IgG was 8% (n=6; age range 1.3 to 14.2 years-old at the time of HEV testing). Prevalence increased to 30% when considering only the 20 children with a past history of an unexplained episode of elevated transaminases since LT. None had HEV IgM, serum HEV-RNA, or increased transaminases at the time of HEV testing. Among the six IgG seropositive children, two had received intravenous immunoglobulins prior to screening and four children had a negative control (seroreversion) 3 to 42 months after the first testing. CONCLUSION The prevalence of HEV infection in our cohort is low and similar to other pediatric reports. We saw no cases of chronic hepatitis or fibrosis attributable to HEV. The lower immunosuppressive regimen used in PLT children compared to other solid organ transplant recipients may account for this good outcome.
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Affiliation(s)
- Elie Abi Nader
- Unit of Pediatric Hepatology, Reference Center for Rare Pediatric Liver Diseases, Necker-Enfants-Malades University Hospital, AP-HP, 149, Sèvres Street, 75015 Paris, France; University of Paris-Descartes, Sorbonne Paris-Cité, 75006 Paris, France.
| | - Muriel Girard
- Unit of Pediatric Hepatology, Reference Center for Rare Pediatric Liver Diseases, Necker-Enfants-Malades University Hospital, AP-HP, 149, Sèvres Street, 75015 Paris, France; University of Paris-Descartes, Sorbonne Paris-Cité, 75006 Paris, France
| | - Marianne Leruez-Ville
- Department of Virology, Necker-Enfants-Malades University Hospital, AP-HP, 75015 Paris, France
| | - Samira Sissaoui
- Unit of Pediatric Hepatology, Reference Center for Rare Pediatric Liver Diseases, Necker-Enfants-Malades University Hospital, AP-HP, 149, Sèvres Street, 75015 Paris, France
| | - Florence Lacaille
- Unit of Pediatric Hepatology, Reference Center for Rare Pediatric Liver Diseases, Necker-Enfants-Malades University Hospital, AP-HP, 149, Sèvres Street, 75015 Paris, France
| | - Anne-Marie Roque-Afonso
- Inserm U1993, Department of Virology, National Reference Center for Hepatitis A and Hepatitis E, Paul-Brousse Hospital, AP-HP, 94800 Villejuif, France; University of Paris-Sud, 91405 Paris, France
| | - Dominique Debray
- Unit of Pediatric Hepatology, Reference Center for Rare Pediatric Liver Diseases, Necker-Enfants-Malades University Hospital, AP-HP, 149, Sèvres Street, 75015 Paris, France; University of Paris-Descartes, Sorbonne Paris-Cité, 75006 Paris, France
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Detection of hepatitis E virus (rabbit genotype) in farmed rabbits entering the food chain. Int J Food Microbiol 2020; 319:108507. [PMID: 31981930 DOI: 10.1016/j.ijfoodmicro.2020.108507] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Revised: 12/09/2019] [Accepted: 01/02/2020] [Indexed: 02/06/2023]
Abstract
Hepatitis E virus (HEV) infects humans and many animal species. The rabbit HEV has been found in farmed, wild and pet rabbits as well as in human patients suggesting zoonotic transmission. Although the routes of human infection with rabbit strains are unclear a foodborne transmission is suggested especially when asymptomatically infected animals could enter the food chain. The aims of the study were an evaluation of the prevalence of HEV infections in slaughtered rabbits, identification of the virus genotype(s) and assessment of their genetic relatedness to other zoonotic HEV strains. A pair of blood and liver samples (n = 482) were collected from meat rabbits of different breeds slaughtered at the age of 2.8 to 6 months. The animals originated from 20 small-scale and 4 large-scale commercial farms operating in Poland. The presence of anti-HEV antibodies in animals was detected by the use of a recomWell HEV IgG (human) ELISA kit (Mikrogen Diagnostik) adapted to rabbit sera. The isolation of HEV and sample process control virus (feline calicivirus) RNA from homogenates of liver destined for food and virus-positive sera was performed using a QIAamp® Viral RNA Mini Kit (Qiagen). A one-step real-time reverse transcription PCR method containing a target-specific internal amplification control was used for detection of HEV. The (sub)genotype of detected rabbit HEV strains was identified based on sequence analysis of the ORF2 and ORF2/3 virus genome fragments. Anti-HEV antibodies were detected in 29 (6%) out of 482 rabbit sera samples collected from animals raised only on the small-scale rabbit farms. Four sera were also positive for HEV RNA. Viral RNA was detected in 72 (14.9%) animal livers. Analysing ELISA and PCR results using Student's t-test, there were significant differences observed in the frequency of HEV infections between rabbits from small-scale and commercial farms (t = 2.675, p = 0.015 < 0.05 for ELISA and t = 2.705, p = 0.014 < 0.05 for PCR). All detected virus strains were identified as HEV gt3 ra subtype. The results of this study provide data on the occurrence of HEV infections in rabbits entering the food chain, suggesting that a risk of foodborne HEV infection due to consumption of contaminated meat and liver exists. In this light, the presence of rabbit HEV in food animals is pertinent as an issue of food safety and the surveillance of these animals for emerging or re-emerging viruses.
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Wang H, Kjellberg I, Sikora P, Rydberg H, Lindh M, Bergstedt O, Norder H. Hepatitis E virus genotype 3 strains and a plethora of other viruses detected in raw and still in tap water. WATER RESEARCH 2020; 168:115141. [PMID: 31590036 DOI: 10.1016/j.watres.2019.115141] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 09/24/2019] [Accepted: 09/29/2019] [Indexed: 06/10/2023]
Abstract
In this study, next generation sequencing was used to explore the virome in 20L up to 10,000L water from different purification steps at two Swedish drinking water treatment plants (DWTPs), and in tap water. One DWTP used ultrafiltration (UF) with 20 nm pores, the other UV light treatment after conventional treatment of the water. Viruses belonging to 26 different families were detected in raw water, in which 6-9 times more sequence reads were found for phages than for known environmental, plant or vertebrate viruses. The total number of viral reads was reduced more than 4-log10 after UF and 3-log10 over UV treatment. However, for some viruses the reduction was 3.5-log10 after UF, as for hepatitis E virus (HEV), which was also detected in tap water, with sequences similar to those in raw water and after treatment. This indicates that HEV had passed through the treatment and entered into the supply network. However, the viability of the viruses is unknown. In tap water 10-130 International Units of HEV RNA/mL were identified, which is a comparable low amount of virus. The risk of getting infected through consumption of tap water is probably negligible, but needs to be investigated. The HEV strains in the waters belonged to subtypes HEV3a and HEV3c/i, which is associated with unknown source of infection in humans infected in Sweden. None of these subtypes are common among pigs or wild boar, the major reservoirs for HEV, indicating that water may play a role in transmitting this virus. The results indicate that monitoring small fecal/oral transmitted viruses in DWTPs may be considered, especially during community outbreaks, to prevent potential transmission by tap water.
