Prevalence and phylogenetic analysis of hepatitis E virus in pigs, wild boars, roe deer, red deer and moose in Lithuania

Prevalence of Paslahepevirus balayani in commercial swine food products from Spain

Paslahepevirus balayani (formerly known as hepatitis E virus) is an emerging cause of foodborne disease in Europe, transmitted mainly by the consumption of raw or undercooked pork. Since little is known about the presence of the virus in several pork products that are eaten uncooked, our aim was to evaluate the prevalence of Paslahepevirus balayani in groups of commercial pork products intended for human consumption subjected to different processing techniques. A total of 1265 samples of pork products from Spain were divided into four groups and tested for the presence of Paslahepevirus balayani RNA: unprocessed pig and wild boar meat frozen at -20 °C (n = 389), dry-cured pork products (n = 391), dry-cured and salted pork products (n = 219), and boiled products (n = 266) (none of these products contained pork liver). Five samples were positive for Paslahepevirus balayani RNA (overall prevalence: 0.4%; 95% CI: 0.17% - 0.92%). All positive samples were from unprocessed meat stored at -20 °C, with a prevalence in this group of 1.3% (95% CI: 0.42-3.44); two samples came from pigs (1.1%; 95% CI: 0.13-3.81) and three from wild boar (1.5%; 95% CI: 0.31-4.28). None of the pork samples in the other groups was positive. In conclusion, Paslahepevirus balayani was found in unprocessed swine products form Spain, but not in processed products intended to be consumed undercooked, demonstrating that transmission of this zoonotic virus by eating these pork products should be more seriously considered.

Hepatitis E Virus in the Wild Boar Population: What Is the Real Zoonotic Risk in Portugal?

Hepatitis E virus (HEV) is an important zoonosis in wild boar. Reported zoonotic cases are mainly associated with the consumption of raw/undercooked meat and/or liver. This study aims to determine the occurrence of HEV in the Portuguese wild boar population. During the hunting season 2021/2022, 123-matched samples (liver, faeces, and blood) were collected from hunted wild boars throughout Portugal. An RT-PCR assay tested liver and faeces samples to detect HEV-RNA. From blood samples, an ELISA test was performed. Only one liver sample was positive for HEV (0,8%) and one other from faeces. A total of 34 sera were seropositive (26.7%). At the same time, in a survey of 106 hunters, 21 consumed/ate the liver of wild boars (19.8%). Only three recognised the possibility of consuming it undercooked. Contrary to previous studies in Portugal, the prevalence of HEV in liver and faeces is low, but the seropositivity is higher. But, when analyzing in detail, it could be observed that an HEV hotspot exists in the southeast of central Portugal and that it is a zoonotic risk for hunters of this region. The data of this study reinforce the importance of including HEV in surveillance programs for wildlife diseases to expand the potential zoonotic information.

Hepatitis A Virus and Hepatitis E Virus as Food- and Waterborne Pathogens-Transmission Routes and Methods for Detection in Food

Foodborne viruses are an important threat to food safety and public health. Globally, there are approximately 5 million cases of acute viral hepatitis due to hepatitis A virus (HAV) and hepatitis E virus (HEV) every year. HAV is responsible for numerous food-related viral outbreaks worldwide, while HEV is an emerging pathogen with a global health burden. The reported HEV cases in Europe have increased tenfold in the last 20 years due to its zoonotic transmission through the consumption of infected meat or meat products. HEV is considered the most common cause of acute viral hepatitis worldwide currently. This review focuses on the latest findings on the foodborne transmission routes of HAV and HEV and the methods for their detection in different food matrices.

Phylodynamic Analysis Suggests That Deer Species May Be a True Reservoir for Hepatitis E Virus Genotypes 3 and 4

Hepatitis E virus (HEV) genotypes 3 and 4 (HEV-3 and HEV-4) cause zoonotic infection in humans, with domestic pigs and wild boars being the main reservoirs of infection. Other than suids, HEV-3 and HEV-4 are found in ruminants, most frequently in deer species. However, it is still debatable, whether HEV infection in deer is a spillover, or indicates a stable virus circulation in these host species. To explore the patterns of HEV-3 and HEV-4 transmission in deer and other host species, we performed a Bayesian analysis of HEV sequences available in GenBank. A total of 27 HEV sequences from different deer species were found in GenBank. Sequences from wild boars collected in the same territories, as well as sequences from all mammals that were most similar to sequences from deer in blast search, were added to the dataset, comprising 617 in total sequences. Due to the presence of partial genomic sequences, they were divided into four subsets (two ORF1 fragments and two ORF2 fragments) and analyzed separately. European HEV-3 sequences and Asian HEV-4 sequences collected from deer species demonstrated two transmission patterns. The first pattern was spillover infection, and the second pattern was deer-to-deer transmission, indicating stable HEV circulation in these species. However, all geographic HEV clusters that contained both deer and swine sequences originated from ancestral swine strains. HEV-3 and HEV-4 transmission patterns in ungulates reconstructed by means of Bayesian analysis indicate that deer species are a true host for HEV. However, wild and domestic swine are often the primary source of infection for ruminants living in the same areas. Complete HEV genomic sequences from different parts of the world are crucial for further understanding the HEV-3 and HEV-4 circulation patterns in wildlife.

