An epidemic outbreak of hepatitis E in Yangon of Myanmar: Antibody assay and animal transmission of the virus

Uchida, Tatsuo; Aye, Thein Thein; Ma, Xuezhung; Iida, Fusae; Shikata, Toshio; Ichikawa, Munetaka; Rikihisa, Tetsuji; Win, Khin Maung

doi:10.1111/j.1440-1827.1993.tb01116.x

Cited by 20 publications

(22 citation statements)

References 11 publications

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“…From south‐east Asian countries, Indonesia reported two HEV outbreaks, in East Java and Kalimantan island . Other south‐east Asian countries, such as Myanmar and Vietnam only reported one outbreak …”

Section: Resultsmentioning

confidence: 99%

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The global burden of hepatitis E outbreaks: a systematic review

Hakim

Wang

Bramer

et al. 2016

Liver International

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Hepatitis E virus (HEV) is responsible for repeated water-borne outbreaks since the past century, representing an emerging issue in public health. However, the global burden of HEV outbreak has not been comprehensively described. We performed a systematic review of confirmed HEV outbreaks based on published literatures. HEV outbreaks have mainly been reported from Asian and African countries, and only a few from European and American countries. India represents a country with the highest number of reported HEV outbreaks. HEV genotypes 1 and 2 were responsible for most of the large outbreaks in developing countries. During the outbreaks in developing countries, a significantly higher case fatality rate was observed in pregnant women. is reported in the population of pregnant women after infection with genotype 1.

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Section: Resultsmentioning

confidence: 99%

“…15,16 Other south-east Asian countries, such as Myanmar and Vietnam only reported one outbreak. 18,19 In east Asia, the largest reported outbreak in the world so far was reported from Xinjiang, China. A huge number of 120 000 suspected cases was reported during prolonged outbreak that lasted from…”

Section: Number Of Studies Included In the Review (N = 98)mentioning

confidence: 99%

The global burden of hepatitis E outbreaks: a systematic review

Hakim

Wang

Bramer

et al. 2016

Liver International

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“…Studies in non-human primates indicate that anti-HEV, whether due to prior infection or passive or active immunization against HEV, successfully protects against challenge with HEV. 22,26,[37][38][39] These findings are especially important for the development and deployment of hepatitis E vaccines.…”

Section: Discussionmentioning

confidence: 99%

Epidemic of hepatitis E in a military unit in Abbotrabad, Pakistan.

Bryan¹,

Iqbal²,

Tsarev³

et al. 2002

The American Journal of Tropical Medicine and Hygiene

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Abstract. An outbreak of hepatitis caused by hepatitis E virus (HEV) in Abbottabad, Pakistan was traced to fecal contamination of a water system. Of 109 men hospitalized with hepatitis, 104 (95%) had serologic evidence of acute hepatitis E (IgM antibody to HEV [anti-HEV]), three (3%) probably had acute hepatitis E (high titers of IgG anti-HEV without IgM), and two had acute hepatitis A. Among a subset of 44 men with acute hepatitis E from whom three serum specimens were obtained over a four-month period, the anti-HEV IgG geometric mean titers (GMTs) decreased from 1,519 during the outbreak to 657 at four months. The IgM anti-HEV was detected in 40 (91%) of 44 sera obtained at admission (GMT ‫ס‬ 533 during acute disease), but in only six (14%) four months later. The prevalence of anti-HEV in this population before the outbreak was estimated to be 30%. The presence of IgG anti-HEV appeared to protect against clinical hepatitis or development of serologic evidence of new infection with HEV. This is the second major epidemic of hepatitis E in the Pakistani military confirmed by an anti-HEV enzyme-linked immunosorbent assay (ELISA). Evidence that pre-existing antibody as measured by this ELISA protects against disease is important for assessment of vaccine development.

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“…Epidemics of hepatitis E have been reported primarily in developing regions of Africa, the Middle East, and Southeast and Central Asia; one epidemic occurred in North America (Mexico) (3,4,6,14,17,(39)(40)(41). Although sporadic HEV infections have occurred in industrialized nations, there is an unexpectedly high prevalence of antibodies to HEV (anti-HEV) (as high as 21.3%) among blood donors in the United States, where hepatitis E is not endemic (35).…”

mentioning

confidence: 99%

Detection of Immunoglobulin M Antibodies to Hepatitis E Virus by Class Capture Enzyme Immunoassay

Engle

Bryan

et al. 2003

Clin Vaccine Immunol

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The measurement of antibodies to hepatitis E virus (anti-HEV) has been essential for understanding the epidemiology of hepatitis E. Studies to determine the prevalence of HEV infections require a reliable serologic assay that is sensitive and specific. It is also important to distinguish the acute from the convalescent phase of an infection; this usually requires the detection of the immunoglobulin M (IgM) class of antibody. Few enzyme immunoassays (EIAs) that measure IgM anti-HEV have been described, and most have utilized the sandwich method. The present study describes an EIA that detects IgM anti-HEV by antibody class capture methodology. The assay was validated by using serum and/or plasma panels from experimentally infected nonhuman primates. It was used to demonstrate an anamnestic response and the reappearance of IgM anti-HEV in a chimpanzee experimentally challenged with HEV at two different times 45 months apart. The class capture method was more sensitive than the sandwich EIA when used to test clinical samples from two hepatitis E epidemics in Pakistan; it also had the advantage of distinguishing IgM anti-HEV in the presence of high titers of IgG anti-HEV.

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An epidemic outbreak of hepatitis E in Yangon of Myanmar: Antibody assay and animal transmission of the virus

Cited by 20 publications

References 11 publications

The global burden of hepatitis E outbreaks: a systematic review

The global burden of hepatitis E outbreaks: a systematic review

Epidemic of hepatitis E in a military unit in Abbotrabad, Pakistan.

Detection of Immunoglobulin M Antibodies to Hepatitis E Virus by Class Capture Enzyme Immunoassay

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