Autochthonous hepatitis E in Southwest England: natural history, complications and seasonal variation, and hepatitis E virus IgG seroprevalence in blood donors, the elderly and patients with chronic liver disease

Dalton, Harry R.; Stableforth, William; Thurairajah, Prem Harichander; Hazeldine, Simon; Remnarace, R.; Usama, Warshow; Farrington, Liz; Hamad, Noor; Sieberhagen, Cyril; Ellis, Vic; Mitchell, Jonathan; Hussaini, S. H.; Banks, M.; Ijaz, Samreen; Bendall, Richard

doi:10.1097/meg.0b013e3282f5195a

Cited by 259 publications

(262 citation statements)

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“…63 In a series from the UK, the disease showed seasonal peaks in spring and summer and no cases during winter. 64 In another series, the disease appeared to be more common among residents of coastal and estuarine areas 65 ; the exact reason underlying this relationship is unclear.…”

Section: Characteristics Of Affected Subjectsmentioning

confidence: 97%

“…64,65 This mode of transmission was initially suspected because of the observation that genomic sequences of HEV isolates from two autochthonous cases in the United States were more closely-related to swine HEV than to human HEV isolates. 9,11 Subsequent experimental studies showed that human genotype 3 and 4 HEV could infect experimental pigs, and that swine HEV isolates could be transmitted to primates, which served as a surrogate for humans.…”

Section: Reservoir Of Infection and Mode Of Transmissionmentioning

confidence: 99%

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Hepatitis E: Epidemiology and Natural History

Aggarwal

2013

Journal of Clinical and Experimental Hepatology

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Section: Characteristics Of Affected Subjectsmentioning

confidence: 97%

Section: Reservoir Of Infection and Mode Of Transmissionmentioning

confidence: 99%

Hepatitis E: Epidemiology and Natural History

Aggarwal

2013

Journal of Clinical and Experimental Hepatology

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“…# Confirmation by immunoblot/Western blot. $ Report includes other study type of EL1 - [31] is also reported in Table 3 and [49] in Table 2. · Significant result from logistic regression.…”

Section: Potential For Zoonotic Transmission By Direct Animal Contactmentioning

confidence: 99%

“…Hepatitis E is usually selflimiting but very recently chronic infections have been described in organ transplant recipients in France [28,29] and The Netherlands [26]. Fulminant and even fatal hepatitis E caused by gt3 have been reported in Japan [30] and in Europe [31][32][33][34][35], often in older males with underlying chronic liver disease. In contrast, in hyper-endemic gt1 and gt2 areas, pregnant women are at higher risk for severe disease and death [36,37].…”

Section: Introductionmentioning

confidence: 99%

Transmission routes and risk factors for autochthonous hepatitis E virus infection in Europe: a systematic review

2009

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SUMMARYIncreasing numbers of non-travel-associated hepatitis E virus (HEV) infections have been reported in Europe in recent years. Our objective was to review the evidence on risk factors and transmission routes of autochthonous HEV infection and hepatitis E in Europe in order to develop recommendations for future research, prevention and control. A systematic literature review was performed to identify all primary reports and studies published during 1998-2008 on hepatitis E in humans and animals in Europe by searching Pubmed, reference lists of major articles and international conference proceedings. Each of the 106 included studies was categorized into one of three evidence levels (EL) based on study design and diagnostic methodology. The evidence was generally weak (73 were assigned to EL1, two to both EL1 and EL2, and 30 to EL2), further compounded by the use of poorly validated serological assays in some studies. Only one casecontrol study was assigned to EL3. Persons with autochthonous hepatitis E infection were on average older than the general population and predominantly male. There was no evidence for one main transmission route of HEV infection or risk factor for hepatitis E. However, zoonotic transmission seemed likely and person-to-person transmission too inefficient to cause clinical disease. Multiple routes of transmission probably exist and should be further investigated through analytical studies and reliable diagnostic kits. Based on current evidence that points to zoonotic transmission from pigs, thorough cooking of all porcine products, prevention of crosscontamination in the kitchen and improved education for occupationally exposed people (e.g. pig farmers, veterinarians and sewage workers) may help prevent HEV infection. Although evidence for parenteral transmission is limited, it is recommended that a risk assessment is undertaken.

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“…However, autochthonous HEV infections have recently been documented from developed countries like France, Japan, United Kingdom and USA. [13][14][15] While contaminated water and food remains the source of infection in developing world, zoonotic transmission of HEV has been documented in developed industrialized nations.…”

Section: Hepatitis E Virus Burdenmentioning

confidence: 99%