scholarly journals Hepatitis E Outbreak in the Central Part of Italy Sustained by Multiple HEV Genotype 3 Strains, June–December 2019

Viruses ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 1159
Author(s):  
Anna Garbuglia ◽  
Roberto Bruni ◽  
Umbertina Villano ◽  
Francesco Vairo ◽  
Daniele Lapa ◽  
...  
Keyword(s):  
Temporal Distribution ◽  
Epidemiological Data ◽  
Hepatitis E ◽  
Genotype 3 ◽  
Pork Products ◽  
The Past ◽  
Italian Regions ◽  
Sporadic Cases ◽  
Acute Hepatitis E ◽  
Viral Sequences

In European countries, autochthonous acute hepatitis E cases are caused by Hepatitis E Virus (HEV) genotype 3 and are usually observed as sporadic cases. In mid/late September 2019, a hepatitis E outbreak caused by HEV genotype 3 was recognized by detection of identical/highly similar HEV sequences in some hepatitis E cases from two Italian regions, Abruzzo and Lazio, with most cases from this latter region showing a link with Abruzzo. Overall, 47 cases of HEV infection were finally observed with onsets from 8 June 2019 to 6 December 2019; they represent a marked increase as compared with just a few cases in the same period of time in the past years and in the same areas. HEV sequencing was successful in 35 cases. The phylogenetic analysis of the viral sequences showed 30 of them grouped in three distinct molecular clusters, termed A, B, and C: strains in cluster A and B were of subtype 3e and strains in cluster C were of subtype 3f. No strains detected in Abruzzo in the past years clustered with the strains involved in the present outbreak. The outbreak curve showed partially overlapped temporal distribution of the three clusters. Analysis of collected epidemiological data identified pork products as the most likely source of the outbreak. Overall, the findings suggest that the outbreak might have been caused by newly and almost simultaneously introduced strains not previously circulating in this area, which are possibly harbored by pork products or live animals imported from outside Abruzzo. This possibility deserves further studies in this area in order to monitor the circulation of HEV in human cases as well as in pigs and wild boars.

scholarly journals Pork products associated with human infection caused by an emerging phylotype of hepatitis E virus in England and Wales

2017 ◽  
Vol 145 (12) ◽  
pp. 2417-2423 ◽  
Author(s):  
B. SAID ◽  
M. USDIN ◽  
F. WARBURTON ◽  
S. IJAZ ◽  
R.S. TEDDER ◽  
...  
Keyword(s):  
Hepatitis E Virus ◽  
Animal Husbandry ◽  
Epidemiological Data ◽  
Hepatitis E ◽  
Human Infection ◽  
Genotype 3 ◽  
Virus Genotype ◽  
England And Wales ◽  
Pork Products ◽  
The Uk

SUMMARYSince 2010, human hepatitis E infections have increased in England and Wales. Most cases are locally acquired and caused by hepatitis E virus genotype 3 (HEV G3). HEV G3 is linked to the consumption of pork products. The increase is associated with the emergence of a new phylotype, HEV G3-group 2 (G3-2, also known as G3abcdhij). Sixty individuals with confirmed hepatitis E infection and no history of travel outside the UK were recruited: 19 were infected with HEV G3-group 1 (G3-1 or G3efg) and 41 with G3-2. Epidemiological data relating to usual shopping habits and consumption of ham and sausages were analysed together with typing data to identify any associations with HEV phylotype. Study participants who purchased ham and/or sausage from a major supermarket were more likely to have HEV G3-2 infection (Relative risks 1·85, P = 0·06, CI 0·97–3·53). The HEV G3-2 phylotype has not been detected in indigenous UK pigs and it is suggested that human infections could be the result of consumption of products made from pork originating outside the UK. This does not infer blame on the supermarket but the epidemiology of HEV is dynamic and reflects complex animal husbandry practices which need to be explored further.

scholarly journals Hepatitis E Virus Occurrence in Pigs Slaughtered in Italy

Animals ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 277
Author(s):  
Eleonora Chelli ◽  
Elisabetta Suffredini ◽  
Paola De Santis ◽  
Dario De Medici ◽  
Santina Di Bella ◽  
...  
Keyword(s):  
Hepatitis E Virus ◽  
Phylogenetic Analyses ◽  
Hepatitis E ◽  
Rt Pcr ◽  
High Seroprevalence ◽  
Genotype 3 ◽  
Sporadic Cases ◽  
Wild Boar Meat ◽  
Small Clusters ◽  
Frequent Exposure

