Prevalence of Hepatitis E Virus Antibodies, Israel, 2009–2010

Mor, Orna; Bassal, Ravit; Michaeli, Michal; Wax, Marina; Ram, Daniela; Cohen‐Ezra, Oranit; Cohen, Dani; Mendelson, Ella; Ben‐Ari, Ziv; Shohat, Tamy

doi:10.3201/eid2104.140245

Cited by 12 publications

(12 citation statements)

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“…Human serum samples were collected from: Bedouins living in the southern district, in tribes that own dromedary camels (overall 305; 296 tested for the first time in this study and nine added from our previous study [21]), non-Bedouin Arabs (overall 320; 297 from the present study and 23 from our previous study [21]) and from Jews (195 samples presented in our previous study [21]). All human samples were randomly selected using an age-stratified sampling design from the stored sera bank of the Israeli Centre for Disease Control.…”

Section: Methodsmentioning

confidence: 99%

“…Human HEV infection, investigated using seroprevalence studies, was found to be more prevalent in older ages [7][8][9][10][11][12][13][14][15][16][17][18][19][20], lower socio-economic status [21], poorer residence areas [9,[14][15], among sheltered homeless adults [22] or uneducated people [14], specific nationalities (for example, higher in mixed race donors and ethnic groups within China [12,15], or in immigrants from Afghanistan [14]), drinking water from wells or rivers [15], consumption of meat products [7,15,17,23] especially pork [24,25] and following blood transfusions [1].…”

Section: Introductionmentioning

confidence: 99%

“…While almost all Israeli-Arabs were born in Israel, Jews compose a mixed population of Israeli-born and non-Israeli-born individuals. Previously, we have shown that the overall HEV seroprevalence in Israel was 10.6% and higher in Arabs (22.5%) compared with Jews (10.3%); with most of the anti-HEV positive Jews being immigrants not born in Israel [21]. However, an assessment of anti-HEV prevalence in specific subgroups of Arabs has not been done.…”

Section: Introductionmentioning

confidence: 99%

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Seroprevalence of hepatitis E virus in dromedary camels, Bedouins, Muslim Arabs and Jews in Israel, 2009–2017

et al. 2019

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Hepatitis E virus (HEV) is an emerging cause of viral hepatitis worldwide. Recently, HEV-7 has been shown to infect camels and humans. We studied HEV seroprevalence in dromedary camels and among Bedouins, Arabs (Muslims, none-Bedouins) and Jews and assessed factors associated with anti-HEV seropositivity. Serum samples from dromedary camels (n = 86) were used to determine camel anti-HEV IgG and HEV RNA positivity. Human samples collected between 2009 and 2016 from >20 years old Bedouins (n = 305), non-Bedouin Arabs (n = 320) and Jews (n = 195), were randomly selected using an age-stratified sampling design. Human HEV IgG levels were determined using Wantai IgG ELISA assay. Of the samples obtained from camels, 68.6% were anti-HEV positive. Among the human populations, Bedouins and non-Bedouin Arabs had a significantly higher prevalence of HEV antibodies (21.6% and 15.0%, respectively) compared with the Jewish population (3.1%). Seropositivity increased significantly with age in all human populations, reaching 47.6% and 34.8% among ⩾40 years old, in Bedouins and non-Bedouin Arabs, respectively. The high seropositivity in camels and in ⩾40 years old Bedouins and non-Bedouin Arabs suggests that HEV is endemic in Israel. The low HEV seroprevalence in Jews could be attributed to higher socio-economic status.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Seroprevalence of hepatitis E virus in dromedary camels, Bedouins, Muslim Arabs and Jews in Israel, 2009–2017

et al. 2019

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“…3 Unlike the ongoing surveillance for polio, there is no HEV monitoring in Israel. The overall prevalence of anti-HEV IgG antibodies in Israel was recently found to be 10.6%, 4 but in a study that retrospectively assessed acute HEV infections in Israel between 1993 and 2013, only 68 HEV positive cases were identified (∼3 per year). 5 HEV has already been identified in sewage and in other environmental samples in several Mediterranean and Middle East countries, [6][7][8] but not in Israel.…”