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Affiliation(s)
- Hao Wang
- Department of Infectious Diseases/Virology, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Sweden
| | | | - Per Sikora
- Department of Pathology and Genetics, Institute of Biomedicine at Sahlgrenska Academy, University of Gothenburg, 41345, Gothenburg, Sweden; Clinical Genomics Gothenburg, SciLife Labs, Gothenburg, Sweden
| | | | - Magnus Lindh
- Department of Infectious Diseases/Virology, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Sweden; Region Västra Götaland, Sahlgrenska University Hospital, Department of Infectious Diseases, Gothenburg, Sweden
| | - Olof Bergstedt
- Göteborgs Stad Kretslopp och vatten, Gothenburg, Sweden; City of Gothenburg and DRICKS Chalmers University of Technology, Gothenburg, Sweden
| | - Heléne Norder
- Department of Infectious Diseases/Virology, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Sweden; Region Västra Götaland, Sahlgrenska University Hospital, Department of Infectious Diseases, Gothenburg, Sweden.
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Hepatitis E virus infections in Europe. J Clin Virol 2019; 120:20-26. [PMID: 31536936 DOI: 10.1016/j.jcv.2019.09.004] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Accepted: 09/06/2019] [Indexed: 12/11/2022]
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Seroprevalence Study of Anti-HEV IgG among Different Adult Populations in Corsica, France, 2019. Microorganisms 2019; 7:microorganisms7100460. [PMID: 31623185 PMCID: PMC6843757 DOI: 10.3390/microorganisms7100460] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Revised: 09/19/2019] [Accepted: 10/15/2019] [Indexed: 02/07/2023] Open
Abstract
Hepatitis E virus (HEV) is a major cause of acute hepatitis worldwide. In France, hyperendemic areas including Corsica have an anti-HEV Immunoglobulin G (IgG) prevalence higher than 50%. The aim of this study was to determine the seroprevalence of anti-HEV IgG in three adult populations in Corsica and the risk factors associated with antibody detection. Between 2017 and 2019, a total of 930 individuals, including 467 blood donors, 393 students or university staff members and 70 patients from general practice, were tested for the presence of anti-HEV IgG using the Wantai HEV IgG enzyme immunoassay kit and filled a questionnaire. The association between seropositivity and potential risk factors was tested with univariate and multivariate analyses. Out of the 930 samples, 52.3% (486/930) were seropositive—54.4% (254/467) among blood donors, 47.6% (187/393) among university students and 64.3% (45/70) among patients of general practice. Three main risk factors were identified: (i) skinning and butchering (Adjusted Odds Ratio aOR = 2.76, 95% confidence interval [95% CI] [1.51–5.37]; p-value < 10−3), (ii) consumption of a local pork live raw sausage (fittonu) (aOR = 1.95 95% CI [1.45–2.64]; p-value = 10−5), and (iii) increasing age (p-value = 0.003). Seropositivity rates between the different populations were homogeneous after age stratification. This cross-sectional study indicates a high anti-HEV IgG seroprevalence in the Corsican adult population, not significantly different between women and men and increasing with age. This serosurvey also showed homogeneity regarding the exposure to HEV among three different types of populations. Finally, we confirmed the endemicity of Corsica with respect to HEV and identified a strong association between consumption of figatellu/fittonu and the practice of skinning and butchering with the detection of anti-HEV IgG.
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Niederhauser C, Widmer N, Hotz M, Tinguely C, Fontana S, Allemann G, Borri M, Infanti L, Sarraj A, Sigle J, Stalder M, Thierbach J, Waldvogel S, Wiengand T, Züger M, Gowland P. Current hepatitis E virus seroprevalence in Swiss blood donors and apparent decline from 1997 to 2016. ACTA ACUST UNITED AC 2019; 23. [PMID: 30180927 PMCID: PMC6124188 DOI: 10.2807/1560-7917.es.2018.23.35.1700616] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Hepatitis E virus (HEV) is a virus of emerging importance to transfusion medicine. Studies from several European countries, including Switzerland, have reported high seroprevalence of hepatitis E as a consequence of endemic infections. Published HEV seroprevalence estimates within developed countries vary considerably; primarily due to improved diagnostic assays. The purpose of this study was to investigate the seroprevalence of anti-HEV IgG in Swiss blood donations. Methods: We used the highly sensitive Wantai HEV IgG EIA and assessed regional distribution patterns. We analysed age- and sex-matched archive plasma dating back 20 years from canton Bern to investigate recent changes in HEV seroprevalence levels. Results: On average, 20.4% (95% confidence intervals: 19.1–21.8) of the 3,609 blood samples collected in 2014–16 were anti-HEV IgG positive; however, distinct differences between geographical regions were observed (range: 12.8–33.6%). Seroprevalence increased with age with 30.7% of males and 34.3% of women being positive donors over > 60 years old. Differences between sexes may be attributed to dissimilarities in the average age of this group. Within the specified region of the Bern canton, overall prevalence has declined over two decades from 30.3% in 1997/98 to 27.0% in 2006 and 22.3% in 2015/6. Conclusions: HEV seroprevalence in Switzerland is high, but has declined over the last decades. The result shows that primarily endemic HEV infections occur and that current blood products may pose a risk to vulnerable transfusion recipients. Nucleic acid screening of all blood products for HEV will begin in November 2018.
