Hepatitis E Virus in Domestic Pigs, Wild Boars, Pig Farm Workers, and Hunters in Estonia

Ivanova, Anna; Tefanova, Valentina; Reshetnjak, Irina; Кузнецова, Т. В.; Geller, Julia; Lundkvist, Åke; Janson, Marilin; Neare, Kädi; Velström, Kaisa; Jokelainen, Pikka; Lassen, Brian; Hütt, Pirje; Saar, T.; Viltrop, Arvo; Golovljova, Irina

doi:10.1007/s12560-015-9210-8

Cited by 67 publications

(64 citation statements)

References 46 publications

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“…This is in line with various previous studies [14,15,34,35,49,[52][53][54][55][56][57], while a few authors did not find evidence for such an association [58][59][60]. Based on the tendencies found in our study (HEV IgG prevalence, serological evidence of (post)acute HEV infection) and the support from literature [38], we hypothesize that professional exposure to domestic pigs is a stronger risk factor than having occasional contact to wild boar when hunting. This can be explained by the remarkably high circulation of HEV in domestic pigs [54,[61][62][63][64].…”

Section: Discussionsupporting

confidence: 92%

“…In humans, seroprevalence in the general population (blood donors) in Europe ranged from 0.6 to 52.5% [32]. Higher prevalence estimates were demonstrated for professional risk groups with direct contact to domestic pigs as well as for hunters and forestry workers [33][34][35][36][37][38]. A protective effect of wearing gloves during disembowelling [31] provides indirect evidence for the risk of exposure due to direct contact with wild boar.…”

Section: Introductionmentioning

confidence: 99%

“…A protective effect of wearing gloves during disembowelling [31] provides indirect evidence for the risk of exposure due to direct contact with wild boar. Only few studies have specifically compared seroprevalence in people with direct contact to wild boar (i.e., hunters) and domestic pigs [35,38].…”

Section: Introductionmentioning

confidence: 99%

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Performance of Hepatitis E Virus (HEV)-antibody tests: a comparative analysis based on samples from individuals with direct contact to domestic pigs or wild boar in Germany

Sommerkorn

Schauer

Schreiner

et al. 2017

Med Microbiol Immunol

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In Europe, Hepatitis E virus (HEV) genotype 3 causes most human infections, and domestic pigs and wild boar represent the main reservoirs. Contact to these animals represents one source of human infection. However, interpretation of studies is challenged in the absence of a serological gold standard. Hence, this study compared results of different HEV immunoassays. Plasma samples from 139 individuals who had professional contact to pigs (veterinarians, meat inspectors, slaughterhouse workers; n = 114) or hunted regularly (n = 25) were tested with assays specific for HEV IgG, HEV IgM, HEV IgA, and total HEV immunoglobulin as well as for viral RNA. Furthermore, overall HEV IgG was defined (i.e., two of three IgG assays reveal the same result) to compare serological findings. Borderline results were always quoted as positive. For IgG, apparent prevalence was higher in Wantai (48.2%) compared to Euroimmun (11.5%) and Mikrogen assays (17.3%) (p = 0.0001). The overall IgG prevalence was estimated to be 18.7%. For total Ig, Wantai (40.3%) also yielded higher prevalence than Euroimmun (15.8%) (p = 0.0001). The HEV IgM prevalence ranged from 0% (Euroimmun) to 4.3% (Mikrogen). Four percent of individuals tested IgA positive, whilst none harboured HEV RNA. Our results support previous studies that the higher IgG prevalence estimated with the Wantai assay result from a higher sensitivity of this test. However, further studies are needed to verify specificity given the challenge of defining true negative samples. The high percentage of individuals with HEV IgG observed in this study underlines that direct contact to pigs represents a risk factor for HEV infection.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

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Performance of Hepatitis E Virus (HEV)-antibody tests: a comparative analysis based on samples from individuals with direct contact to domestic pigs or wild boar in Germany

Sommerkorn

Schauer

Schreiner

et al. 2017

Med Microbiol Immunol

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“…By the time the animals are transferred to the research campus, most no longer are viremic or shedding the virus, and with good workplace practices, transmission to persons with pig contact will be low. Individuals with close contact to the pigs, such as veterinarians and farm workers, or to pig blood, such as slaughter-house workers and hunters, have been found to have higher rates of anti-HEV than the general population and suggest that close contact with pigs or wild boar is a risk factor for acquiring HEV (31)(32)(33)(34).…”