Detection of Hepatitis E Virus Genotype 3 in Feces of Capybaras (Hydrochoeris hydrochaeris) in Brazil

Hepatitis E virus (HEV) is an emerging zoonotic pathogen associated with relevant public health issues. The aim of this study was to investigate HEV presence in free-living capybaras inhabiting urban parks in São Paulo state, Brazil. Molecular characterization of HEV positive samples was undertaken to elucidate the genetic diversity of the virus in these animals. A total of 337 fecal samples were screened for HEV using RT-qPCR and further confirmed by conventional nested RT-PCR. HEV genotype and subtype were determined using Sanger and next-generation sequencing. HEV was detected in one specimen (0.3%) and assigned as HEV-3f. The IAL-HEV_921 HEV-3f strain showed a close relationship to European swine, wild boar and human strains (90.7-93.2% nt), suggesting an interspecies transmission. Molecular epidemiology of HEV is poorly investigated in Brazil; subtype 3f has been reported in swine. This is the first report of HEV detected in capybara stool samples worldwide.

Current Knowledge of Hepatitis E Virus (HEV) Epidemiology in Ruminants

Hepatitis E virus (HEV) infection represents an emerging public health concern worldwide. In industrialized countries, increasing numbers of autochthonous cases of human HEV infection are caused by zoonotic transmission of genotypes 3 and 4, mainly through the consumption of contaminated raw or undercooked meat of infected pigs and wild boars, which are considered the main reservoirs of HEV. However, in the last few years, accumulating evidence seems to indicate that several other animals, including different ruminant species, may harbor HEV. Understanding the impact of HEV infection in ruminants and identifying the risk factors affecting transmission among animals and to humans is critical in order to determine their role in the epidemiological cycle of HEV. In this review, we provide a summary of current knowledge on HEV ecology in ruminants. A growing body of evidence has revealed that these animal species may be potential important hosts of HEV, raising concerns about the possible implications for public health.

Hepatitis E virus detection in hunted wild boar (Sus scrofa) livers in Central Italy

Hepatitis E virus (HEV) is a zoonotic pathogen, responsible for numerous cases of infection in humans. Transmission occurs through the orofecal route, and ingestion of contaminated foods represents an important risk factor for final consumer's health. Wild animal species, in particular wild boar (Sus scrofa), are the main virus reservoirs; liver is the target organ, from which, through the hematic diffusion, HEV reaches different tissues and organs, as muscular one. The hygienic-sanitary critical issues connected with game meat food chain in general, and particularly wild boar, with special regards to any geographical area where this animal species can be directly in contact with humans, domestic ones (i.e., domestic pig), and other wild reservoirs (i.e., wild ruminants), finds favorable environmental conditions, have induced us to conduce the present scientific investigation. During the hunting season 2019/2020, a total of 156 wild boar livers were collected from provided plucks at slaughterhouse in Ascoli Piceno. Nested RT-PCR was used for the viral RNA detection. Results demonstrated a positivity of 5.12% (8/156), and the circulation in the screened area of genotype 3 subtype c, which is frequently identified in Central Italy. HEV sanitary relevance and the emerging role of any food chains in its transmission impose further detailed studies. The molecular screening of hunted wild boars' livers can provide important information about virus's circulation in wild animal populations in a specific area.