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Affiliation(s)
| | - Nadja Widmer
- Interregional Blood Transfusion SRC, Berne Switzerland
| | | | | | - Stefano Fontana
- Servizio Trasfusionale CRS della Svizzera Italiana, Lugano, Switzerland.,Interregional Blood Transfusion SRC, Berne Switzerland
| | | | - Mauro Borri
- Servizio Trasfusionale CRS della Svizzera Italiana, Lugano, Switzerland
| | - Laura Infanti
- Blood Transfusion Service Beider Basel, Basel, Switzerland
| | - Amira Sarraj
- Blood Transfusion Service SRC Neuchâtel/Jura, Neuchâtel, Switzerland
| | - Jörg Sigle
- Blood Transfusion Service SRC, Aargau/Solothurn, Switzerland
| | | | - Jutta Thierbach
- Blood Transfusion Service SRC Nordostschweiz, St. Gallen, Switzerland
| | | | - Tina Wiengand
- Blood Transfusion Service SRC Zentralschweiz, Luzern, Switzerland
| | - Max Züger
- Blood Transfusion Service SRC Thurgau, Münsterlingen, Switzerland
| | - Peter Gowland
- Interregional Blood Transfusion SRC, Berne Switzerland
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Yin W, Han Y, Xin H, Liu W, Song Q, Li Z, Gao S, Jiang F, Cao J, Bi S, Liu H. Hepatitis E outbreak in a mechanical factory in Qingdao City, China. Int J Infect Dis 2019; 86:191-196. [DOI: 10.1016/j.ijid.2019.07.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Revised: 07/06/2019] [Accepted: 07/09/2019] [Indexed: 01/17/2023] Open
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Wong CC, Thean SM, Ng Y, Kang JSL, Ng TY, Chau ML, Koh TH, Chan KP. Seroepidemiology and genotyping of hepatitis E virus in Singapore reveal rise in number of cases and similarity of human strains to those detected in pig livers. Zoonoses Public Health 2019; 66:773-782. [DOI: 10.1111/zph.12624] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Revised: 06/12/2019] [Accepted: 06/14/2019] [Indexed: 12/17/2022]
Affiliation(s)
- Chui Ching Wong
- Department of Microbiology Singapore General Hospital Singapore
| | - Su Ming Thean
- Department of Microbiology Singapore General Hospital Singapore
| | - Youming Ng
- National Environment Agency Environmental Health Institute Singapore
| | - Joanne Su Lin Kang
- National Environment Agency Environmental Health Institute Singapore
- Singapore Food Agency National Centre for Food Science Singapore
| | - Tong Yong Ng
- Department of Microbiology Singapore General Hospital Singapore
- Duke‐National University of Singapore Medical School Singapore
| | - Man Ling Chau
- National Environment Agency Environmental Health Institute Singapore
- Singapore Food Agency National Centre for Food Science Singapore
| | - Tse Hsien Koh
- Department of Microbiology Singapore General Hospital Singapore
- Duke‐National University of Singapore Medical School Singapore
| | - Kwai Peng Chan
- Department of Microbiology Singapore General Hospital Singapore
- Duke‐National University of Singapore Medical School Singapore
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Mrzljak A, Dinjar-Kujundzic P, Jemersic L, Prpic J, Barbic L, Savic V, Stevanovic V, Vilibic-Cavlek T. Epidemiology of hepatitis E in South-East Europe in the "One Health" concept. World J Gastroenterol 2019; 25:3168-3182. [PMID: 31333309 PMCID: PMC6626717 DOI: 10.3748/wjg.v25.i25.3168] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Revised: 05/16/2019] [Accepted: 05/31/2019] [Indexed: 02/06/2023] Open
Abstract
The significance of hepatitis E virus (HEV) as an important public health problem is rising. Until a decade ago, cases of HEV infection in Eur-ope were mainly confined to returning travelers, but nowadays, hepatitis E represents an emerging zoonotic infection in many European countries. The aim of this manuscript is to perform a systematic review of the published literature on hepatitis E distribution in humans, animals and environmental samples ("One Health" concept) in the South-Eastern European countries. Comparison of the available data showed that the anti-HEV seroprevalence in the South-Eastern Europe varies greatly, depending on the population studied, geographical area and methods used. The IgG seroprevalence rates in different population groups were found to be 1.1%-24.5% in Croatia, up to 20.9% in Bulgaria, 5.9-%17.1% in Romania, 15% in Serbia, up to 9.7% in Greece and 2%-9.7% in Albania. Among possible risk factors, older age was the most significant predictor for HEV seropositivity in most studies. Higher seroprevalence rates were found in animals. HEV IgG antibodies in domestic pigs were detected in 20%-54.5%, 29.2%-50%, 38.94%-50% and 31.1%-91.7% in Serbia, Bulgaria, Romania and Croatia, respectively. In wild boars seroprevalence rates were up to 10.3%, 30.3% and 31.1% in Romania, Slovenia and Croatia, respectively. A high HEV RNA prevalence in wild boars in some countries (Croatia and Romania) indicated that wild boars may have a key role in the HEV epidemiology. There are very few data on HEV prevalence in environmental samples. HEV RNA was detected in 3.3% and 16.7% surface waters in Slovenia and Serbia, respectively. There is no evidence of HEV RNA in sewage systems in this region. The available data on genetic characterization show that human, animal and environmental HEV strains mainly belong to the genotype 3.
