Hepatitis E in Norway: seroprevalence in humans and swine

Lange, Heidi; Øverbø, Joakim; Borgen, Katrine; Dudman, Susanne; Hoddevik, Gunnar; Urdahl, Anne Margrete; Vold, Line; Sjurseth, Siri K.

doi:10.1017/s0950268816002144

Cited by 59 publications

(54 citation statements)

References 28 publications

(40 reference statements)

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“…Therefore, these results suggest that a direct contact to pigs represents a remarkably high risk for HEV infection. This is in line with various previous studies [14,15,34,35,49,[52][53][54][55][56][57], while a few authors did not find evidence for such an association [58][59][60]. Based on the tendencies found in our study (HEV IgG prevalence, serological evidence of (post)acute HEV infection) and the support from literature [38], we hypothesize that professional exposure to domestic pigs is a stronger risk factor than having occasional contact to wild boar when hunting.…”

Section: Discussionsupporting

confidence: 92%

Performance of Hepatitis E Virus (HEV)-antibody tests: a comparative analysis based on samples from individuals with direct contact to domestic pigs or wild boar in Germany

Sommerkorn

Schauer

Schreiner

et al. 2017

Med Microbiol Immunol

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In Europe, Hepatitis E virus (HEV) genotype 3 causes most human infections, and domestic pigs and wild boar represent the main reservoirs. Contact to these animals represents one source of human infection. However, interpretation of studies is challenged in the absence of a serological gold standard. Hence, this study compared results of different HEV immunoassays. Plasma samples from 139 individuals who had professional contact to pigs (veterinarians, meat inspectors, slaughterhouse workers; n = 114) or hunted regularly (n = 25) were tested with assays specific for HEV IgG, HEV IgM, HEV IgA, and total HEV immunoglobulin as well as for viral RNA. Furthermore, overall HEV IgG was defined (i.e., two of three IgG assays reveal the same result) to compare serological findings. Borderline results were always quoted as positive. For IgG, apparent prevalence was higher in Wantai (48.2%) compared to Euroimmun (11.5%) and Mikrogen assays (17.3%) (p = 0.0001). The overall IgG prevalence was estimated to be 18.7%. For total Ig, Wantai (40.3%) also yielded higher prevalence than Euroimmun (15.8%) (p = 0.0001). The HEV IgM prevalence ranged from 0% (Euroimmun) to 4.3% (Mikrogen). Four percent of individuals tested IgA positive, whilst none harboured HEV RNA. Our results support previous studies that the higher IgG prevalence estimated with the Wantai assay result from a higher sensitivity of this test. However, further studies are needed to verify specificity given the challenge of defining true negative samples. The high percentage of individuals with HEV IgG observed in this study underlines that direct contact to pigs represents a risk factor for HEV infection.

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Section: Discussionsupporting

confidence: 92%

Performance of Hepatitis E Virus (HEV)-antibody tests: a comparative analysis based on samples from individuals with direct contact to domestic pigs or wild boar in Germany

Sommerkorn

Schauer

Schreiner

et al. 2017

Med Microbiol Immunol

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“…Similar results were obtained in the Netherlands and France [41, 43]. In Norway, increased seroprevalence has recently been reported in swine farm workers, but not among veterinarians [29]. In Spain, a case of acute hepatitis E in a slaughterhouse worker, probably infected after manipulating HEV-infected animals, was reported [238].…”

Section: Routes Of Transmission and Risk Groupssupporting

confidence: 70%

“…In Europe, high HEV seroprevalence has been detected in swine from Spain [143, 144], Italy [145–147], Norway [29], Denmark [148], UK [149, 150], Estonia [151], Germany [152, 153], or Switzerland [154, 155]. According to the seroprevalence data, 76% to 98% of Spanish swine farms have evidence of HEV presence [143, 144, 156, 157].…”

Section: Hev In Animalsmentioning

confidence: 99%

Hepatitis E Virus in Industrialized Countries: The Silent Threat

Clemente-Casares

Ramos-Romero

Ramirez-Gonzalez

et al. 2016

BioMed Research International

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Hepatitis E virus (HEV) is the main cause of acute viral hepatitis worldwide. Its presence in developing countries has been documented for decades. Developed countries were supposed to be virus-free and initially only imported cases were detected in those areas. However, sporadic and autochthonous cases of HEV infection have been identified and studies reveal that the virus is worldwide spread. Chronic hepatitis and multiple extrahepatic manifestations have also been associated with HEV. We review the data from European countries, where human, animal, and environmental data have been collected since the 90s. In Europe, autochthonous HEV strains were first detected in the late 90s and early 2000s. Since then, serological data have shown that the virus infects quite frequently the European population and that some species, such as pigs, wild boars, and deer, are reservoirs. HEV strains can be isolated from environmental samples and reach the food chain, as shown by the detection of the virus in mussels and in contaminated pork products as sausages or meat. All these data highlight the need of studies directed to control the sources of HEV to protect immunocompromised individuals that seem the weakest link of the HEV epidemiology in industrialized regions.

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“…The serological prevalence was even higher in a retrospective study conducted in Spain, 204 out of 208 farms (98%, 95% CI 96.1–99.9) having at least one anti-HEV IgG-positive pig [11]. Similarly, in a retrospective study recently carried out in Norway, anti-HEV IgG were detected in 90% (137/153) of the herds [12]. …”

Section: Hev Prevalence In Farmed Pigsmentioning

confidence: 99%

From the epidemiology of hepatitis E virus (HEV) within the swine reservoir to public health risk mitigation strategies: a comprehensive review

Salines

Andraud

Rose

2017

Vet Res

128

139

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Hepatitis E virus (HEV) is the causative agent of hepatitis E in humans, an emerging zoonosis mainly transmitted via food in developed countries and for which domestic pigs are recognised as the main reservoir. It therefore appears important to understand the features and drivers of HEV infection dynamics on pig farms in order to implement HEV surveillance programmes and to assess and manage public health risks. The authors have reviewed the international scientific literature on the epidemiological characteristics of HEV in swine populations. Although prevalence estimates differed greatly from one study to another, all consistently reported high variability between farms, suggesting the existence of multifactorial conditions related to infection and within-farm transmission of the virus. Longitudinal studies and experimental trials have provided estimates of epidemiological parameters governing the transmission process (e.g. age at infection, transmission parameters, shedding period duration or lag time before the onset of an immune response). Farming practices, passive immunity and co-infection with immunosuppressive agents were identified as the main factors influencing HEV infection dynamics, but further investigations are needed to clarify the different HEV infection patterns observed in pig herds as well as HEV transmission between farms. Relevant surveillance programmes and control measures from farm to fork also have to be fostered to reduce the prevalence of contaminated pork products entering the food chain.Electronic supplementary materialThe online version of this article (doi:10.1186/s13567-017-0436-3) contains supplementary material, which is available to authorized users.

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Hepatitis E in Norway: seroprevalence in humans and swine

Cited by 59 publications

References 28 publications

Performance of Hepatitis E Virus (HEV)-antibody tests: a comparative analysis based on samples from individuals with direct contact to domestic pigs or wild boar in Germany

Performance of Hepatitis E Virus (HEV)-antibody tests: a comparative analysis based on samples from individuals with direct contact to domestic pigs or wild boar in Germany

Hepatitis E Virus in Industrialized Countries: The Silent Threat

From the epidemiology of hepatitis E virus (HEV) within the swine reservoir to public health risk mitigation strategies: a comprehensive review

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