Molecular and Pathological Detection of Hepatitis E Virus in Roe Deer (Capreolus capreolus) and Fallow Deer (Dama dama) in Central Italy

Hepatitis E virus (HEV) is a common causative agent of acute hepatitis in the world, with a serious public health burden in both developing and industrialized countries. Cervids, along with wild boars and lagomorphs, are the main wild hosts of HEV in Europe and constitute a documented source of infection for humans. The aim of this study was to evaluate the presence of HEV in roe deer (Capreolus capreolus) and fallow deer (Dama dama) living in Tuscany, Central Italy. Liver samples from 48 roe deer and 60 fallow deer were collected from carcasses during the hunting seasons. Following the results obtained from molecular and histopathologic studies, 5/48 (10.4%) roe deer and 1/60 (1.7%) fallow deer liver samples were positive for the presence of HEV RNA. All PCR-positive livers were also IHC-positive for viral antigen presence, associated with degenerative and inflammatory lesions with predominantly CD3+ cellular infiltrates. This study represents the first identification in Italy of HEV RNA in roe and fallow deer and the first study in literature describing liver alterations associated with HEV infection in cervids. These results demonstrate that HEV is present in wild cervid populations in Italy and confirm the potential zoonotic role of these species.

Nationwide survey of hepatitis E virus infection among wildlife in Japan

In Japan, hepatitis E virus (HEV) causes hepatitis in humans through the consumption of raw or undercooked meat, including game meat. In the present study, nationwide surveillance of HEV infection among a total of 5,557 wild animals, including 15 species, was conducted in Japan. The prevalence of anti-HEV antibodies in wild boar was 12.4%, with higher positive rates in big boars (over 50 kg, 18.4%) than in small individuals (less than 30 kg, 5.3%). Furthermore, HEV RNA was more frequently detected in piglets than in older boars. Interestingly, the detection of HEV among wildlife by ELISA and RT-PCR suggested that HEV infection in Sika deer was a very rare event, and that there was no HEV infection among wild animals except for wild boar, Sika deer and Japanese monkeys. In conclusion, wild boar, especially piglets, are at high risk of HEV infection, while other wild animals showed less risk or no risk of HEV transmission.

A systematic review and meta-analysis of hepatitis E virus (HEV) in wild boars

This systematic review and meta-analysis summarize the available information on Hepatitis E virus (HEV) -specific antibody seroprevalence and HEV RNA prevalence in wild boar, one of the most abundant game species worldwide. A literature search (CAB Abstracts, Web of Science, Embase and Scopus) was performed to find relevant peer-reviewed works published during the period 1990-2020. A random-effect model was carried out to calculate the pooled HEV-specific antibody seroprevalence and HEV RNA prevalence estimates with 95% confidence intervals, and I2 statistic was used to assess the heterogeneity of the data. Values by subgroups were compared according to the geographical area, age class (≤ 12 months old and > 12 months old), and sample type (bile, faeces, liver, meat/muscle, serum). Sixty-nine publications were selected, with the majority of the studies from Southern Europe (n = 27). The pooled HEV-specific antibody seroprevalence in wild boar was 28% (CI95% 23-34) and the HEV RNA prevalence 8% (CI95% 6-10). The analysis highlighted a significant heterogeneity among the estimates from the included studies (I2 = 98% and I2 = 95% for HEV-specific antibody seroprevalence and viral prevalence respectively). The moderator analysis indicated a statistically significant difference (p-value = 0.03) for the HEV RNA prevalence according to the sample type, with the highest value in bile (17%, CI95% 9-27), followed by liver (10%, CI95% 7-14), serum (7%, CI95% 4-10), faeces (5%, CI95% 2-9), and meat/muscle (3%, CI95% 0.04-10). Finally, the HEV RNA prevalence in Europe (8.7, CI95% 6.7-11) was significantly (p-value = 0.04) higher than in Asia (4, CI95% 0.6-8). The analysis highlights the important role of wild boar in the epidemiology of HEV.

Genetic Diversity and Epidemiological Significance of Wild Boar HEV-3 Strains Circulating in Poland

The wild boar is the most important reservoir of zoonotic HEV-3 strains among different wildlife species. The aim of the study was subtype identification of wild boar HEV-3 strains circulating in Poland. Wild boar liver was used in the study in the form of homogenates prepared from 57 samples positive for HEV in a real-time RT-PCR. These samples were collected from juvenile and adult wild boars hunted in the jurisdictions of different Regional Directorates of State Forests (RDSF) across Poland. Subtype identification of detected HEV strains was based on a phylogenetic analysis of the most conserved HEV ORF2 genome fragment. Out of 57 tested samples, consensus HEV ORF2 sequences of 348 bp were obtained for 45 strains. Nineteen strains were identified and belonged to the HEV gt 3a and 3i subtypes, whereas 26 were not assigned to any virus subtype. HEV gt 3i strains prevailed in the Polish wild boar population, 16 of such were identified, and they were significantly more often observed in the RDSF Katowice area (χ² = 28.6, p = 0.027 (<0.05)) compared to other regions of the country. Circulation of 3a strains was limited only to the RDSF Gdańsk territory (χ² = 48, p = 0.000 (<0.05)). The virus strains detected in the Polish population of wild boars representing previously identified HEV subtypes in wild boars, pigs, or humans in Europe are of epidemiological importance for public health.

