Hepatitis E, Central African Republic

Escribà, Josep M.; Nakouné, Emmanuel; Recio, Carlos; Massamba, Péguy-Martial; Matsika-Claquin, Marcelle Diane; Goumba, Charles; Rose, Angela; Nicand, Élisabeth; García, Elsa; Leklegban, Cornelia; Koffi, B.

doi:10.3201/eid1404.070833

Cited by 49 publications

(56 citation statements)

References 8 publications

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“…14 In humans, hepatitis E has been reported worldwide. [15][16][17][18][19][20] It is considered as an emerging viral disease of importance to public health and a significant cause of acute clinical hepatitis among adults in Asia, Middle East and Africa. 2,21,22 High lethality rates have been reported in some developing countries, especially among pregnant women.…”

Section: Introductionmentioning

confidence: 99%

High Prevalence of Hepatitis E in Humans and Pigs and Evidence of Genotype-3 Virus in Swine, Madagascar

Temmam¹,

Besnard²,

Andriamandimby³

et al. 2013

The American Society of Tropical Medicine and Hygiene

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Abstract. Hepatitis E virus (HEV) causes an orofecal disease transmitted through poor hygiene environments, contaminated food (mainly pork products), or by contacts with infected animals. Very little data are currently available regarding the disease in the Southwestern Indian Ocean Islands. We report the first sero-and viro-survey for HEV in human and swine in Madagascar. A seroprevalence rate of 14.1% (60 of 427) was measured in slaughterhouse workers. Seroprevalence to HEV in pigs was estimated to 71.2% (178 of 250), strongly suggesting the existence of a zoonotic cycle. Three out of 250 pig livers (1.2%) tested HEV RNA-positive by quantitative polymerase chain reaction. Phylogenetic analyses based on 1-kb sequences of the ORF 2-3 identified these viruses as HEV genotype 3. Sequences clustered in a distinct Malagasy sub-clade, possibly representative of a new sub-genotype, for which the date of emergence was estimated around 1989. Further studies are needed to confirm other transmission routes of HEV to humans, especially through non-zoonotic cycles.

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Section: Introductionmentioning

confidence: 99%

High Prevalence of Hepatitis E in Humans and Pigs and Evidence of Genotype-3 Virus in Swine, Madagascar

Temmam¹,

Besnard²,

Andriamandimby³

et al. 2013

The American Society of Tropical Medicine and Hygiene

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“…The route of HEV transmission during outbreaks is well established, and was usually associated with the consumption of faecally contaminated drinking water [2,3,4,5,6,9,10,43,59]. In contrast, it is poorly documented for sporadic hepatitis E cases reported in both developing and developed countries [14,21,44,60].…”

Section: Epidemiologymentioning

confidence: 99%

“…In contrast, it is poorly documented for sporadic hepatitis E cases reported in both developing and developed countries [14,21,44,60]. To date, four major documented routes of HEV transmission have been reported: waterborne transmission [2,3,4,5,6,7,8,61]; foodborne transmission [29,48]; bloodborne transmission [62,63], and vertical transmission [64,65,66]. Person-to-person HEV transmission is rarely reported and is considered as an uncommon event, both in the context of outbreaks and sporadic infections [67,68].…”

Section: Epidemiologymentioning

confidence: 99%

“…In developing countries of Asia, Africa and Latin America, the faecal-oral route through drinking contaminated water is the principal route of HEV transmission, and is responsible for the majority of hepatitis E outbreaks occurring in these areas [2,3,4,5,6,7,8,59,61,73,74,75]. These outbreaks usually occur during the rainy season, floods or the monsoon, conditions facilitating contamination of pipes, groundwater and sources of drinking water by human excreta [6,7,8,59].…”

Section: Epidemiologymentioning

confidence: 99%

“…Mammalian hepatitis E virus (HEV), the etiological agent of hepatitis E in humans (previously known as non-A, non-B enterically-transmitted hepatitis virus), is a disease of worldwide distribution [1], usually transmitted by the oral-faecal route via contaminated water [2,3,4,5,6]. The first indication of the circulation of an enterically-transmitted non-A, non-B hepatitis virus came from two independent studies conducted in India in the 1980s [7,8].…”

Section: Introductionmentioning

confidence: 99%

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Epidemiology of Mammalian Hepatitis E Virus Infection

et al. 2013

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Mammalian hepatitis E virus (HEV), the etiological agent of hepatitis E in humans, is a recently discovered infectious agent. It was identified for the first time in 1983 using electron microscopy on a faecal specimen of a person infected with non-A, non-B enterically-transmitted hepatitis. Based on retrospective and prospective studies, HEV was long described as one of the leading causes of acute viral hepatitis in tropical and subtropical countries, whereas in developed countries hepatitis E was considered an imported disease from HEV hyperendemic countries. Data from studies conducted during the past decade have greatly shifted our knowledge on the epidemiology and clinical spectrum of HEV. Recently, it has been shown that contrary to previous beliefs, hepatitis E is also an endemic disease in several developed countries, particularly in Japan and in Europe, as evidenced by reports of high anti-HEV immunoglobulin G prevalence in healthy individuals and an increasing number of non-travel-related acute hepatitis E cases. Moreover, a porcine reservoir and growing evidence of zoonotic transmission have been reported in these countries. This review summarizes the current knowledge on the epidemiology and prevention of transmission of mammalian HEV.

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Long‐term shedding of hepatitis E virus in the feces of pigs infected naturally, born to sows with and without maternal antibodies

Kanai

Tsujikawa²,

Yunoki³

et al. 2009

Journal of Medical Virology

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Pigs are presumed reservoirs for hepatitis E virus (HEV) transmission to humans. To examine infection kinetics, two litters of domestic pigs (A and B, each containing 10 piglets) infected naturally with HEV were studied until pigs were 6 months old. Maternal IgG and IgA antibodies were detected in litter A piglets, but not in litter B ones. All pigs shed HEV in feces when they were 30-110 days old, and 17 developed viremia at 40-100 days of age. Phylogenetic analysis revealed a highly close sequence of HEV genotype 3 in all pigs. The serum levels of specific IgG and IgA were similar in all pigs, although IgA was not detected in the feces. Interestingly, the onset of both viremia and seroconversion was delayed significantly in litter A pigs. The kinetics of fecal virus shedding was similar in both litters; shedding was not detected after the pigs were 120 days old. The differences in the infection kinetics between litters A and B suggested that maternal antibodies delayed the onset of viremia and seroconversion. Quantitative real-time reverse transcriptase-polymerase chain reaction revealed that HEV RNA in feces peaked 10 days after initial shedding of approximately 10(6.0) copies/g. The viral load was much lower in the serum than in the feces. At 200 days of age, HEV RNA was found in the internal organs of 3 out of 13 pigs. These study findings improve the understanding of the dynamics of natural HEV transmission in pigs, which could help in controlling virus transmission from pigs to humans.

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Hepatitis E, Central African Republic

Abstract: Hepatitis E, Central African Republic

Cited by 49 publications

References 8 publications

High Prevalence of Hepatitis E in Humans and Pigs and Evidence of Genotype-3 Virus in Swine, Madagascar

High Prevalence of Hepatitis E in Humans and Pigs and Evidence of Genotype-3 Virus in Swine, Madagascar

Epidemiology of Mammalian Hepatitis E Virus Infection

Long‐term shedding of hepatitis E virus in the feces of pigs infected naturally, born to sows with and without maternal antibodies

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