Novel Hepatitis E Virus in Ferrets, the Netherlands

Human hepatitis E virus (HEV) infections by genotype 3 strains in industrialized countries are hypothesized to be caused by pigs. To examine this hypothesis, the potential health risks of transmission routes should be examined. Possible foodborne transmission was studied by quantifying the presence and infectivity of HEV in commercial porcine livers in The Netherlands. A comparison of four tissue disruption and seven RNA extraction methods revealed that mechanical disruption followed by silica-based RNA extraction gave the highest RNA yields and was therefore employed on commercial porcine livers. Four (6.5%) of 62 porcine livers were HEV RNA positive by reverse transcriptase PCR and Southern blot hybridization. Each positive liver was estimated to contain ∼65 PCR-detectable units per g. Sequences were obtained for three of four positive livers and classified as HEV genotype 3. Ninety-three percent similarity to Dutch human HEV sequences and 97% similarity to Dutch swine HEV sequences were observed. To determine whether positive livers contained infectious HEV particles, extracts from livers with known HEV RNA sequences were inoculated intravenously in pigs. Two control pigs were included: one was inoculated with a high dose known to result in infection (104 PCR-detectable units of HEV RNA), and the other was inoculated with a lower concentration of virus that equaled the concentration of PCR-detectable units in commercial livers (∼20 PCR-detectable units). Infection was observed in the high-dose control, but not in other pigs, suggesting a dose-dependent response in pigs. Hence, the implications of HEV RNA in commercial porcine livers in The Netherlands are unknown. However, HEV RNA is present in commercial porcine livers, and sufficient heating of porcine livers before consumption as precautionary measure is recommended.

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Non-travel related Hepatitis E virus genotype 3 infections in the Netherlands; A case series 2004 – 2006

BMC Infectious Diseases ◽

10.1186/1471-2334-8-61 ◽

2008 ◽

Vol 8 (1) ◽

Cited By ~ 81

Author(s):

Katrine Borgen ◽

Tineke Herremans ◽

Erwin Duizer ◽

Harry Vennema ◽

Saskia Rutjes ◽

...

Keyword(s):

The Netherlands ◽

Hepatitis E Virus ◽

Case Series ◽

Hepatitis E ◽

Genotype 3 ◽

Virus Genotype

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Sources of Hepatitis E Virus Genotype 3 in the Netherlands

Emerging Infectious Diseases ◽

10.3201/eid1503.071472 ◽

2009 ◽

Vol 15 (3) ◽

pp. 381-387 ◽

Cited By ~ 106

Author(s):

Saskia A. Rutjes ◽

Willemijn J. Lodder ◽

Froukje Lodder-Verschoor ◽

Harold H.J.L. van den Berg ◽

Harry Vennema ◽

...

Keyword(s):

The Netherlands ◽

Hepatitis E Virus ◽

Hepatitis E ◽

Genotype 3 ◽

Virus Genotype

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Seroprevalence of hepatitis E antibodies and risk profile of HEV seropositivity in The Netherlands, 2006–2007

Epidemiology and Infection ◽

10.1017/s0950268811002913 ◽

2012 ◽

Vol 140 (10) ◽

pp. 1838-1847 ◽

Cited By ~ 33

Author(s):

L. VERHOEF ◽

M. KOOPMANS ◽

E. DUIZER ◽

J. BAKKER ◽

J. REIMERINK ◽

...

Keyword(s):

Multivariate Analysis ◽

Chronic Hepatitis ◽

The Netherlands ◽

Hepatitis E Virus ◽

Hepatitis E ◽

Risk Profile ◽

Older Age ◽

Industrialized Countries ◽

Vulnerable People ◽

Independent Association

SUMMARYHepatitis E virus (HEV) is now considered an endemic pathogen in industrialized countries, leading to acute and sometimes chronic hepatitis, mostly in vulnerable people. The endemic sources are unclear. A survey in The Netherlands in 2006–2007 showed a 1·9% seroprevalence of HEV antibodies measured by ELISA and confirmed by immunoblot in a nationwide sample. Overall, in 134/7072 (1·9%) seropositive individuals, older age (P<0·01), being male (P<0·01), working with patients (P=0·03), working with animals (P=0·07), recent diarrhoeal complaints (P=0·07) and adhering to a religion that considers pigs unclean (P<0·01) were independently associated with seropositivity in multivariate analysis. Sub-analysis of 59/4022 (1·5%) anti-HEV antibody-positive subjects with probable endemic exposure showed independent association with youngest household member being aged <5 years or between 19 and <65 years (P=0·05) in multivariate analysis. These findings may contribute to a better understanding of the sources of endemic HEV exposure, and also highlight the need for systematic epidemiological and serological evaluation of new cases.

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