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Affiliation(s)
- Anna Mrzljak
- Department of Medicine, Merkur University Hospital; School of Medicine, University of Zagreb, Zagreb 10000, Grad Zagreb, Croatia
| | | | - Lorena Jemersic
- Croatian Veterinary Institute, Zagreb 10000, Grad Zagreb, Croatia
| | - Jelena Prpic
- Croatian Veterinary Institute, Zagreb 10000, Grad Zagreb, Croatia
| | - Ljubo Barbic
- Faculty of Veterinary Medicine, University of Zagreb, Zagreb 10000, Grad Zagreb, Croatia
| | - Vladimir Savic
- Croatian Veterinary Institute, Zagreb 10000, Grad Zagreb, Croatia
| | - Vladimir Stevanovic
- Faculty of Veterinary Medicine, University of Zagreb, Zagreb 10000, Grad Zagreb, Croatia
| | - Tatjana Vilibic-Cavlek
- Department of Virology, Croatian Institute of Public Health; School of Medicine, University of Zagreb, Zagreb 10000, Grad Zagreb, Croatia
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Rivadulla E, Varela MF, Mesquita JR, Nascimento MSJ, Romalde JL. Detection of Hepatitis E Virus in Shellfish Harvesting Areas from Galicia (Northwestern Spain). Viruses 2019; 11:618. [PMID: 31284466 PMCID: PMC6669863 DOI: 10.3390/v11070618] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 07/01/2019] [Accepted: 07/03/2019] [Indexed: 12/23/2022] Open
Abstract
The hepatitis E virus (HEV) affects almost 20 million individuals annually, causing approximately 3.3 million acute liver injuries, 56,600 deaths, and huge healthcare-associated economic losses. Shellfish produced close to urban and livestock areas can bioaccumulate this virus and transmit it to the human population. The aim of this study was to evaluate the presence of HEV in molluscan shellfish, in order to deepen the knowledge about HEV prevalence in Galicia (northwestern Spain), and to investigate this as a possible route of HEV transmission to humans. A total of 168 shellfish samples was obtained from two different Galician rías (Ría de Ares-Betanzos and Ría de Vigo). The samples were analyzed by reverse transcription-quantitative PCR (RT-qPCR). RT-nested PCR and sequencing were used for further genotyping and phylogenetic analysis of positive samples. HEV was detected in 41 (24.4%) samples, at quantification levels ranging from non-quantifiable (<102 copies of the RNA genome (RNAc)/g tissue) to 1.1 × 105 RNAc/g tissue. Phylogenetic analysis based on the open reading frame (ORF)2 region showed that all sequenced isolates belonged to genotype 3, and were closely related to strains of sub-genotype e, which is of swine origin. The obtained results demonstrate a significant prevalence of HEV in bivalve molluscs from Galician rías, reinforcing the hypothesis that shellfish may be a potential route for HEV transmission to humans.
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Affiliation(s)
- Enrique Rivadulla
- Departamento de Microbiología y Parasitología, CIBUS-Facultad de Biología, Universidade de Santiago de Compostela, 15782 Santiago de Compostela, Spain
| | - Miguel F Varela
- Departamento de Microbiología y Parasitología, CIBUS-Facultad de Biología, Universidade de Santiago de Compostela, 15782 Santiago de Compostela, Spain
| | - João R Mesquita
- Instituto de Ciências Biomédicas Abel Salazar (ICBAS), Universidade do Porto, 4050-313 Porto, Portugal
- Epidemiology Research Unit (EPIUnit), Instituto de Saúde Pública da Universidade do Porto, 4050-600 Porto, Portugal
| | - Maria S J Nascimento
- Epidemiology Research Unit (EPIUnit), Instituto de Saúde Pública da Universidade do Porto, 4050-600 Porto, Portugal
- Laboratório de Microbiologia, Departamento de Ciências Biológicas, Faculdade de Farmácia, Universidade do Porto, 4050-313 Porto, Portugal
| | - Jesús L Romalde
- Departamento de Microbiología y Parasitología, CIBUS-Facultad de Biología, Universidade de Santiago de Compostela, 15782 Santiago de Compostela, Spain.
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The Current Host Range of Hepatitis E Viruses. Viruses 2019; 11:v11050452. [PMID: 31108942 PMCID: PMC6563279 DOI: 10.3390/v11050452] [Citation(s) in RCA: 68] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Revised: 05/08/2019] [Accepted: 05/14/2019] [Indexed: 01/01/2023] Open
Abstract
Hepatitis E virus (HEV) is an emerging zoonotic pathogen transmitting both human to human via the fecal oral route and from animals to humans through feces, direct contact, and consumption of contaminated meat products. Understanding the host range of the virus is critical for determining where potential threats to human health may be emerging from and where potential reservoirs for viral persistence in the environment may be hiding. Initially thought to be a human specific disease endemic to developing countries, the identification of swine as a primary host for genotypes 3 and 4 HEV in industrialized countries has begun a long journey of discovering novel strains of HEV and their animal hosts. As we continue identifying new strains of HEV in disparate animal species, it is becoming abundantly clear that HEV has a broad host range and many of these HEV strains can cross between differing animal species. These cross-species transmitting strains pose many unique challenges to human health as they are often unrecognized as sources of viral transmission.
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Tengan FM, Figueiredo GM, Nunes AKS, Manchiero C, Dantas BP, Magri MC, Prata TVG, Nascimento M, Mazza CC, Abdala E, Barone AA, Bernardo WM. Seroprevalence of hepatitis E in adults in Brazil: a systematic review and meta-analysis. Infect Dis Poverty 2019; 8:3. [PMID: 30646964 PMCID: PMC6334402 DOI: 10.1186/s40249-018-0514-4] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Accepted: 12/25/2018] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Hepatitis E virus (HEV) is a member of the Hepeviridae family; it has four main genotypes and one serotype. While genotypes 1 and 2 cause epidemic hepatitis and are transmitted via water and the fecal-oral route, genotypes 3 and 4 are zoonotic. In the various seroprevalence studies of hepatitis E in Brazil, the numbers reported vary widely and are difficult to interpret. The aim of this study was to analyze existing seroprevalence studies of hepatitis E in adults in Brazil. MAIN TEXT We searched the PubMed, Latin American and Caribbean Health Sciences and Embase databases for studies published from inception to May 12, 2018 concerning infection by HEV in Brazil without time period or language restrictions. We included studies that presented data concerning hepatitis E seroprevalence in adults in Brazil, had a sample size ≥50 patients and whose method used for the detection of anti-HEV was standardized and commercialized. We also evaluated the quality of the articles using a list of criteria that totalized 9 items. Of the 20 studies ultimately analyzed, 10 (50%) were from the southeast region of Brazil, 3 (15%) were from the central-west region, 3 (15%) were from the northern region, 2 (10%) were from the northeast region and 2 (10%) were from the southern region. Regarding the quality evaluation of the studies, the mean score was 5.6 (range: 4-8). The estimated overall seroprevalence of HEV infection in the adult population was 6.0% (95% CI: 5.0-7.0); in subgroup analyses, we observed that the prevalence of anti-HEV antibodies in blood donors was 7.0% (95% CI: 5.0-8.0), whereas in the general population, it was 3.0% (95% CI: 2.0-4.0). CONCLUSIONS The results of this systematic review indicate that there should be national investment in the prevention of hepatitis E virus infection in Brazil, including the implementation of improvements in basic sanitation and guidance regarding the appropriate handling of animal waste and the optimal cooking of vegetables, meat and their derivatives.
