Hepatitis E Virus Infection in Dromedaries, North and East Africa, United Arab Emirates, and Pakistan, 1983–2015

Rasche, Andrea; Saqib, Muhammad; Liljander, Anne; Bornstein, S.; Zohaib, Ali; Renneker, Stefanie; Steinhagen, Katja; Wernery, Renate; Younan, Mario; Gluecks, Ilona; Hilali, M.; Musa, Bakri E.; Jores, Joerg; Wernery, Ulrich; Drexer, Jan Felix; Drosten, Christian; Corman, Victor M.

doi:10.3201/eid2207.160168

Cited by 72 publications

(67 citation statements)

References 14 publications

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“…Bactrian camels and dromedary camels both belong to genus Camelus, but it seems that they are different as being hosts of many pathogens, such as Middle East respiratory syndrome (MERS) coronavirus (22) and West Nile virus (23). In all previous molecular surveillance studies on HEV in dromedary and Bactrian camels, as well as the present study, only HEV7 was found in dromedary camels and only HEV8 was detected in Bactrian camels (16,17,19), suggesting that dromedary and Bactrian camels are probably the sole natural hosts of HEV7 and HEV8, respectively. The separation of HEV genotypes may result from the species barrier and/or the geographical isolation of these two camel species.…”

Section: Discussionsupporting

confidence: 43%

“…These four genotypes are the major genotypes that circulate in humans causing hepatitis E. HEV5 and HEV6 have been identified in wild boar in Japan, but the zoonotic risk of these two genotypes is still unknown (15). More recently, HEV7 has been isolated from dromedary camels in Dubai, United Arab Emirates (16), and several other countries (17). A case report of chronic infection of a human by HEV7 has appeared, indicating that zoonotic transmission of this HEV genotype can occur (18).…”

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confidence: 99%

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Transmission of a Novel Genotype of Hepatitis E Virus from Bactrian Camels to Cynomolgus Macaques

Wang

Teng

Lau

et al. 2019

J Virol

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Hepatitis E virus (HEV) is zoonotic and a major cause of acute viral hepatitis worldwide. Recently, we identified a novel HEV genotype 8 (HEV8) in Bactrian camels in Xinjiang, China. However, the epidemiology, pathogenicity, and zoonotic potential of HEV8 are unclear. Here, we present the prevalence of HEV8 in China and investigate its pathogenicity and cross-species transmission in cynomolgus macaques. Fresh fecal and milk samples from Bactrian camels collected from four provinces/regions in China were screened for HEV RNA by reverse transcriptase PCR (RT-PCR). An HEV8-positive sample was used to inoculate two cynomolgus macaques to examine the potential for cross-species infection. The pathogenicity of HEV8 was analyzed by testing HEV markers and liver function during the study period and histopathology of liver biopsy specimens at 3, 13, and 25 weeks postinoculation. Extrahepatic replication was tested by using reverse transcriptase quantitative PCR (RT-qPCR) and immunofluorescence assays. The overall prevalence of HEV8 RNA in Chinese Bactrian camels was 1.4% (4/295), and positive samples were found in three different provinces/regions in China. Histopathology confirmed acute and chronic HEV8 infections in the two monkeys. Multiple tissues were positive for HEV RNA and ORF2 proteins. Renal pathology was observed in the monkey with chronic hepatitis. Whole-genome sequencing showed only 1 to 3 mutations in the HEV8 in the fecal samples from the two monkeys compared to that from the camel. HEV8 is circulating in multiple regions in China. Infection of two monkeys with HEV8 induced chronic and systemic infections, demonstrating the high potential zoonotic risk of HEV8.IMPORTANCE It is estimated that one-third of the world population have been exposed to hepatitis E virus (HEV). In developed countries and China, zoonotic HEV strains are responsible for almost all acute and chronic HEV infection cases. It is always of immediate interest to investigate the zoonotic potential of novel HEV strains. In 2016, we discovered a novel HEV genotype, HEV8, in Bactrian camels, but the epidemiology, zoonotic potential, and pathogenicity of the virus were unknown. In the present study, we demonstrated that HEV8 was circulating in multiple regions in China and was capable of infecting cynomolgus macaques, a surrogate for humans, posing high risk of zoonosis. Chronic hepatitis, systemic infection, and renal pathology were observed. Collectively, these data indicate that HEV8 exhibits a high potential for zoonotic transmission. Considering the importance of Bactrian camels as livestock animals, risk groups, such as camelid meat and milk consumers, should be screened for HEV8 infection.

