Hepatitis E Epidemic, Biratnagar, Nepal, 2014

Shrestha, Ananta; Lama, T. K.; Karki, Sneha; Sigdel, Deepak R.; Rai, Utsav; Rauniyar, Shyam K.; Al‐Mahtab, Mamun; Takahashi, Kazuaki; Arai, Masahiro; Akbar, Sk. Md. Fazle; Mishiro, Shunji

doi:10.3201/eid2104.141512

Cited by 32 publications

(33 citation statements)

References 2 publications

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“…This suggests less HEV transmission in the Chitwan district. During an epidemic in Biratnagar, Nepal, 2014, HEV IgM prevalence was as high as 94–100% in acute hepatitis patients [11]. In our study, subjects were blood donors, considered healthy and therefore would not capture the symptomatic group of the population.…”

Section: Discussionmentioning

confidence: 99%

“…In Nepal, regular HEV outbreaks have occurred during the previous 4 decades, with reported outbreaks in 1973, 1981–1982, 1987, 1995 and 2014 [9–11]. During these outbreaks, a maternal mortality rate of 21–25% was reported [9].…”

Section: Introductionmentioning

confidence: 99%

“…During these outbreaks, a maternal mortality rate of 21–25% was reported [9]. During an outbreak in Biratnagar in 2014, the case fatality rate was 0.2% [11]. HEV IgG prevalence in 1999–2000 was estimated to be 38% among the general population of Nepal [9].…”

Section: Introductionmentioning

confidence: 99%

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Hepatitis E virus seroepidemiology: a post-earthquake study among blood donors in Nepal

et al. 2016

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BackgroundAs one of the causative agents of viral hepatitis, hepatitis E virus (HEV) has gained public health attention globally. HEV epidemics occur in developing countries, associated with faecal contamination of water and poor sanitation. In industrialised nations, HEV infections are associated with travel to countries endemic for HEV, however, autochthonous infections, mainly through zoonotic transmission, are increasingly being reported. HEV can also be transmitted by blood transfusion. Nepal has experienced a number of HEV outbreaks, and recent earthquakes resulted in predictions raising the risk of an HEV outbreak to very high. This study aimed to measure HEV exposure in Nepalese blood donors after large earthquakes.MethodsSamples (n = 1,845) were collected from blood donors from Kathmandu, Chitwan, Bhaktapur and Kavre. Demographic details, including age and sex along with possible risk factors associated with HEV exposure were collected via a study-specific questionnaire. Samples were tested for HEV IgM, IgG and antigen. The proportion of donors positive for HEV IgM or IgG was calculated overall, and for each of the variables studied. Chi square and regression analyses were performed to identify factors associated with HEV exposure.ResultsOf the donors residing in earthquake affected regions (Kathmandu, Bhaktapur and Kavre), 3.2% (54/1,686; 95% CI 2.7–4.0%) were HEV IgM positive and two donors were positive for HEV antigen. Overall, 41.9% (773/1,845; 95% CI 39.7–44.2%) of donors were HEV IgG positive, with regional variation observed. Higher HEV IgG and IgM prevalence was observed in donors who reported eating pork, likely an indicator of zoonotic transmission. Previous exposure to HEV in Nepalese blood donors is relatively high.ConclusionDetection of recent markers of HEV infection in healthy donors suggests recent asymptomatic HEV infection and therefore transfusion-transmission in vulnerable patients is a risk in Nepal. Surprisingly, this study did not provide evidence of a large HEV outbreak following the devastating earthquakes in 2015.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Hepatitis E virus seroepidemiology: a post-earthquake study among blood donors in Nepal

et al. 2016

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“…(1) In Asian countries, contaminated water supply is the predominant route of HEV infection. (2)(3)(4) Nepal is highly endemic for hepatitis E infection, and five epidemics have occurred over the last 30 years. (5) All the reported sporadic and epidemic acute hepatitis E infections in Nepal have so far been caused by HEV genotype 1.…”

mentioning

confidence: 99%

Acute hepatitis E virus infection in human immunodeficiency virus–positive men and women in Nepal: Not quite a rare entity

Gupta

Shrestha²,

Adhikari

et al. 2016

Hepatology

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“…Recently the outbreak was observed in 2014 in Eastern part of Nepal, Biratnagar, causing 1481 infections and 11 deaths [9]. From different studies, the prevalence of HEV specific IgG is found to be 16-38% among general population in Nepal [6,10].…”

Section: Introductionmentioning

confidence: 99%

Post-Earth Quake assessment of HEV prevalence among general population

Khadka¹,

Dhital²,

Jb³

et al. 2018

Virol Mycol

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Hepatitis E virus (HEV) infection is a global disease causing acute hepatitis, transmitted by fecal contaminated water. In South East Asian countries like, Nepal Hepatitis E virus is a most common causative agent of sporadic viral hepatitis and outbreaks. The risk of viral hepatitis has escalated after April earth quake in Nepal. The study was done with the objective to find the prevalence of HEV specific IgM among the general population. Blood samples from 570 healthy populations were tested for HEV IgM by using the Wantai HEV-IgM ELISA, and 1.40% of the study population is found to be harboring the HEV IgM. The study fostered the low level exposure to virus with human reservoirs.

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Hepatitis E Epidemic, Biratnagar, Nepal, 2014

Cited by 32 publications

References 2 publications

Hepatitis E virus seroepidemiology: a post-earthquake study among blood donors in Nepal

Hepatitis E virus seroepidemiology: a post-earthquake study among blood donors in Nepal

Acute hepatitis E virus infection in human immunodeficiency virus–positive men and women in Nepal: Not quite a rare entity

Post-Earth Quake assessment of HEV prevalence among general population

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