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Affiliation(s)
- Fátima Mitiko Tengan
- Department of Infectious and Parasitic Diseases, School of Medicine, University of São Paulo (Universidade de São Paulo - USP), São Paulo, SP Brazil
- Laboratory of Viral Medical Research in Hepatology (Laboratório de Investigação Médica em Hepatologia por vírus - LIM-47), Clinics Hospital, School of Medicine, USP, São Paulo, SP Brazil
| | - Gerusa M. Figueiredo
- Instituto de Medicina Tropical da Universidade de Sao Paulo, São Paulo, SP Brazil
| | - Arielle K. S. Nunes
- Laboratory of Viral Medical Research in Hepatology (Laboratório de Investigação Médica em Hepatologia por vírus - LIM-47), Clinics Hospital, School of Medicine, USP, São Paulo, SP Brazil
| | - Carol Manchiero
- Laboratory of Viral Medical Research in Hepatology (Laboratório de Investigação Médica em Hepatologia por vírus - LIM-47), Clinics Hospital, School of Medicine, USP, São Paulo, SP Brazil
| | - Bianca P. Dantas
- Laboratory of Viral Medical Research in Hepatology (Laboratório de Investigação Médica em Hepatologia por vírus - LIM-47), Clinics Hospital, School of Medicine, USP, São Paulo, SP Brazil
| | - Mariana C. Magri
- Laboratory of Viral Medical Research in Hepatology (Laboratório de Investigação Médica em Hepatologia por vírus - LIM-47), Clinics Hospital, School of Medicine, USP, São Paulo, SP Brazil
| | - Thamiris V. G. Prata
- Laboratory of Viral Medical Research in Hepatology (Laboratório de Investigação Médica em Hepatologia por vírus - LIM-47), Clinics Hospital, School of Medicine, USP, São Paulo, SP Brazil
| | - Marisa Nascimento
- Nursing Division, Clinics Hospital, School of Medicine, USP, São Paulo, SP Brazil
| | - Celso C. Mazza
- Department of Infectious and Parasitic Diseases, School of Medicine, University of São Paulo (Universidade de São Paulo - USP), São Paulo, SP Brazil
- Laboratory of Viral Medical Research in Hepatology (Laboratório de Investigação Médica em Hepatologia por vírus - LIM-47), Clinics Hospital, School of Medicine, USP, São Paulo, SP Brazil
| | - Edson Abdala
- Department of Infectious and Parasitic Diseases, School of Medicine, University of São Paulo (Universidade de São Paulo - USP), São Paulo, SP Brazil
- Laboratory of Viral Medical Research in Hepatology (Laboratório de Investigação Médica em Hepatologia por vírus - LIM-47), Clinics Hospital, School of Medicine, USP, São Paulo, SP Brazil
| | - Antonio A. Barone
- Department of Infectious and Parasitic Diseases, School of Medicine, University of São Paulo (Universidade de São Paulo - USP), São Paulo, SP Brazil
- Laboratory of Viral Medical Research in Hepatology (Laboratório de Investigação Médica em Hepatologia por vírus - LIM-47), Clinics Hospital, School of Medicine, USP, São Paulo, SP Brazil
| | - Wanderley M. Bernardo
- School of Medicine, USP, São Paulo, SP Brazil
- Brazilian Medical Association (AMB), São Paulo, SP Brazil
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Abstract
Hepatitis E virus (HEV) is an important human pathogen that historically has been difficult to study. Limited levels of replication in vitro hindered our understanding of the viral life cycle. Sporadic and low-level virus shedding, lack of standardized detection methods, and subclinical infections made the development of animal models difficult. Better diagnostic techniques and understanding of the virus increased our ability to identify and characterize animal strains and animals that are amenable to model human-relevant infection. These advances are translating into the development of useful HEV animal models so that some of the greatest concerns associated with HEV infection, including host immunology, chronic infection, severe pregnancy mortality, and extrahepatic manifestations, can now be studied. Continued development of these animal models will be instrumental in understanding the many complex questions associated with HEV infection and for assessing therapeutics and prevention strategies to minimize HEV becoming a greater risk to the human population.
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Affiliation(s)
- Scott P Kenney
- Food Animal Health Research Program, College of Veterinary Medicine, Ohio State University, Wooster, Ohio 44691, USA;
| | - Xiang-Jin Meng
- Virginia-Maryland College of Veterinary Medicine, Virginia Polytechnic Institute and State University, Blacksburg, Virginia 24060, USA;
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40
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Antia RE, Adekola AA, Jubril AJ, Ohore OG, Emikpe BO. Hepatitis E Virus infection seroprevalence and the associated risk factors in animals raised in Ibadan, Nigeria. J Immunoassay Immunochem 2018; 39:509-520. [PMID: 30212262 DOI: 10.1080/15321819.2018.1514507] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Hepatitis E (HE) is an important viral hepatitis of global public and livestock health, and food security significance due to the ubiquitous distribution, multiple transmission route and zoonotic potentials. HE is also endemic in most developing countries including Nigeria. This study therefore investigates the seroprevalence and associated risk factors of HEV infection in pigs raised in Ibadan, Nigeria. Taking an analytical cross-sectional study design, 176 animals (comprising 120 pigs, 26 goats, and 30 cattle) were randomly sampled at the Bodija Municipal abattoir, Ibadan. Serum samples and demographic information were collected for HEV antibody detection (using a commercial recombinant genotype-3 antigen ELISA kit) and risk factors, respectively. A 57.5% (69/120) HEV seroprevalence was reported in the pigs while 0% prevalence was reported in the goats and cattle. In the pigs, a significant age-based HEV seropositivity difference (χ2 = 5.30; OR = 0.20-0.89; p = 0.02) with a higher seroprevalence in the < 6 months (68.42%; 39/57) compared to the > 6 months age group (47.62%; 20/63) was reported. No significant sex, breed and husbandry system effect on HEV seroprevalence was detected in the pigs. This study therefore underscores the high HEV seroprevalence and age-based odds of HEV-exposure in pigs in Ibadan, Nigeria.
