A systematic review/meta-analysis of primary research investigating swine, pork or pork products as a source of zoonotic hepatitis E virus

Abstract

The objectives of our study were to identify and categorize primary research investigating swine/pork as a source of zoonotic hepatitis E virus (HEV) using the relatively new technique of scoping study, and to investigate the potential association between human exposure to swine/pork and HEV infection quantitatively using systematic review/meta-analysis methodology. From 1890 initially identified abstracts, 327 were considered for the review. Five study design types (cross-sectional, prevalence, genotyping, case-report and experimental transmission studies) were identified. A significant association between occupational exposure to swine and human HEV IgG seropositivity was reported in 10/13 cross-sectional studies. The association reported between pork consumption and HEV IgG seropositivity was inconsistent. The quantification of viral load in swine and retail pork, viral load required for infection in primates, cohort and case-control studies in humans, and formal risk assessment are recommended before specific public-health policy actions are taken.

Prevalence of hepatitis E virus (HEV) antibodies in Serbian blood donors

“…Also, several studies have reported an association between occupational exposure to swine and a higher HEV IgG seropositivity [13]. In our study of the blood donor population, no association between HEV positive serology and direct contact with domestic or farm animals, including pigs, was found.…”

“…This fact, together with the description of cases of acute hepatitis in people who ate uncooked deer meat or liver from pork or wild boar and the recent detection of HEV RNA and infectious virus in commercial pig livers and pork products sold in local grocery stores has raised the hypothesis of a zoonotic potential for HEV [3,[8][9][10][11][12]. Several studies have suggested that pig handlers, veterinarians, and other workers with occupational exposure to swine present a higher HEV IgG seropositivity, although other studies did not find such an association [2,13].…”

Seroprevalence of Seven Zoonotic Pathogens in Pregnant Women from the Caribbean

“…Recent studies have investigated swine, including pork meat, as a source of zoonotic hepatitis E infection. 22 The results from this study indicate a low prevalence of antibody in the individuals tested (although the possibility that these results may represent false-positives cannot be ruled out); however, the possible route(s) of transmission of this virus requires further study.…”

Bioaccumulation Efficiency, Tissue Distribution, and Environmental Occurrence of Hepatitis E Virus in Bivalve Shellfish from France

“…Genotypes 1 and 2, which mainly infect humans, have been described in Asia, Africa, or Mexico, whereas genotypes 3 and 4 have been described worldwide. Genotypes 3 and 4 have been described in a variety of animal species and present a potential zoonotic risk (4)(5)(6). As with other enteric viruses, HEV may be detected in high concentrations in feces from infected individuals and thus can be detected in raw or treated sewage (5,7).…”

“…As with other enteric viruses, HEV may be detected in high concentrations in feces from infected individuals and thus can be detected in raw or treated sewage (5,7). The fecal-oral transmission route within an animal species and from contaminated food or waters to humans has been documented (4,6,8).…”