In Europe, foodborne transmission has been clearly associated to sporadic cases and small clusters of hepatitis E in humans linked to the consumption of contaminated pig liver sausages, raw venison, or undercooked wild boar meat. In Europe, zoonotic HEV-genotype 3 strains are widespread in pig farms but little information is available on the prevalence of HEV positive pigs at slaughterhouse. In the present study, the prevalence of HEV-RNA positive pigs was assessed on 585 animals from 4 abattoirs located across Italy. Twenty-one pigs (3.6%) tested positive for HEV in either feces or liver by real-time RT-PCR. In these 21 pigs, eight diaphragm muscles resulted positive for HEV-RNA. Among animals collected in one abattoir, 4 out of 91 plasma tested positive for HEV-RNA. ELISA tests for the detection of total antibodies against HEV showed a high seroprevalence (76.8%), confirming the frequent exposure of pigs to the virus. The phylogenetic analyses conducted on sequences of both ORF1 and ORF2 fragments, shows the circulation of HEV-3c and of a novel unclassified subtype. This study provides information on HEV occurrence in pigs at the slaughterhouse, confirming that muscles are rarely contaminated by HEV-RNA compared to liver, which is the most frequently positive for HEV.

scholarly journals An Epidemiologic Investigation of a Case of Acute Hepatitis E

2015 ◽  
Vol 53 (11) ◽  
pp. 3547-3552 ◽  
Author(s):  
Souvik Sarkar ◽  
Elenita M. Rivera ◽  
Ronald E. Engle ◽  
Hanh T. Nguyen ◽  
Cathy A. Schechterly ◽  
...  
Keyword(s):  
Acute Hepatitis ◽  
Blood Donors ◽  
Hepatitis E ◽  
Transmission Risk ◽  
Genotype 3 ◽  
Modes Of Transmission ◽  
Parenteral Transmission ◽  
Potential Mode ◽  
Acute Hepatitis E ◽  
Animal Handlers

Hepatitis E virus (HEV) is considered a zoonotic infection in developed nations. A case of acute hepatitis E in a researcher following a scalpel injury while working on a pig prompted a seroepidemiologic study to identify potential modes of transmission and determine the seroprevalence of HEV among animal handlers at the institute. Sera from personnel (n= 64) in two animal facilities and age/sex-matched blood donors (n= 63) as controls were tested for IgG anti-HEV and, if positive, for IgM anti-HEV and HEV RNA. Sera and stool from pigs aged 6 to 12 weeks from the breeding farm and older pigs from animal facilities were tested similarly. The median age of personnel was 36 years, 74% were white, 56% were male, and 74% had direct exposure to pigs. The prevalence of anti-HEV was 3.1% among personnel compared to 3.2% among blood donors; none were positive for IgM anti-HEV or HEV RNA. IgG anti-HEV was detected in sera from 10% of pigs aged 6 to 8 weeks, 80% aged 10 weeks, 100% aged 12 weeks, and 76% aged >12 weeks. HEV RNA was detected in stool but not sera from three 12-week-old pigs. Sequencing revealed HEV genotype 3 with ∼10% difference between the patient and pig sequences. Parenteral transmission is a potential mode of acute HEV infection. The low and similar seroprevalence of anti-HEV between the at-risk group and age-matched blood donors suggests low transmission risk with universal precautions among animal handlers.

scholarly journals Hepatitis E virus infection in 6-month-old pigs in Taiwan

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Ming-Hui Liao ◽  
Fang-Tzy Wu ◽  
Huimin Bai ◽  
Yen Hai Doan ◽  
Jyh-Yuan Yang ◽  
...  
Keyword(s):  
Hepatitis E Virus ◽  
Phylogenetic Analyses ◽  
Hepatitis E ◽  
Limited Information ◽  
Genotype 3 ◽  
Entire Genome ◽  
Entire Genome Sequence ◽  
Detection Frequency ◽  
Pig Farms ◽  
Acute Hepatitis E