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Section: Discussionsupporting

confidence: 43%

mentioning

confidence: 99%

Transmission of a Novel Genotype of Hepatitis E Virus from Bactrian Camels to Cynomolgus Macaques

Wang

Teng

Lau

et al. 2019

J Virol

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“…Besides HEV‐1 to HEV‐4, a new potentially human pathogenic HEV genotype (HEV‐7) has been described recently (Rasche et al., ; Woo et al., ). This genotype seems to be widely distributed in dromedary camels ( Camelus dromedarius ) from the Middle East (Rasche et al., ; Woo et al., ).…”

Section: Transmission Pathways To Humansmentioning

confidence: 99%

Hepatitis E virus and related viruses in wild, domestic and zoo animals: A review

Spahr

Knauf-Witzens²,

Vahlenkamp

et al. 2017

Zoonoses and Public Health

102

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SummaryHepatitis E is a human disease mainly characterized by acute liver illness, which is caused by infection with the hepatitis E virus (HEV). Large hepatitis E outbreaks have been described in developing countries; however, the disease is also increasingly recognized in industrialized countries. Mortality rates up to 25% have been described for pregnant women during outbreaks in developing countries. In addition, chronic disease courses could be observed in immunocompromised transplant patients. Whereas the HEV genotypes 1 and 2 are mainly confined to humans, genotypes 3 and 4 are also found in animals and can be zoonotically transmitted to humans. Domestic pig and wild boar represent the most important reservoirs for these genotypes. A distinct subtype of genotype 3 has been repeatedly detected in rabbits and a few human patients.Recently, HEV genotype 7 has been identified in dromedary camels and in an immunocompromised transplant patient. The reservoir animals get infected with HEV without showing any clinical symptoms. Besides these well-known animal reservoirs, HEVspecific antibodies and/or the genome of HEV or HEV-related viruses have also been detected in many other animal species, including primates, other mammals and birds.In particular, genotypes 3 and 4 infections are documented in many domestic, wildlife and zoo animal species. In most cases, the presence of HEV in these animals can be explained by spillover infections, but a risk of virus transmission through contact with humans cannot be excluded. This review gives a general overview on the transmission pathways of HEV to humans. It particularly focuses on reported serological and molecular evidence of infections in wild, domestic and zoo animals with HEV or HEVrelated viruses. The role of these animals for transmission of HEV to humans and other animals is discussed. K E Y W O R D Scross-species transmission, domestic animals, hepatitis E virus, wildlife, zoo animals, zoonosis

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“…Four of nine publications on Camelpox discussed human transmission, including a paper that reported the first laboratory-confirmed case of human Camelpox (Bera et al 2011). There were five papers on hepatitis E, one of the five known human hepatitis virus strains, in which camel meat and milk were implicated as risk factors in humans through whole-genome sequencing, HEV IgM, or HEV RNA detection (Pavio et al 2015 Khuroo andKhuroo 2016;Lee et al 2016;Rasche et al 2016;Spahr et al 2018). In one of these reports, a liver transplant patient in the United Arab Emirates consumed camel meat and milk regularly and was chronically infected with hepatitis E (Lee et al 2016).…”

Section: Viralmentioning

confidence: 99%

A Review of Zoonotic Pathogens of Dromedary Camels

2019

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Dromedary, or one-humped, camels Camelus dromedarius are an almost exclusively domesticated species that are common in arid areas as both beasts of burden and production animals for meat and milk.Currently, there are approximately 30 million dromedary camels, with highest numbers in Africa and the Middle East. The hardiness of camels in arid regions has made humans more dependent on them, especially as a stable protein source. Camels also carry and may transmit disease-causing agents to humans and other animals. The ability for camels to act as a point source or vector for disease is a concern due to increasing human demands for meat, lack of biosafety and biosecurity protocols in many regions, and a growth in the interface with wildlife as camel herds become sympatric with non-domestic species. We conducted a literature review of camel-borne zoonotic diseases and found that the majority of publications (65%) focused on Middle East respiratory syndrome (MERS), brucellosis, Echinococcus granulosus, and Rift Valley fever. The high fatality from MERS outbreaks during 2012-2016 elicited an immediate response from the research community as demonstrated by a surge of MERS-related publications. However, we contend that other camel-borne diseases such as Yersinia pestis, Coxiella burnetii, and Crimean-Congo hemorrhagic fever are just as important to include in surveillance efforts. Camel populations, particularly in sub-Saharan Africa, are increasing exponentially in response to prolonged droughts, and thus, the risk of zoonoses increases as well. In this review, we provide an overview of the major zoonotic diseases present in dromedary camels, their risk to humans, and recommendations to minimize spillover events.

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Hepatitis E Virus Infection in Dromedaries, North and East Africa, United Arab Emirates, and Pakistan, 1983–2015

Cited by 72 publications

References 14 publications

Transmission of a Novel Genotype of Hepatitis E Virus from Bactrian Camels to Cynomolgus Macaques

Transmission of a Novel Genotype of Hepatitis E Virus from Bactrian Camels to Cynomolgus Macaques

Hepatitis E virus and related viruses in wild, domestic and zoo animals: A review

A Review of Zoonotic Pathogens of Dromedary Camels

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