This paper was completed on June 22, 2007, and approved by the German Advisory Committee Blood (Arbeitskreis Blut) on October 1, 2007. It was compiled by the members of the subgroup ‘Assessment of Pathogens Transmissible by Blood’ of the German Advisory Committee Blood (Arbeitskreis Blut): 
 
Prof. Dr. Georg Pauli 
 
Dr. Johannes Blumel 
 
Prof. Dr. Reinhard Burger 
 
Prof. Dr. Christian Drosten 
 
Dr. Albrecht Groner 
 
Prof. Dr. Lutz Gurtler 
 
Dr. Margarethe Heiden 
 
PD Dr. Martin Hildebrandt 
 
Prof. Dr. Dr. Bernd Jansen 
 
Dr. Horst Klamm 
 
Dr. Thomas Montag-Lessing 
 
Dr. Ruth Offergeld 
 
Prof. Dr. Rainer Seitz 
 
Dr. Uwe Schlenkrich 
 
Dr. Volkmar Schottstedt 
 
Dr. Hannelore Willkommen 
 
Prof. Dr. Carl-Heinz Wirsing von Konig

Hepatitis E Virus

Hepatitis E: An emerging infection in high income countries

Hepatitis E virus (HEV) causes an important public health disease in many developing countries and is also endemic in some industrialized countries. In addition to humans, strains of HEV have been genetically identified from pig, chicken, rat, mongoose, deer, rabbit and fish. While the genotypes 1 and 2 HEV are restricted to humans, the genotypes 3 and 4 HEV are zoonotic and infect humans and other animal species. As a part of our ongoing efforts to search for potential animal reservoirs for HEV, we tested goats from Virginia for evidence of HEV infection and showed that 16% (13/80) of goat sera from Virginia herds were positive for IgG anti-HEV. Importantly, we demonstrated that neutralizing antibodies to HEV were present in selected IgG anti-HEV positive goat sera. Subsequently, in an attempt to genetically identify the HEV-related agent from goats, we conducted a prospective study in a closed goat herd with known anti-HEV seropositivity and monitored a total of 11 kids from the time of birth until 14 weeks of age for evidence of HEV infection. Seroconversion to IgG anti-HEV was detected in seven of the 11 kids, although repeated attempts to detect HEV RNA by a broad-spectrum nested RT-PCR from the faecal and serum samples of the goats that had seroconverted were unsuccessful. In addition, we also attempted to experimentally infect laboratory goats with three well-characterized mammalian strains of HEV but with no success. The results indicate that a HEV-related agent is circulating and maintained in the goat population in Virginia and that the goat HEV is likely genetically very divergent from the known HEV strains.

/pdf/serological-evidence-for-a-hepatitis-e-virus-related-agent-49wdauc3ch.pdf

Serological evidence for a hepatitis e virus-related agent in goats in the United States.

The aim of current study was to investigate the epidemiology of Hepatitis E virus (HEV) in humans and geographically matched food animals as a novel zoonotic assessment in Egypt. Blood samples were collected from patients who had a history of jaundice and attended to fever and general hospitals. Animal blood samples were collected from cows, buffaloes, sheep and goats convenient to HEV seropositive humans. Enzyme Immuno Assay (EIA) protocol was used to determine IgG anti-HEV. Sex and pregnancy were investigated as potential risk factors for HEV infection. Of 134 examined humans, 51 (38.1%) were positive for IgG anti-HEV. The males showed 26.8% seropositivity while the recorded female seropositivity was 50.8%, with a significant difference at P = 0.005, Odds Ratio (OR) = 0.35 at 95% confidence interval (CI): 0.17-0.73. There was a significant difference at P = 0.02 between seropositivity in pregnant (25%) and non-pregnant women (59.6%); OR was 0.23 (95% CI: 0.06-0.81). Anorexia was the most common symptom whereas paraesthesia and back pain were the least within icteric seropositive HEV humans. Hepatitis E virus seropositivity was recorded in 21.6%, 14%, 4.4% and 9.4% from examined cows, buffaloes, sheep and goats, respectively. The infected food animals were convenient to positive HEV humans who may declare the epidemiological picture of potential zoonotic HEV.

Seroprevalence of hepatitis E virus in humans and geographically matched food animals in Egypt.

Emerging viral infections represent a public health risk pointed out by the spreading of pathogens with potential zoonotic risk. Moreover, the risk of zoonosis has probably been underestimated in occupational settings. A literature review between 2007 and 2018 was performed to identify evidences concerning the epidemiological associations between some emerging viruses and occupational diseases. Observational studies and case-reports were selected and analyzed. West Nile Virus (WNV) disease, Crimean-Congo Hemorrhagic Fever (CCHF) disease and Hepatitis E virus (HEV) infection were included in the review for their potential zoonotic transmission. The most important risk factor for acquiring WNV infection and CCHF infection is the exposure to infected mosquitoes and ticks, respectively; therefore, outdoor workers are at risk of infection. HEV is responsible for epidemics and endemics of acute hepatitis in humans, that can become infected through waterborne, foodborne and zoonotic transmission routes. A total of 10, 34 and 45 eligible studies for WNV, CCHF virus (CCFHV) and HEV, respectively, were analyzed by year, country, study design, risk group and outcomes. The occupational risk groups mainly included farm and agricultural workers, veterinarians, slaughterers, animal handlers, healthcare workers and soldiers. These findings support the need to develop effective interventions to prevent transmission of emerging viruses.

/pdf/emerging-zoonotic-viral-infections-of-occupational-health-4t6bvfo6ny.pdf

Emerging zoonotic viral infections of occupational health importance.

SUMMARY. The aim of this study was to further investigate the prevalence of infection and genotype of hepatitis E virus (HEV) among different species of animals, people whose works are related to pigs and the general population in the suburb of Beijing, China. Serum and faecal samples were collected from 10 animal species and humans. Anti-HEV was detected by enzyme immunoassays (EIA); HEV RNA was amplified by reverse transcription‐nested polymerase chain reaction (RT-nPCR) method. PCR products were cloned and sequenced. The isolated swine HEV sequences were analysed phylogenetically. The positive rates of serum anti-HEV in swine, cattle, milk cow, horse, sheep, donkey, dog, duck, chicken, pig farm workers and slaughterhouse workers, and general population were 81.17% (802/988), 25.29% (66/ 261), 14.87% (40/269), 14.29% (40/280), 9.30% (53/ 514), 0 (0/25), 0 (0/20), 2.53% (8/316), 3.03% (7/231), 58.73% (37/63), 35.87% (66/184) and 20.06% (538/ 2682), respectively. The anti-HEV prevalence in adult swine (‡6 months) and younger swine (£3 months) was 91.49% (591/646) and 61.7% (211/342), respectively. The positive rate of HEV RNA in young swine faeces was 47.94% (93/ 194). All 93 isolates from the younger swine shared 87.8‐ 100% nucleotide homology with each other and had identities of 75.6‐78.9%, 73.9‐76.1%, 76.4‐80.6% and 83.1‐95.0% with the corresponding regions of genotypes 1‐4 HEV, respectively. Phylogenetic analysis showed that all HEV isolates belong to genotype 4, subgenotype 4d. These results suggest a potential risk of zoonotic transmission of HEV from younger swine to farmers who rear pigs.

Potential risk of zoonotic transmission from young swine to human: seroepidemiological and genetic characterization of hepatitis E virus in human and various animals in Beijing, China

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Potential risk of zoonotic transmission from young swine to human: seroepidemiological and genetic characterization of hepatitis E virus in human and various animals in Beijing, China