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Hiding in Plain Sight? It's Time to Investigate Other Possible Transmission Routes for Hepatitis E Virus (HEV) in Developed Countries.
Food Environ Virol. 2018 09; 10(3):225-252.FE

Abstract

Historically in developed countries, reported hepatitis E cases were typically travellers returning from countries where hepatitis E virus (HEV) is endemic, but now there are increasing numbers of non-travel-related ("autochthonous") cases being reported. Data for HEV in New Zealand remain limited and the transmission routes unproven. We critically reviewed the scientific evidence supporting HEV transmission routes in other developed countries to inform how people in New Zealand may be exposed to this virus. A substantial body of indirect evidence shows domesticated pigs are a source of zoonotic human HEV infection, but there is an information bias towards this established reservoir. The increasing range of animals in which HEV has been detected makes it important to consider other possible animal reservoirs of HEV genotypes that can or could infect humans. Foodborne transmission of HEV from swine and deer products has been proven, and a large body of indirect evidence (e.g. food surveys, epidemiological studies and phylogenetic analyses) support pig products as vehicles of HEV infection. Scarce data from other foods suggest we are neglecting other potential sources of foodborne HEV infection. Moreover, other transmission routes are scarcely investigated in developed countries; the role of infected food handlers, person-to-person transmission via the faecal-oral route, and waterborne transmission from recreational contact or drinking untreated or inadequately treated water. People have become symptomatic after receiving transfusions of HEV-contaminated blood, but it is unclear how important this is in the overall hepatitis E disease burden. There is need for broader research efforts to support establishing risk-based controls.

Authors+Show Affiliations

Institute of Environmental Science and Research, 34 Kenepuru Drive, Kenepuru, Porirua, 5022, New Zealand.Institute of Environmental Science and Research, 34 Kenepuru Drive, Kenepuru, Porirua, 5022, New Zealand. joanne.hewitt@esr.cri.nz.New Zealand Ministry for Primary Industries, Pastoral House, 25 The Terrace, Wellington, New Zealand.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Review

Language

eng

PubMed ID

29623595

Citation

King, Nicola J., et al. "Hiding in Plain Sight? It's Time to Investigate Other Possible Transmission Routes for Hepatitis E Virus (HEV) in Developed Countries." Food and Environmental Virology, vol. 10, no. 3, 2018, pp. 225-252.
King NJ, Hewitt J, Perchec-Merien AM. Hiding in Plain Sight? It's Time to Investigate Other Possible Transmission Routes for Hepatitis E Virus (HEV) in Developed Countries. Food Environ Virol. 2018;10(3):225-252.
King, N. J., Hewitt, J., & Perchec-Merien, A. M. (2018). Hiding in Plain Sight? It's Time to Investigate Other Possible Transmission Routes for Hepatitis E Virus (HEV) in Developed Countries. Food and Environmental Virology, 10(3), 225-252. https://doi.org/10.1007/s12560-018-9342-8
King NJ, Hewitt J, Perchec-Merien AM. Hiding in Plain Sight? It's Time to Investigate Other Possible Transmission Routes for Hepatitis E Virus (HEV) in Developed Countries. Food Environ Virol. 2018;10(3):225-252. PubMed PMID: 29623595.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Hiding in Plain Sight? It's Time to Investigate Other Possible Transmission Routes for Hepatitis E Virus (HEV) in Developed Countries. AU - King,Nicola J, AU - Hewitt,Joanne, AU - Perchec-Merien,Anne-Marie, Y1 - 2018/04/05/ PY - 2017/12/17/received PY - 2018/03/29/accepted PY - 2018/4/7/pubmed PY - 2019/3/21/medline PY - 2018/4/7/entrez KW - Autochthonous KW - Hepatitis E virus KW - New Zealand KW - Transmission routes SP - 225 EP - 252 JF - Food and environmental virology JO - Food Environ Virol VL - 10 IS - 3 N2 - Historically in developed countries, reported hepatitis E cases were typically travellers returning from countries where hepatitis E virus (HEV) is endemic, but now there are increasing numbers of non-travel-related ("autochthonous") cases being reported. Data for HEV in New Zealand remain limited and the transmission routes unproven. We critically reviewed the scientific evidence supporting HEV transmission routes in other developed countries to inform how people in New Zealand may be exposed to this virus. A substantial body of indirect evidence shows domesticated pigs are a source of zoonotic human HEV infection, but there is an information bias towards this established reservoir. The increasing range of animals in which HEV has been detected makes it important to consider other possible animal reservoirs of HEV genotypes that can or could infect humans. Foodborne transmission of HEV from swine and deer products has been proven, and a large body of indirect evidence (e.g. food surveys, epidemiological studies and phylogenetic analyses) support pig products as vehicles of HEV infection. Scarce data from other foods suggest we are neglecting other potential sources of foodborne HEV infection. Moreover, other transmission routes are scarcely investigated in developed countries; the role of infected food handlers, person-to-person transmission via the faecal-oral route, and waterborne transmission from recreational contact or drinking untreated or inadequately treated water. People have become symptomatic after receiving transfusions of HEV-contaminated blood, but it is unclear how important this is in the overall hepatitis E disease burden. There is need for broader research efforts to support establishing risk-based controls. SN - 1867-0342 UR - https://www.unboundmedicine.com/medline/citation/29623595/Hiding_in_Plain_Sight_It's_Time_to_Investigate_Other_Possible_Transmission_Routes_for_Hepatitis_E_Virus__HEV__in_Developed_Countries_ L2 - https://dx.doi.org/10.1007/s12560-018-9342-8 DB - PRIME DP - Unbound Medicine ER -