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Affiliation(s)
- Richard Edem Antia
- a Department of Veterinary Pathology , University of Ibadan , Ibadan , Nigeria
| | | | - Afusat Jagun Jubril
- a Department of Veterinary Pathology , University of Ibadan , Ibadan , Nigeria
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41
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King NJ, Hewitt J, Perchec-Merien AM. Hiding in Plain Sight? It's Time to Investigate Other Possible Transmission Routes for Hepatitis E Virus (HEV) in Developed Countries. FOOD AND ENVIRONMENTAL VIROLOGY 2018; 10:225-252. [PMID: 29623595 DOI: 10.1007/s12560-018-9342-8] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2017] [Accepted: 03/29/2018] [Indexed: 06/08/2023]
Abstract
Historically in developed countries, reported hepatitis E cases were typically travellers returning from countries where hepatitis E virus (HEV) is endemic, but now there are increasing numbers of non-travel-related ("autochthonous") cases being reported. Data for HEV in New Zealand remain limited and the transmission routes unproven. We critically reviewed the scientific evidence supporting HEV transmission routes in other developed countries to inform how people in New Zealand may be exposed to this virus. A substantial body of indirect evidence shows domesticated pigs are a source of zoonotic human HEV infection, but there is an information bias towards this established reservoir. The increasing range of animals in which HEV has been detected makes it important to consider other possible animal reservoirs of HEV genotypes that can or could infect humans. Foodborne transmission of HEV from swine and deer products has been proven, and a large body of indirect evidence (e.g. food surveys, epidemiological studies and phylogenetic analyses) support pig products as vehicles of HEV infection. Scarce data from other foods suggest we are neglecting other potential sources of foodborne HEV infection. Moreover, other transmission routes are scarcely investigated in developed countries; the role of infected food handlers, person-to-person transmission via the faecal-oral route, and waterborne transmission from recreational contact or drinking untreated or inadequately treated water. People have become symptomatic after receiving transfusions of HEV-contaminated blood, but it is unclear how important this is in the overall hepatitis E disease burden. There is need for broader research efforts to support establishing risk-based controls.
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Affiliation(s)
- Nicola J King
- Institute of Environmental Science and Research, 34 Kenepuru Drive, Kenepuru, Porirua, 5022, New Zealand
| | - Joanne Hewitt
- Institute of Environmental Science and Research, 34 Kenepuru Drive, Kenepuru, Porirua, 5022, New Zealand.
| | - Anne-Marie Perchec-Merien
- New Zealand Ministry for Primary Industries, Pastoral House, 25 The Terrace, Wellington, New Zealand
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42
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Kantala T, Maunula L. Hepatitis E virus: zoonotic and foodborne transmission in developed countries. Future Virol 2018. [DOI: 10.2217/fvl-2018-0062] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Hepatitis E virus (HEV), together with hepatitis A virus, transmits via the fecal–oral route. The number of domestic hepatitis E cases among Europeans has grown alarmingly during the past 5 years. Surveillance studies suggest that the number of foodborne HEV infections is increasing most rapidly. Zoonotic HEV genotype HEV-3 is prevalent among pigs and wild boars in Europe and many developed countries, whereas zoonotic genotype HEV-4 is more common in pigs in some Asian countries. This review presents the most recent data about possible foodborne transmission of HEV via pigs and other production animals and about the presence of HEV in high-risk foods, such as ready-to-eat meat products. Possible solutions about how to tackle this problem are discussed here.
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Affiliation(s)
- Tuija Kantala
- Department of Food Hygiene & Environmental Health, Faculty of Veterinary Medicine, University of Helsinki, P.O. Box 66, FI-00014, Helsinki, Finland
- Finnish Food Safety Authority Evira, Mustialankatu 3, FI-00790 Helsinki, Finland
| | - Leena Maunula
- Department of Food Hygiene & Environmental Health, Faculty of Veterinary Medicine, University of Helsinki, P.O. Box 66, FI-00014, Helsinki, Finland
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43
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O'Hara Z, Crossan C, Craft J, Scobie L. First Report of the Presence of Hepatitis E Virus in Scottish-Harvested Shellfish Purchased at Retail Level. FOOD AND ENVIRONMENTAL VIROLOGY 2018; 10:217-221. [PMID: 29442296 PMCID: PMC5951870 DOI: 10.1007/s12560-018-9337-5] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Accepted: 01/19/2018] [Indexed: 05/21/2023]
Abstract
Shellfish samples (n = 310) purchased from local supermarkets were analysed for the presence of hepatitis E virus (HEV) by nested RT-PCR and real-time qRT-PCR. Overall, 2.9% of samples tested positive for the presence of HEV. Phylogenetic analysis of HEV sequences revealed all as being genotype 3 HEV. This is the first report of the detection of HEV in commercially sold shellfish in Scotland. These findings may encourage further research that will help address the gaps in the knowledge in respect to foodborne transmission of HEV in Scotland and the rest of the United Kingdom.
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Affiliation(s)
- Zoe O'Hara
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, Scotland, UK.
| | - Claire Crossan
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, Scotland, UK
| | - John Craft
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, Scotland, UK
| | - Linda Scobie
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, Scotland, UK
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44
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Hepatitis E in High-Income Countries: What Do We Know? And What Are the Knowledge Gaps? Viruses 2018; 10:v10060285. [PMID: 29799485 PMCID: PMC6024799 DOI: 10.3390/v10060285] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Revised: 05/16/2018] [Accepted: 05/23/2018] [Indexed: 12/11/2022] Open
Abstract
Hepatitis E virus (HEV) is a positive-strand RNA virus transmitted by the fecal–oral route. HEV genotypes 1 and 2 infect only humans and cause mainly waterborne outbreaks. HEV genotypes 3 and 4 are widely represented in the animal kingdom, and are mainly transmitted as a zoonosis. For the past 20 years, HEV infection has been considered an imported disease in developed countries, but now there is evidence that HEV is an underrecognized pathogen in high-income countries, and that the incidence of confirmed cases has been steadily increasing over the last decade. In this review, we describe current knowledge about the molecular biology of HEV, its clinical features, its main routes of transmission, and possible therapeutic strategies in developed countries.