Abstract Hepatitis E virus (HEV) is the causative agent of acute hepatitis E. Genotype 3 (G3) and 4 (G4) HEV have recently been identified in and isolated from swine as the main HEV genotypes worldwide. However, there is limited information on HEV infection status among pigs in Taiwan, especially pigs in the stage before transportation to the slaughterhouse. To determine the frequency of HEV infection among pigs in Taiwan, we detected and quantified HEV RNA contained in 295 fecal specimens collected from 6-month-old pigs bred in 30 pig farms located in 8 counties. We found that 25.1% (74/295) of the fecal specimens were positive for HEV RNA by a quantitative real-time reverse transcription-polymerase chain reaction, and the copy number ranged from 2.3 × 103 to 2.08 × 107 copies/g. Amplification of a 338 bp sequence in ORF2 was achieved in 16 of 74 HEV RNA-positive samples, and their nucleotide sequences were determined. Two HEV sequences appeared to belong to subtype 3a of G3 and the remaining 14 HEV sequences belonged to subtype 4b of G4 (G4b). The entire genome sequence of two G4b HEVs was obtained by next-generation sequence analyses, and the phylogenetic analyses indicated that unique G4b HEVs were circulating in pig farms in Taiwan. In the present study, we found that both G3 and G4 HEVs were circulating in Taiwanese pig farms and G4b was the predominant subtype. In addition, the relatively high detection frequency of HEV RNA in the 6-month-old pigs indicated that Taiwanese pigs just before transportation to the slaughterhouse are at risk of carrying HEVs, and thus thorough cooking or heating of pork meat or organs is needed before consumption in Taiwan and possibly in other countries as well.

scholarly journals Hepatitis E virus in Italy: molecular analysis of travel-related and autochthonous cases

2011 ◽  
Vol 92 (7) ◽  
pp. 1617-1626 ◽  
Author(s):  
Giuseppina La Rosa ◽  
Michele Muscillo ◽  
Valentina Spuri Vennarucci ◽  
Anna Rosa Garbuglia ◽  
Patrizia La Scala ◽  
...  
Keyword(s):  
Acute Hepatitis ◽  
Hepatitis E Virus ◽  
Hepatitis E ◽  
The Body ◽  
Industrialized Countries ◽  
Genotype 3 ◽  
Serum Samples ◽  
Specific Primers ◽  
Body Of Knowledge ◽  
Acute Hepatitis E

Human hepatitis E virus (HEV) is considered an emerging pathogen in industrialized countries. The aim of the present study was to contribute to the body of knowledge available on the molecular epidemiology of acute hepatitis E in Italy. Three sets of HEV-specific primers targeting the ORF1 and ORF2 were used to examine serum samples collected from acute hepatitis patients positive for anti-HEV IgG and/or IgM, between 2007 and 2010. Seventeen patients (39.5 %) tested HEV RNA-positive: 12 infections, due to genotype 1, were associated with travel to endemic areas (Bangladesh, India and Pakistan), while five infections, due to genotype 3, were presumably autochthonous. Risk factors identified in this group included exposure to raw seafood, pork liver sausages and wild boar. Results from the present study confirm that human HEV infection in Italy is caused by different genotypes, depending on whether the infection is travel-related or autochthonous.

scholarly journals A26 Molecular epidemiology of hepatitis E virus in Ireland 2016

2019 ◽  
Vol 5 (Supplement_1) ◽  
Author(s):  
Charlene Bennett ◽  
Linda Dunford ◽  
Suzie Coughlan ◽  
Cillian De Gascun ◽  
Joanne O’Gorman
Keyword(s):  
Molecular Epidemiology ◽  
Foodborne Pathogens ◽  
Hepatitis E Virus ◽  
Risk Mitigation ◽  
Hepatitis E ◽  
Mitigation Measures ◽  
Clinical Samples ◽  
Bootstrap Support ◽  
Genotype 3 ◽  
Pork Products

