A serological study of intrafamilial spread from patients with sporadic hepatitis E virus infection

Abstract

Intrafamilial transmission is rare in epidemic hepatitis E; its frequency in sporadic hepatitis E is not known. We followed up 86 household contacts (age range 4-75 years, mean +/- SD 32.4 +/- 15.8; 49 males), who were family members of patients with acute sporadic hepatitis E. Of the 86 contacts, 68 (79%) tested negative for IgG anti-hepatitis E virus antibodies. Four (4.7%) had IgM anti-hepatitis E virus antibodies at the time of diagnosis of hepatitis E in the index case; two of these contacts possibly had hepatitis E virus infection acquired simultaneously with that in the index case, and two could have had intrafamilial transmission. None developed serological evidence of hepatitis E virus infection over a period of 49 +/- 18 days after the diagnosis of index case, although a majority lacked IgG antibodies to hepatitis E virus and were likely to be susceptible. This suggests that person-to-person transmission is uncommon in sporadic hepatitis E.

Hepatitis E: Epidemiology and Natural History

“…48,49 During outbreaks of hepatitis E, secondary attack rates among household contacts of patients with hepatitis E cases have been much lower than those observed among susceptible household contacts of patients with hepatitis A, another enterically-transmitted form of hepatitis. Even when multiple cases occur in a family, the time interval between these is shorter than the minimum incubation period, indicating exposure to a common waterborne primary source rather than personto-person spread 48 though a recent report has questioned this finding.…”

“…34 In the sporadic setting too, secondary spread of HEV appears to be infrequent. 49 Transmission of hepatitis E through materno-fetal transfer and transfusion of blood and blood products is known. A proportion of healthy blood donors in endemic regions have detectable HEV viremia and transfusion of their blood has been shown to lead to HEV infection among recipients.…”

Epidemiological investigation of an outbreak of viral hepatitis in a defence establishment

“…New cases stopped appearing after water contamination was controlled which is further corroborative of HEV as the incriminating agent. 12 Importance of the study lies in number of trained mandays lost in hospitalization, sick leave, after care and observation for follow up. There were no fatalities possibly because of early prediction and immediate institution of control measures; however long convalescence resulted in low work out put in the respective offices.…”

Chronic hepatitis E: A brief review

“…Subsequent data have corroborated this finding and therefore zoonotic transmission might be an important mode of spread of hepatitis E in the developed world. Person to person transmission is considered uncommon during both epidemic and sporadic setting [11,12] . Vertical transmission from mother to fetus and blood transfusion related transmission of HEV has also been documented [13,14] .…”