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45
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Rodríguez-Lázaro D, Hernandez M, Cook N. Hepatitis E Virus: A New Foodborne Zoonotic Concern. ADVANCES IN FOOD AND NUTRITION RESEARCH 2018; 86:55-70. [PMID: 30077224 DOI: 10.1016/bs.afnr.2018.04.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Hepatitis E virus (HEV) is an enteric nonenveloped single-stranded RNA virus. Among the mammalian lineages, four genotypes are associated to human infection: genogroups 1 and 2 infect only humans and are mainly found in developing countries, while genogroups 3 and 4 are zoonotic, being found in a variety of animal species including pigs, and are autochthonous in developed countries. HEV infection can result in liver damage and with genotypes 1 and 2 symptoms can be particularly severe in pregnant women, with a high lethality ratio. Several cases of foodborne transmission of hepatitis E have been reported, often involving consumption of meat, especially raw or undercooked. Information is lacking on the exact extent of foodborne transmission of HEV.
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Affiliation(s)
- David Rodríguez-Lázaro
- Microbiology Division, Department of Biotechnology and Food Science, University of Burgos, Burgos, Spain.
| | - Marta Hernandez
- Microbiology Division, Department of Biotechnology and Food Science, University of Burgos, Burgos, Spain; Laboratory of Molecular Biology and Microbiology, ITACyL, Valladolid, Spain
| | - Nigel Cook
- Jorvik Food and Environmental Virology, York, United Kingdom
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46
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La Rosa G, Proroga YTR, De Medici D, Capuano F, Iaconelli M, Della Libera S, Suffredini E. First Detection of Hepatitis E Virus in Shellfish and in Seawater from Production Areas in Southern Italy. FOOD AND ENVIRONMENTAL VIROLOGY 2018; 10:127-131. [PMID: 28956272 DOI: 10.1007/s12560-017-9319-z] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Accepted: 09/23/2017] [Indexed: 05/21/2023]
Abstract
Shellfish samples (n = 384) from production areas, water samples from the same areas (n = 39) and from nearby sewage discharge points (n = 29) were analyzed for hepatitis E virus (HEV) by real-time and nested RT-PCR. Ten shellfish samples (2.6%) and five seawater samples (12.8%) tested positive for HEV; all characterized strains were G3 and showed high degree of sequence identity. An integrated surveillance in seafood and waters is relevant to reduce the risk of shellfish-associated illnesses.
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Affiliation(s)
- G La Rosa
- Department of Environment and Health, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy.
| | - Y T R Proroga
- Department of Food Inspection, Istituto Zooprofilattico Sperimentale del Mezzogiorno, Via della Salute 2, 80055, Portici, Italy
| | - D De Medici
- Department of Food Safety, Nutrition and Veterinary Public Health, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy
| | - F Capuano
- Department of Food Inspection, Istituto Zooprofilattico Sperimentale del Mezzogiorno, Via della Salute 2, 80055, Portici, Italy
| | - M Iaconelli
- Department of Environment and Health, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy
| | - S Della Libera
- Department of Environment and Health, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy
| | - E Suffredini
- Department of Food Safety, Nutrition and Veterinary Public Health, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy.
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47
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De Winter BCM, Hesselink DA, Kamar N. Dosing ribavirin in hepatitis E-infected solid organ transplant recipients. Pharmacol Res 2018; 130:308-315. [PMID: 29499270 DOI: 10.1016/j.phrs.2018.02.030] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Revised: 02/06/2018] [Accepted: 02/26/2018] [Indexed: 12/22/2022]
Abstract
Hepatitis E virus (HEV) is the most common cause of viral hepatitis worldwide. Genotypes 1 and 2 (GT1 and GT2) are mainly present in developing countries, while GT3 and GT4 are prevalent in developed and high-income countries. In the majority of cases, HEV causes a self-limiting hepatitis. GT3 and GT4 can be responsible for a chronic hepatitis that can lead to cirrhosis in immunocompromized patients, i.e. solid-organ- and stem-cell-transplant-patients, human immunodeficiency virus-infected patients, and patients receiving chemotherapy or immunotherapy. HEV has also been associated with extra-hepatic manifestations such as neurologic disorders (Guillain-Barré Syndrome and neuralgic amyotrophy) and kidney disease. In patients with chronic hepatitis, reduction of immunosuppression, when possible, is the first therapeutic option. In the remaining patients, ribavirin therapy has been shown to very efficient for treating HEV infection leading to a sustained virological response in nearly 80-85% of patients. However, the mechanism of action of ribavirin in this setting is still unknown, as is the impact of HEV RNA polymerase mutations. There are unmet needs with regard to the treatment of chronic HEV with ribavirin. These include the optimal dosing and duration of treatment, and the potential beneficial effects of therapeutic drug monitoring on the virological response and the incidence of side effects. In the present review, we will provide an overview of HEV epidemiology, its mode of transmission and clinical manifestations, as well as its treatment by ribavirin with a focus on the drug's pharmacokinetics and dosing.
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Affiliation(s)
- Brenda C M De Winter
- Department of Hospital Pharmacy, Erasmus MC, University Medical Center Rotterdam, The Netherlands
| | - Dennis A Hesselink
- Department of Internal Medicine, Erasmus MC, University Medical Center Rotterdam, The Netherlands; Rotterdam Transplant Group, Division of Nephrology and Organ Transplantation, CHU Rangueil, INSERM U1043, IFR-BMT, Université Paul Sabatier, Toulouse, France
| | - Nassim Kamar
- Department of Internal Medicine, Division of Nephrology and Organ Transplantation, CHU Rangueil, INSERM U1043, IFR-BMT, Université Paul Sabatier, Toulouse, France.
