Three cases of acute or fulminant hepatitis E caused by ingestion of pork meat and entrails in Hokkaido, Japan: Zoonotic food‐borne transmission of hepatitis E virus and public health concerns

Miyashita, Kencho; Kang, Jong-Hon; Saga, Akiyoshi; Takahashi, Kazuaki; Shimamura, Tsuyoshi; Yasumoto, Atsushi; Fukushima, H.; Sogabe, Susumu; Konishi, Kouhei; Uchida, Tatsuo; Fujinaga, Atsuro; Matsui, Takeshi; Sakurai, Yasuo; Tsuji, Kiichiro; Maguchi, Hiroyuki; Taniguchi, Masahiko; Abe, Natsumi; Akbar, Sheikh Mohammad Fazle; Arai, Masahiro; Mishiro, Shunji

doi:10.1111/j.1872-034x.2012.01006.x

Cited by 63 publications

(55 citation statements)

References 26 publications

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“…In addition, amongst the 68 cases suspected of having acquired infection through pork consumption, 34 (50.0%) had consumed pork liver. These dietary behaviours amongst cases may explain possible routes of HEV infection, which is in line with previous studies that point towards pork and deer meat as possible risk factors (Colson et al, 2010;Kamar et al, 2012;Miyashita et al, 2012;Tei et al, 2003). In marked contrast, infections with enterohaemorrhagic Escherichia coli (EHEC) originate from cows, and EHEC cases have been associated with consumption of raw beef.…”

Section: Discussionsupporting

confidence: 58%

“…In 2001, the first domestic case of transfusion-related HEV infection was reported in Hokkaido (Matsubayashi et al, 2004(Matsubayashi et al, ) and, in 2004, an outbreak of HEV infection in a family, including a fatal case, occurred in Hokkaido (Matsubayashi et al, 2008). In addition, consumption of deer meat resulted in a fatality, and pork consumption caused an outbreak, raising concerns about HEV infections (Miyashita et al, 2012;Tei et al, 2003).…”

Section: Introductionmentioning

confidence: 99%

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Epidemiology of domestically acquired hepatitis E virus infection in Japan: assessment of the nationally reported surveillance data, 2007–2013

Kanayama

Arima

Yamagishi

et al. 2015

Journal of Medical Microbiology

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In recent years, there has been an increase in the number of reported hepatitis E virus (HEV) infections from developed countries. To describe recent trends in notification and potential risk groups and risk factors in Japan, HEV infection cases and demographic, food consumption, clinical and laboratory data reported during 2007-2013 were analysed. In total, 530 HEV infections were reported during 2007-2013. Amongst 462 domestic cases, the mean age was 56.5 years (SD 13.9) and 80.1 % were male. Forty-three cases (9.3 %) were asymptomatic, amongst which 11 were detected from blood donations. Whilst ,50 cases were reported annually during 2007-2011, the number of reported cases increased to 121 in 2012 and 126 in 2013. The increase was characterized by a rise in the number of domestic, symptomatic cases (P50.05) and cases confirmed by anti-HEV IgA detection (P,0.01). HEV genotypes G3 and G4 were consistently dominant. The major suspected source of infection was food-borne, and the major suspected foods were pig, wild boar and deer meat. The observed increase during 2012-2013 was most likely due to the coverage of the anti-HEV IgA assay by the National Health Insurance system in Japan in October 2011 and its acceptance for surveillance purposes. However, the increase was not associated with detection of asymptomatic cases. Moreover, males aged 50-69 years remained as the high-risk group, and pork and other meats continued to be the most suspected items. Our findings indicated that HEV infection is an emerging and important public health concern in Japan.

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Section: Discussionsupporting

confidence: 58%

Section: Introductionmentioning

confidence: 99%

Epidemiology of domestically acquired hepatitis E virus infection in Japan: assessment of the nationally reported surveillance data, 2007–2013

Kanayama

Arima

Yamagishi

et al. 2015

Journal of Medical Microbiology

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“…Although HEV infection in pigs does not pose a major economic risk to pork production, the risk of zoonotic transmission to humans is an important aspect of public health (14). Professionals working in close proximity to swine, swine manure, or sewage, pig farm workers, hunters, and veterinary practitioners may become infected with HEV through occupational activities (18,24).…”

Section: Introductionmentioning

confidence: 99%

Preliminary study on the detection of hepatitis E virus (HEV) antibodies in pigs and wild boars in Poland

Weiner

Tokarska-Rodak

Plewik³

et al. 2016

Journal of Veterinary Research

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Introduction: Although HEV infection in pigs does not pose a major economic risk to pork production, the risk of zoonotic transmission to humans is an important aspect of public health. HEV genotype 3 infections were reported in developed countries in individuals who had consumed raw meat or meat products from deer, wild boars, or pigs. The aim of the study was the analysis of the occurrence of HEV-specific antibodies among wild boars and domestic pigs in Poland. Material and Methods: A total of 290 samples from wild boars and 143 samples from pigs were tested. The antibodies were tested by ELISA. Results: The presence of anti-HEV IgG was demonstrated in 44.1% of pigs and 31.0% of wild boars. Anti-HEV IgG antibodies were detected in 1.4% of samples from pigs and in 2.1% of samples from wild boars at borderline level. The statistical analysis shows significant differences in the positive results for anti-HEV IgG between the groups of pigs and wild boars (P = 0.0263). Conclusion: Regular surveillance of the occurrence of HEV in swine and wild boars should be performed in the future.

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“…In developed countries, hepatitis E was considered rare and reported in travellers returning from countries endemic for HEV. However, autochthonous HEV linked to zoonotic transmission is reported in developed countries (103,163,246), including Australia (201). This could be attributed to changes in risk behaviours among humans, such as increased consumption of undercooked pork.…”

Section: Discussionmentioning

confidence: 99%

“…As more people are likely to travel to such countries in the future (for example due to decreased cost of international travel) (245), the incidence of HEV infection may increase. Consumption of undercooked infected meat or contact with infected animals is another risk factor associated with HEV infection; which has the potential to expose a greater number of people to this virus (162,246). These factors threaten to increase the incidence of HEV in the future.…”

Section: Hepatitis E -An Emerging Infectious Diseasementioning

confidence: 99%

Evaluating the risks posed by hepatitis E virus to blood supply safety

Shrestha¹

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Transfusion is an important field of clinical medicine, responsible for saving the lives of millions of people. However, concerns remain for patients' safety from adverse reactions and transfusion transmissible infections (TTIs). While risks from well-known TTIs (such as human immunodeficiency virus, human T-lymphotrophic virus, hepatitis B virus, hepatitis C virus and Treponema pallidum) have been reduced in developed nations, developing countries struggle to maintain the minimum screening requirements for these infections.

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Three cases of acute or fulminant hepatitis E caused by ingestion of pork meat and entrails in Hokkaido, Japan: Zoonotic food‐borne transmission of hepatitis E virus and public health concerns

Cited by 63 publications

References 26 publications

Epidemiology of domestically acquired hepatitis E virus infection in Japan: assessment of the nationally reported surveillance data, 2007–2013

Epidemiology of domestically acquired hepatitis E virus infection in Japan: assessment of the nationally reported surveillance data, 2007–2013

Preliminary study on the detection of hepatitis E virus (HEV) antibodies in pigs and wild boars in Poland

Evaluating the risks posed by hepatitis E virus to blood supply safety

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