Abstract Foodborne viruses such as hepatitis E virus (HEV) pose an increasing risk to public health and to confidence in Irish food. Hepatitis E has been acknowledged as a significant pathogen of likely zoonotic transmission, with pork products and shellfish being implicated as potential sources. The European Food Safety Authority has recommended that systematic strain typing of viruses in humans, animals, and food commodities is needed to improve understanding of etiological agents and foodborne transmission pathways, in particular for HEV. The dominant autochthonous genotype of HEV in Europe is genotype 3, thought to be associated with consumption of contaminated food, specifically pork products. However, little is known about the epidemiology of HEV in Ireland. In 2016, HEV became a notifiable disease in Ireland. Following this, as part of the Department of Agriculture, Food and the Marine-funded FoVIRA study, the molecular epidemiology of HEV in Irish clinical samples has been characterized for the first time. HEV RNA-positive clinical specimens from 2016 were genetically characterized (n = 14). A 450 nucleotide fragment of the ORF2 region of the HEV genome was amplified, with contiguous sequence assembly performed using DNA Lasergene v14. Sequences were aligned with ClustalW implemented in Bioedit v7.1.9 and compared to reference strains from GenBank. A maximum likelihood phylogenetic tree was constructed using the Hasegawa–Kishino–Yano model and a discrete gamma distribution to model evolutionary rate distances between sites. Evolutionary analyses were conducted in MEGA7. Statistical support was provided by bootstrapping with 1,000 replicates. Fourteen strains belonged to genotype 3 and were classified as the following subtypes: 3c (n = 7), 3e (n = 4), 3f (n = 1), 3 untyped (n = 1), and 1 untyped. Phylogenetic analysis showed the formation of two distinct clusters of genotype 3:3abchij and 3efg, with strong bootstrap support. A genotype 1 was detected and found to be associated with travel. Data generated from this research will contribute to a risk exposure assessment and will be used to identify potential control points and risk mitigation measures for viral foodborne pathogens. This study will provide a unique opportunity to build national capability in the area of food testing within Irish public laboratories.

scholarly journals Clinical Characteristics of Acute Hepatitis E and Their Correlation with HEV Genotype 3 Subtypes in Italy

Pathogens ◽  
2020 ◽  
Vol 9 (10) ◽  
pp. 832
Author(s):  
Claudia Minosse ◽  
Elisa Biliotti ◽  
Daniele Lapa ◽  
Alessia Rianda ◽  
Mauro Marchili ◽  
...  
Keyword(s):  
Viral Load ◽  
Acute Hepatitis ◽  
Epigastric Pain ◽  
Clinical Manifestations ◽  
Clinical Information ◽  
Hepatitis E ◽  
International Normalized Ratio ◽  
Genotype 3 ◽  
Lazio Region ◽  
Acute Hepatitis E

Genotype 3 (GT3) is responsible for most European autochthonous hepatitis E virus (HEV) infections. This study analyzed circulating genotypes and GT3 subtypes in the Lazio region, Italy, between 2011 and 2019, as well as their pathogenic characteristics. Of the 64 evaluable HEV GT3 patient-derived sequences, identified subtypes included GT3f (n = 36), GT3e (n = 15), GT3c (n = 9), GT3a (n = 1) and three unsubtyped GT3 sequences. GT3c strains were similar to Dutch sequences (96.8–98.1% identity), GT3e strains showed high similarity (96.8%) with a United Kingdom sequence, while the most related sequences to GT3f Italian strains were isolated in France, Belgium and Japan. One sequence was closely related to another Italian strain isolated in raw sewage in 2016. The liver functioning test median values for 56 evaluable GT3 patients were: alanine aminotransferase (ALT), 461 (range 52–4835 U/L); aspartate aminotransferase (AST), 659 (range 64–6588 U/L); and total bilirubin, 3.49 (range 0.4–33 mg/dL). The median HEV RNA viral load for 26 evaluable GT3 patients was 42,240 IU/mL (range 5680–895,490 IU/mL). Of the 37 GT3 patients with available clinical information, no correlation was observed between HEV clinical manifestations and GT3 subtype. HEV symptoms were comparable among GT3c/e/f patients across most analyzed categories except for epigastric pain, which occurred more frequently in patients with HEV GT3e (75%) than in patients with GT3c (50%) or GT3f (19%) (p = 0.01). Additionally, patients with HEV GT3c exhibited significantly higher median international normalized ratio (INR) than patients with GT3e and GT3f (p = 0.033). The severity of GT3 acute hepatitis E was not linked to HEV RNA viral load or to the GT3 subtype.

scholarly journals Phylogenetic analysis of two new complete genomes of the hepatitis E virus (HEV) genotype 3 from Thailand

2020 ◽  
Vol 47 (11) ◽  
pp. 8657-8668
Author(s):  
Tipsuda Chanmanee ◽  
Pravech Ajawatanawong ◽  
Suda Louisirirotchanakul ◽  
Watcharasak Chotiyaputta ◽  
Siwaporn Chainuvati ◽  
...  
Keyword(s):  
Hepatitis E Virus ◽  
Acute Viral Hepatitis ◽  
Hepatitis E ◽  
Viral Transmission ◽  
Genotype 3 ◽  
Genome Sequences ◽  
The Past ◽  
Complete Genomes ◽  
Genome Study ◽  
Siriraj Hospital

