Hepatitis E Outbreak on Cruise Ship

Said, B.; Ijaz, Samreen; Kafatos, George; Booth, Linda; Thomas, Helen; Walsh, Amanda L.; Ramsay, Mary; Morgan, Dilys

doi:10.3201/eid1511.091094

Cited by 227 publications

(176 citation statements)

References 18 publications

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“…The large variation observed for oysters was due to a high value in July (allometric coefficient of 22). For clams, the allometric coefficients in January and March (10 and 9) were lower than those obtained in the 3 other experiments (14,16,18). For the 2 other species, low variability was observed.…”

Section: Conditions For the Bioaccumulation Experimentsmentioning

confidence: 63%

“…More recently, it was reported that a Japanese man acquired an HEV infection after ingesting uncooked shellfish while traveling in Vietnam (17). Similarly, in 2008, English tourists returning from a cruise ship developed hepatitis E, and the main risk factors were gender, age, and shellfish consumption while on board (18). More generally, in countries where seafood dishes are common, as in China, shellfish consumption is considered a key risk factor for developing hepatitis E (19).…”

mentioning

confidence: 99%

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

Grodzki

Schaeffer

Piquet

et al. 2014

Appl Environ Microbiol

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dHepatitis E virus (HEV), an enteric pathogen of both humans and animals, is excreted by infected individuals and is therefore present in wastewaters and coastal waters. As bivalve molluscan shellfish are known to concentrate viral particles during the process of filter feeding, they may accumulate this virus. The bioaccumulation efficiencies of oysters (Crassostrea gigas), flat oysters (Ostrea edulis), mussels (Mytilus edulis), and clams (Ruditapes philippinarum) were compared at different time points during the year. Tissue distribution analysis showed that most of the viruses were concentrated in the digestive tissues of the four species. Mussels and clams were found to be more sensitive to sporadic contamination events, as demonstrated by rapid bioaccumulation in less than 1 h compared to species of oysters. For oysters, concentrations increased during the 24-h bioaccumulation period. Additionally, to evaluate environmental occurrence of HEV in shellfish, an environmental investigation was undertaken at sites potentially impacted by pigs, wild boars, and human waste. Of the 286 samples collected, none were contaminated with hepatitis E virus, despite evidence that this virus is circulating in some French areas. It is possible that the number of hepatitis E viral particles discharged into the environment is too low to detect or that the virus may have a very short period of persistence in pig manure and human waste.

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Section: Conditions For the Bioaccumulation Experimentsmentioning

confidence: 63%

mentioning

confidence: 99%

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

Grodzki

Schaeffer

Piquet

et al. 2014

Appl Environ Microbiol

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“…25,26 In these areas, large outbreaks of hepatitis E are unheard of and only a few limited food-borne outbreaks have been reported. 57,58 In these areas, sporadic disease due to HEV infection is also rare, forming only a minority of all cases with acute viral hepatitis.…”

Section: Epidemiology In Low-endemicity Regionsmentioning

confidence: 99%

Hepatitis E: Epidemiology and Natural History

Aggarwal

2013

Journal of Clinical and Experimental Hepatology

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“…Hepatitis E virus infection is usually mild or asymptomatic without sequelae, and less than 5% of exposed individuals develop hepatitis (3)(4)(5). However, fulminant infection sporadically occurs, and in some patients, chronic infection may ensue, often with rapid fibrosis progression leading to cirrhosis; this most commonly occurs in immunocompromised individuals, such as solid organ recipients and patients receiving chemotherapy (6)(7)(8)(9)(10)(11).…”

mentioning

confidence: 99%