Occupational Exposure to Hepatitis E Virus (HEV) in Swine Workers

Galiana, Carolina; Fernández-Barredo, Salceda; García-Muñoz, Ángel; Gómez, Marı́a; Pérez‐Gracia, María Teresa

doi:10.4269/ajtmh.2008.78.1012

Cited by 105 publications

(79 citation statements)

References 26 publications

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“…6, P=0 . 01) for anti-HEV IgG seroprevalence confirmed by immunoblot [94]. Conversely, the EL3 case-control study found that drinking well water and contact with surface was not related to HEV infection [52].…”

Section: Potential For Water-borne Transmissionmentioning

confidence: 95%

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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Section: Potential For Water-borne Transmissionmentioning

confidence: 95%

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

2009

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“…45,46 In Madagascar, we found that HEV seroprevalence among slaughterhouse workers reached 33.3% in the district of Fianarantsoa, but the average seropositivity (14.1%) could be considered as modest when compared with other studies. Indeed, studies in Spain, 47 Germany, 48 Switzerland, 49 and in the United States 24,50 have shown that HEV seroprevalence in exposed human populations, such as veterinarians and slaughterhouse workers, can reach more than 35%, whereas in non-exposed humans (i.e., blood donors) the seroprevalence is significantly lower. Further studies are needed to measure the seroprevalence of HEV in the Malagasy general population, and to determine if pig breeders are at higher risk of contamination.…”

Section: Discussionmentioning

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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“…Occupational exposures to farm animals, especially swine, have been associated with HEV infection in some studies in Africa, Europe, and the United States (73,133,145,146), but a recent study in Thailand found no difference between the seroprevalence among swine workers and that among others in the local population (147). Inadequately treated manure from swine farms represents another potential source of environmental contamination (148)(149)(150).…”

Section: Epidemiologic Patterns Of Hepatitis E Virus Infectionmentioning

confidence: 99%

Host Immune Status and Response to Hepatitis E Virus Infection

2014

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SUMMARY Hepatitis E virus (HEV), identified over 30 years ago, remains a serious threat to life, health, and productivity in developing countries where access to clean water is limited. Recognition that HEV also circulates as a zoonotic and food-borne pathogen in developed countries is more recent. Even without treatment, most cases of HEV-related acute viral hepatitis (with or without jaundice) resolve within 1 to 2 months. However, HEV sometimes leads to acute liver failure, chronic infection, or extrahepatic symptoms. The mechanisms of pathogenesis appear to be substantially immune mediated. This review covers the epidemiology of HEV infection worldwide, the humoral and cellular immune responses to HEV, and the persistence and protection of antibodies produced in response to both natural infection and vaccines. We focus on the contributions of altered immune states (associated with pregnancy, human immunodeficiency virus [HIV], and immunosuppressive agents used in cancer and transplant medicine) to the elevated risks of chronic infection (in immunosuppressed/immunocompromised patients) and acute liver failure and mortality (among pregnant women). We conclude by discussing outstanding questions about the immune response to HEV and interactions with hormones and comorbid conditions. These questions take on heightened importance now that a vaccine is available.

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Occupational Exposure to Hepatitis E Virus (HEV) in Swine Workers

Cited by 105 publications

References 26 publications

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

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

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

Host Immune Status and Response to Hepatitis E Virus Infection

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