AbstractHepatitis E virus (HEV) is a causative agent of acute viral hepatitis globally. Evolutionary phylogeny classifies the HEV into eight genotypes that correlate with the viral transmission. Only four genotypes have been proven to be responsible for transmission in humans. However, there has been no report on the genomics and genotyping of HEV in Thailand during the past ten years. Here, we identified the genotype distributions of the Thai isolates of HEV and we sequenced two HEV genomes. We screened for 18 Thai isolates of HEV from Siriraj Hospital in Bangkok, from 2014–2016. The HEV genomes were sequenced from the serum and feces of a patient. The results showed that all Thai isolates of HEV were identified as genotype 3 (HEV-3). The ORF2 and genome phylogenies suggested two subgenotypes, called 3.1 and 3.2. The Thai isolates of HEV were frequently found in the subgenotype 3.1. The genome sequences of the two Thai isolates of HEV from the serum and fecal samples of the same patient showed 91% nucleotide similarity with the HEV genotype 3. Comparisons between the HEV genome and the ORF2 phylogenies illustrated that the ORF2 tree can be used to identify HEV genotypes, but it has less phylogenetic power for the HEV evolution. The two new genome sequences of HEV-3 from Thailand could contribute valuable information to the HEV genome study. (226 words)

scholarly journals First report of acute autochthonous hepatitis E in Portugal

2011 ◽  
Vol 6 (02) ◽  
pp. 201-203 ◽  
Author(s):  
Vitor Duque ◽  
Conceição Ventura ◽  
Diana Seixas ◽  
Saraiva Da Cunha ◽  
António Meliço-Silvestre
Keyword(s):  
Differential Diagnosis ◽  
Acute Hepatitis ◽  
Hepatitis E Virus ◽  
Hepatitis E ◽  
Human Case ◽  
European Countries ◽  
Industrialized Countries ◽  
First Report ◽  
Sporadic Cases ◽  
Acute Hepatitis E

Hepatitis E infection is usually a self-limiting disease. In industrialized countries, sporadic cases of acute hepatitis E virus (HEV) infections have been described; their number seems to be increasing in European countries. We report the first human case of autochthonous acute hepatitis E confirmed in Portugal. Patients with acute non-A-C hepatitis should be tested for HEV in Portugal and hepatitis E infection should be considered in the differential diagnosis of unexplained hepatitis cases.

scholarly journals HEVnet: a One Health, collaborative, interdisciplinary network and sequence data repository for enhanced hepatitis E virus molecular typing, characterisation and epidemiological investigations

2019 ◽  
Vol 24 (10) ◽  
Author(s):  
Annemieke Christine Mulder ◽  
Annelies Kroneman ◽  
Eelco Franz ◽  
Harry Vennema ◽  
Anna D. Tulen ◽  
...  
Keyword(s):  
Hepatitis E Virus ◽  
One Health ◽  
Sequence Data ◽  
Epidemiological Data ◽  
Hepatitis E ◽  
Global Network ◽  
Data Repository ◽  
Health Food ◽  
Genotype 3 ◽  
Animal Reservoir

Hepatitis E virus (HEV) is a common cause of acute hepatitis worldwide. In Europe, HEV is a zoonosis transmitted via contaminated pork meat or other pork food products. Genotype 3 is the most prevalent HEV type in the animal reservoir, as well as in humans. Despite an increased incidence of hepatitis E across Europe, much remains unknown about its spread, sources and transmission routes. A One Health approach is crucial to better understand the (molecular) epidemiology of HEV. HEVnet was established in April 2017 as a network and database for sharing sequences and accompanying metadata collected from human, animal, food and environmental sources. HEVnet members working in the public health, veterinary health, food, environmental and blood safety sectors have submitted 1,615 HEV sequences from nine countries as at January 2019. Most are from humans (89%), and sequences of animal (5%), food (6%) or environmental (0.3%) origin are rare. Metadata for human sequences capture mostly sex (93%), year of birth (92%) and sampling (100%); data on region of sampling (37%) and clinical information (hospitalisation 27%, symptoms 20% or mortality 8%) are limited. HEVnet aims to expand into a global network capable of performing cross-sectoral and supranational studies, with a joint repository of molecular and epidemiological data on HEV.

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