Section: Discussionmentioning

confidence: 99%

An Epidemiologic Investigation of a Case of Acute Hepatitis E

et al. 2015

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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 ϳ10% 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.H epatitis E virus (HEV) is a small, single-stranded RNA virus that is transmitted principally by the fecal-oral route in developing nations and presumptively via zoonotic transmission or food exposure in developed nations (1, 2). Four genotypes have been identified. Genotypes 1 and 2 are known to infect only humans and are responsible for large waterborne outbreaks. Genotypes 3 and 4, on the other hand, primarily infect other animals, including swine, rats, and rabbits, among others, and have been associated with sporadic cases of acute and chronic infections in humans (2, 3). Most cases of HEV genotype 3, and probably also genotype 4, are anicteric and asymptomatic and resolve spontaneously without long-term sequelae. However, severe cases with jaundice can occur in the elderly, in persons with immunodeficiency, and in persons with preexisting liver disease. In addition, HEV genotype 1 has been associated with high case fatality rates in pregnant women. Recently, cases of chronic HEV infection due to genotype 3 have been reported in immunosuppressed individuals, such as solid-organ transplant recipients, patients on cancer chemotherapy, and those with human immunodeficiency virus infection and AIDS (4-7).A surprisingly high prevalence of HEV infection, 21%, was reported in the U.S. population from an analysis of samples collected during the Third National Health and Nutrition Examination Survey (NHANES III) (8). Testing positive for anti-HEV was related to older age, and minor associations were found with having a pet in the home and consuming liver or other organ meats more than once per m...

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“…In contrast, a study from the UK indicated that 92.8% of 640 pigs sampled at slaughter were seropositive to HEV (Tedder 2014). Approximately 62% and 73% of serum from domestic pigs were positive for anti-HEV IgG antibodies in Estonia (Ivanova et al 2015) and Denmark (Kaba et al 2013), respectively.…”

Section: Discussionmentioning

confidence: 99%

Seroprevalence of hepatitis E virus in Lithuanian domestic pigs and wildlife

Spancernienė

Buitkuvienė²,

Grigas

et al. 2016

Acta Vet. Brno

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Hepatitis E is an important public health concern disease that causes acute hepatitis in humans with different hepatitis E virus strains reported among domestic and wild animals. In Lithuania, seroprevalence studies on animals considered to be possible virus reservoirs, particularly in wildlife species, had never been investigated before. In order to assess the actual distribution of the virus in the domestic pig and wildlife species, serum samples originating from different geographic areas of Lithuania were tested for the presence of antibodies to the virus using enzyme-linked immunosorbent assay. The study results proved that hepatitis E virus infection is prevalent among domestic pigs, wild boar, moose, and roe deer in Lithuania, with the overall prevalence of IgG antibodies against hepatitis E virus being 43.75%, 57.05%, 11.76%, and 1.20%, respectively. Significantly higher (P < 0.01) seroprevalence values of 53.66% and 80% were observed in weaned pigs and adult wild boar. Herds with 15 001-30 000 pigs were 2.4 times more likely (P < 0.01) to test positive for hepatitis E virus antibodies (70.18%), than herds with ≤ 500 pigs (21.11%). The differences in seroprevalence rates between domestic pigs (from 25 to 66.67%) and wild boar (from 42.86 to 73.33% ) in all 10 counties were not significant (P > 0.05). Estimated low seroprevalence rate in moose, roe deer and absence of antibodies in red deer suggest that such wildlife species are accidental hosts of hepatitis E virus or at least hepatitis E virus is not present in Lithuanian cervides. HEV, sow, wild boar, cervidae, serum, zoonosisAccording to data reported by the World Health Organization (2015), in humans there are estimated 20 million cases of hepatitis E infections, over 3 million symptomatic cases of hepatitis E, and 56 600 hepatitis E-related deaths every year. Therefore, hepatitis E is considered an emerging zoonotic disease in many developing and industrialized countries. The aetiological agent of the disease is hepatitis E virus (HEV) that affects multiple hosts. The HEV is unique among known hepatitis (A, B, C, D) viruses because domestic pigs, wild boar, deer, and other animal species are considered to be possible reservoirs of HEV. Up to date, at least seven genotypes of HEV have been reported, and five of them have been described in humans (HEV-1 and HEV-2 anthroponotic, HEV-3 and HEV-4 zoonotic, HEV-7 zoonotic potential is still being questioned) (Roth et al. 2016). In contrast to humans, pigs and wild boar infected by HEV do not show obvious clinical manifestations.The consumption of raw or undercooked contaminated meat of domestic pig, wild boar or deer and also seafood receiving sewage sludge or direct contact with infected animals have been identified as modes of transmission linked to autochthonous sporadic cases of acute hepatitis E in humans (Pavio et al. 2010;Kaba et al. 2013). Moreover, increased distribution and availability of game meat poses a major risk for foodborne transmission of HEV worldwide. In addition,

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Hepatitis E Virus in Domestic Pigs, Wild Boars, Pig Farm Workers, and Hunters in Estonia

Cited by 67 publications

References 46 publications

Performance of Hepatitis E Virus (HEV)-antibody tests: a comparative analysis based on samples from individuals with direct contact to domestic pigs or wild boar in Germany

Performance of Hepatitis E Virus (HEV)-antibody tests: a comparative analysis based on samples from individuals with direct contact to domestic pigs or wild boar in Germany

An Epidemiologic Investigation of a Case of Acute Hepatitis E

Seroprevalence of hepatitis E virus in Lithuanian domestic pigs and wildlife

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