Section: Introductionmentioning

confidence: 99%

Hepatitis E Virus Genotype 3 in Sewage and Genotype 1 in Acute Hepatitis Cases, Israel

Ram

Manor

Gozlan

et al. 2016

The American Society of Tropical Medicine and Hygiene

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Abstract. Hepatitis E virus (HEV) is an emerging infectious agent in developed countries. HEV genotypes 1 (G1) and 3 (G3) have been identified in environmental and clinical samples in Europe. In Israel, the overall prevalence of anti-HEV IgG antibodies was found to be 10.6%; however, reports of HEV infection are scarce. In this study, the presence of HEV in Israel was investigated using 169 sewage samples from 32 treatment facilities and 49 samples from acute hepatitis patients, all collected between 2013 and 2015. Fourteen sewage samples, from Haifa (11/18 samples), Tel Aviv (2/29 samples), and Beer Sheva (1/17 samples), regions with good sanitary conditions and middle-high socioeconomic populations, were HEV positive. Among the patient samples, 6.1% (3/49) were HEV positive, all returning travelers from India. Genotype analysis revealed G1 HEV in patients and G3 HEV sequences in sewage. Evidence that HEV could be establishing itself in our region may justify more active surveillance to monitor its spread.

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“…As no clinical signs of viral hepatitis were recalled, we assume that HEV infection in these individuals was silent. Previously, we have reported a much lower overall seroprevalence (10.6%) for anti-HEV antibodies in the general Israeli population [28]. Higher prevalence of antibodies to HEV virus in swine workers compared with normal blood donors has already been reported in the United States and other countries [29,30] and demonstrates the high risk for HEV infection among individuals regularly exposed to infected animals.…”

Section: Discussionmentioning

confidence: 84%

Hepatitis E in pigs in Israel: seroprevalence, molecular characterisation and potential impact on humans

et al. 2018

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IntroductionThe zoonotic hepatitis E virus (HEV) genotype 3 (HEV-G3) has become a common cause of acute and chronic hepatitis among humans worldwide. In Israel, while HEV-3 sequences have previously been detected in sewage, only the non-zoonotic HEV-G1 genotype has been found in samples from human patients.AimIn this pilot study, we aimed to assess the status of HEV in a sample of the swine population and among swine farm workers in Israel.MethodsPig blood (n = 141) and faecal samples (n = 39), pig farm sewage samples (n = 8) and blood from farm workers (n = 24) were collected between February 2016 and October 2017. Anti-HEV IgG was detected using the Wantai assay. HEV RNA was analysed with the RealStar HEV kit. HEV open reading frame 1 fragments amplified from representative HEV RNA-positive samples were used for phylogenetic analysis.ResultsOverall prevalence of HEV antibodies in pigs was 75.9% (107/141). HEV RNA was detected in plasma (2.1%, 3/141), faecal (22.8%, 18/79) and pig sewage (4/8) samples. Pig and sewage-derived viral sequences clustered with previously identified human sewage HEV-G3 sequences. Most pig farms workers (23 of 24) were HEV-seropositive; none was viraemic or reported previous clinical signs.ConclusionsThis study showed that domestic pigs in Israel are infected with HEV-G3. The high HEV seropositivity of the farm workers together with the previous identification of this virus in human sewage suggests circulation to humans. The clinical impact of these findings on public health should be further explored.

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Prevalence of Hepatitis E Virus Antibodies, Israel, 2009–2010

Cited by 12 publications

References 11 publications

Seroprevalence of hepatitis E virus in dromedary camels, Bedouins, Muslim Arabs and Jews in Israel, 2009–2017

Seroprevalence of hepatitis E virus in dromedary camels, Bedouins, Muslim Arabs and Jews in Israel, 2009–2017

Hepatitis E Virus Genotype 3 in Sewage and Genotype 1 in Acute Hepatitis Cases, Israel

Hepatitis E in pigs in Israel: seroprevalence, molecular characterisation and potential impact on humans

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