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Non-travel related Hepatitis E virus genotype 3 infections in the Netherlands; a case series 2004 - 2006.

ABSTRACT: BACKGROUND: Human hepatitis E virus (HEV) infections are considered an emerging disease in industrialized countries. In the Netherlands, Hepatitis E virus (HEV) infections have been associated with travel to high-endemic countries. Non-travel related HEV of genotype 3 has been diagnosed occasionally since 2000. A high homology of HEV from humans and pigs suggests zoonotic transmission but direct molecular and epidemiological links have yet to be established. We conducted a descriptive case series to generate hypotheses about possible risk factors for non-travel related HEV infections and to map the genetic diversity of HEV. METHODS: A case was defined as a person with HEV infection laboratory confirmed (positive HEV RT-PCR and/or HEV IgM) after 1 January 2004, without travel to a high-endemic country three months prior to onset of illness. For virus identification 148 bp of ORF2 was sequenced and compared with HEV from humans and pigs. We interviewed cases face to face using a structured questionnaire and collected information on clinical and medical history, food preferences, animal and water contact. RESULTS: We interviewed 19 cases; 17 were male, median age 50 years (25-84 y), 12 lived in the North-East of the Netherlands and 11 had preexisting disease. Most common symptoms were dark urine (n = 16) and icterus (n = 15). Sixteen ate pork >/= once/week and six owned dogs. Two cases had received blood transfusions in the incubation period. Seventeen cases were viremic (genotype 3 HEV), two had identical HEV sequences but no identified relation. For one case, HEV with identical sequence was identified from serum and surface water nearby his home. CONCLUSION: The results show that the modes of transmission of genotype-3 HEV infections in the Netherlands remains to be resolved and that host susceptibility may play an important role in development of disease.

SUBMITTER: Borgen K

PROVIDER: S-EPMC2413240 | biostudies-literature | 2008

REPOSITORIES: biostudies-literature

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Non-travel related Hepatitis E virus genotype 3 infections in the Netherlands; a case series 2004 - 2006.

Borgen Katrine K Herremans Tineke T Duizer Erwin E Vennema Harry H Rutjes Saskia S Bosman Arnold A de Roda Husman Ana Maria AM Koopmans Marion M

BMC infectious diseases 20080508

<h4>Background</h4>Human hepatitis E virus (HEV) infections are considered an emerging disease in industrialized countries. In the Netherlands, Hepatitis E virus (HEV) infections have been associated with travel to high-endemic countries. Non-travel related HEV of genotype 3 has been diagnosed occasionally since 2000. A high homology of HEV from humans and pigs suggests zoonotic transmission but direct molecular and epidemiological links have yet to be established. We conducted a descriptive cas ...[more]

PMID: 18462508

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Project description:BackgroundIn 2010, the incidence of hepatitis C virus (HCV) infection in the United States was estimated to be 17 000 cases annually, based on 850 acute HCV cases reported to the Centers for Disease Control and Prevention by local public health authorities. Absence of symptomatic disease and lack of a specific laboratory test for acute infection complicates diagnosis and surveillance.ObjectiveTo validate estimates of the incidence of acute HCV infection by determining the reporting rate of clinical diagnoses of acute infection to the Massachusetts Department of Public Health (MDPH) and Centers for Disease Control and Prevention.DesignCase series and chart review.SettingTwo hospitals and the state correctional health care system in Massachusetts.Patients183 patients clinically diagnosed with acute HCV infection from 2001 to 2011 and participating in a research study.MeasurementsRate of electronic case reporting of acute HCV infection to the MDPH and rate of subsequent confirmation according to national case definitions.Results149 of 183 (81.4%) clinical cases of acute HCV infection were reported to the MDPH for surveillance classification. The MDPH investigated 43 of these reports as potential acute cases of HCV infection based on their surveillance requirements; ultimately, only 1 met the national case definition and was counted in nationwide statistics published by the Centers for Disease Control and Prevention. Discordance in clinical and surveillance classification was often related to missing clinical or laboratory data at the MDPH as well as restrictive definitions, including requirements for negative hepatitis A and B laboratory results.LimitationFindings may not apply to other jurisdictions because of differences in resources for surveillance.ConclusionClinical diagnoses of acute HCV infection were grossly underascertained by formal surveillance reporting. Incomplete clinician reporting, problematic case definitions, limitations of diagnostic testing, and imperfect data capture remain major limitations to accurate case ascertainment despite automated electronic laboratory reporting. These findings may have implications for national estimates of the incidence of HCV infection.Primary funding sourceNational Institutes of Health.

Dataset Information

Non-travel related Hepatitis E virus genotype 3 infections in the Netherlands; a case series 2004 - 2006.

Publications

Non-travel related Hepatitis E virus genotype 3 infections in the Netherlands; a case series 2004 - 2006.

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