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48
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O'Gorman J, Burke Á, O'Flaherty N. Hepatitis E virus - key points for the clinical haematologist. Br J Haematol 2018; 181:579-589. [PMID: 29468650 DOI: 10.1111/bjh.15133] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Accepted: 01/06/2018] [Indexed: 12/13/2022]
Abstract
In recent years there has been a paradigm shift in our understanding of the epidemiology and clinical features of hepatitis E virus (HEV) infection. Once classically described as an acute hepatitis associated with waterborne outbreaks in areas of poor sanitation, HEV is now recognised to be endemic in Europe and is probably zoonotic in origin. Evidence for transfusion-transmitted HEV has prompted the introduction of blood donor screening in a number of countries, but the risk to the haematology patient from food sources remains. The aim of this review therefore, is to equip the clinical haematologist with the knowledge required to diagnose HEV infection and to aid decision-making in patient management. The article also provides information on addressing patient concerns about their risk of acquiring hepatitis E and how this risk can be mitigated.
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Affiliation(s)
- Joanne O'Gorman
- Consultant Clinical Microbiologist, National Virus Reference Laboratory, University College Dublin, Dublin, Ireland
| | - Áine Burke
- Consultant Haematologist, Sligo University Hospital, Sligo, Ireland
| | - Niamh O'Flaherty
- Consultant Clinical Microbiologist, National Virus Reference Laboratory, University College Dublin, Dublin, Ireland.,Consultant Clinical Microbiologist, Irish Blood Transfusion Service, Dublin 8, Ireland
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49
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Romalde JL, Rivadulla E, Varela MF, Barja JL. An overview of 20 years of studies on the prevalence of human enteric viruses in shellfish from Galicia, Spain. J Appl Microbiol 2017; 124:943-957. [PMID: 29094428 DOI: 10.1111/jam.13614] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Revised: 10/10/2017] [Accepted: 10/11/2017] [Indexed: 12/12/2022]
Abstract
Galicia (NW Spain) has 1490 km of coastline, and its particular topography, characterized by the presence of fiord-like inlets, called rías, with an important primary production, makes this region very favourable for shellfish growth and culture. In fact, Galicia is one of the most important mussel producers in the world. Due to its proximity to cities and villages and the anthropogenic activities in these estuaries, and despite the routine official controls on the bivalve harvesting areas, contamination with material of faecal origin is sometimes possible but, current regulation based on Escherichia coli as an indicator micro-organism has been revealed as useful for bacterial contaminants, this is not the case for enteric viruses. The aim of this review is to offer a picture on the situation of different harvesting areas in Galicia, from a virological standpoint. A recompilation of results obtained in the last 20 years is presented, including not only the data for the well-known agents norovirus (NoV) and hepatitis A virus (HAV) but also data on emerging viral hazards, including sapovirus (SaV), hepatitis E virus (HEV) and aichivirus (AiV). Epidemiological differences related to diverse characteristics of the harvesting areas, viral genotype distribution or epidemiological links between environmental and clinical strains will also be presented and discussed. The presentation of these historical data all together could be useful for future decisions by competent authorities for a better management of shellfish growing areas.
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Affiliation(s)
- J L Romalde
- Departamento de Microbiología y Parasitología, CIBUS-Facultad de Biología, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
| | - E Rivadulla
- Departamento de Microbiología y Parasitología, CIBUS-Facultad de Biología, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
| | - M F Varela
- Departamento de Microbiología y Parasitología, CIBUS-Facultad de Biología, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
| | - J L Barja
- Departamento de Microbiología y Parasitología, CIBUS-Facultad de Biología, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
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50
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Nan Y, Wu C, Zhao Q, Zhou EM. Zoonotic Hepatitis E Virus: An Ignored Risk for Public Health. Front Microbiol 2017; 8:2396. [PMID: 29255453 PMCID: PMC5723051 DOI: 10.3389/fmicb.2017.02396] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Accepted: 11/20/2017] [Indexed: 12/27/2022] Open
Abstract
Hepatitis E virus (HEV) is a quasi-enveloped, single-stranded positive-sense RNA virus. HEV belongs to the family Hepeviridae, a family comprised of highly diverse viruses originating from various species. Since confirmation of HEV's zoonosis, HEV-induced hepatitis has been a public health concern both for developing and developed countries. Meanwhile, the demonstration of a broad host range for zoonotic HEV suggests the existence of a variety of transmission routes that could lead to human infection. Moreover, anti-HEV antibody serosurveillance worldwide demonstrates a higher than expected HEV prevalence rate that conflicts with the rarity and sporadic nature of reported acute hepatitis E cases. In recent years, chronic HEV infection, HEV-related acute hepatic failure, and extrahepatic manifestations caused by HEV infection have been frequently reported. These observations suggest a significant underestimation of the number and complexity of transmission routes previously predicted to cause HEV-related disease, with special emphasis on zoonotic HEV as a public health concern. Significant research has revealed details regarding the virology and infectivity of zoonotic HEV in both humans and animals. In this review, the discovery of HEV zoonosis, recent progress in our understanding of the zoonotic HEV host range, and classification of diverse HEV or HEV-like isolates from various hosts are reviewed in a historic context. Ultimately, this review focuses on current understanding of viral pathogenesis and cross-species transmission of zoonotic HEV. Moreover, host factors and viral determinants influencing HEV host tropism are discussed to provide new insights into HEV transmission and prevalence mechanisms.
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Affiliation(s)
- Yuchen Nan
- Department of Preventive Veterinary Medicine, College of Veterinary Medicine, Northwest A&F University, Xianyang, China
- Scientific Observing and Experimental Station of Veterinary Pharmacology and Diagnostic Technology, Ministry of Agriculture, Xianyang, China
| | - Chunyan Wu
- Department of Preventive Veterinary Medicine, College of Veterinary Medicine, Northwest A&F University, Xianyang, China
- Scientific Observing and Experimental Station of Veterinary Pharmacology and Diagnostic Technology, Ministry of Agriculture, Xianyang, China
| | - Qin Zhao
- Department of Preventive Veterinary Medicine, College of Veterinary Medicine, Northwest A&F University, Xianyang, China
- Scientific Observing and Experimental Station of Veterinary Pharmacology and Diagnostic Technology, Ministry of Agriculture, Xianyang, China
| | - En-Min Zhou
- Department of Preventive Veterinary Medicine, College of Veterinary Medicine, Northwest A&F University, Xianyang, China
- Scientific Observing and Experimental Station of Veterinary Pharmacology and Diagnostic Technology, Ministry of Agriculture, Xianyang, China
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