The Foodborne Transmission of Hepatitis E Virus to Humans

Globally, Hepatitis E virus (HEV) causes over 20 million cases worldwide. HEV is an emerging and endemic pathogen within economically developed countries, chiefly resulting from infections with genotype 3 (G3) HEV. G3 HEV is known to be a zoonotic pathogen, with a broad host range. The primary source of HEV within more economically developed countries is considered to be pigs, and consumption of pork products is a significant risk factor and known transmission route for the virus to humans. However, other foods have also been implicated in the transmission of HEV to humans. This review consolidates the information available regarding transmission of HEV and looks to identify gaps where further research is required to better understand how HEV is transmitted to humans through food.

Hepatitis E Virus Infection and Butchers: A Case-Control Seroprevalence Study

Background

Very few case-control studies to assess the risk of hepatitis E virus (HEV) infection in meat workers have been published. Therefore, we sought to determine: 1) the association of HEV IgG seropositivity and the occupation of butcher; and 2) the sociodemographic, work, clinical and behavioral characteristics of butchers associated with HEV exposure.

Methods

We performed a case-control seroprevalence study of 101 butchers (mean age: 38.50 ± 12.52 years) and 101 age-, gender- and residence-matched control subjects of the general population. Anti-HEV IgG antibodies were determined using a commercially available enzyme-linked immunoassay. Bivariate and regression analyses were used to assess the association between HEV seropositivity and characteristics of butchers.

Results

Anti-HEV IgG antibodies were found in 18 (17.8%) of the 101 butchers and in 14 (13.9%) of the 101 control subjects (odds ratio (OR): 1.34; 95% confidence interval (CI): 0.63 - 2.88; P = 0.44). Stratification by sex, age and area of residence (rural or urban) in cases and controls showed similar seroprevalences of HEV infection among groups. Bivariate analysis showed that HEV seroprevalence was associated with low education (up to 6 years), work place, seniority, eating while working, a history of raising farm animals and national trips. However, further analysis by logistic regression showed that only the variable of national trips was associated with HEV exposure (OR: 5.38; 95% CI: 1.02 - 28.16; P = 0.04). Concerning clinical characteristics of butchers, no association between HEV exposure and health status, history of surgery or blood transfusion was found.

Conclusions

Results from this first age-, gender- and residence-matched serosurvey of HEV infection in butchers in Mexico suggest that this population group does not have a higher risk for HEV infection than people from the general population. However, further studies to confirm the lack of association between HEV infection and the occupation of butcher are needed.

Molecular Characterization and Seroprevalence of Hepatitis E Virus in Inflammatory Bowel Disease Patients and Solid Organ Transplant Recipients

Seroprevalence rates and molecular characterization of hepatitis E virus (HEV) prevalent in the Lithuanian human population has not yet been evaluated. Immunosuppressed individuals have been recognized as a risk group for chronic hepatitis due to HEV genotype 3 (HEV-3) infections. The objectives of the present study were to determine prevalence rates of anti-HEV antibodies among inflammatory bowel disease (IBD) patients and solid organ transplant (SOT) recipients, to isolate and characterize HEV strain present in the Lithuanian human population, and to investigate its capacity to infect non-human primate (MARC-145 and Vero), swine (PK-15) and murine (Neuro-2a) cells in vitro. In the present study, the significant difference of anti-HEV IgG prevalence between healthy (3.0% (95% CI 0–6.3)) and immunosuppressed individuals (12.0% [95% CI 8.1–15.9]) was described. Moreover, our findings showed that anti-HEV IgG seropositivity can be significantly predicted by increasing age (OR = 1.032, p < 0.01), diagnosis of IBD (OR = 4.541, p < 0.01) and reception of SOT (OR = 4.042, <0.05). Locally isolated HEV strain clustered within genotype 3i subtype of genotype 3 and was capable of infecting MARC-145 cells. This study demonstrates higher HEV seroprevalence in the risk group compared to healthy control individuals without confidence interval overlap. The high level of genetic homology between human and animal strains in Lithuania and the capacity of locally isolated strains to infect cells of non-human origin suggests its potential for zoonotic transmission.

Surveillance Study of Hepatitis E Virus (HEV) in Domestic and Wild Ruminants in Northwestern Italy

Simple Summary

Hepatitis E virus (HEV) infection can cause both acute and chronic hepatitis in humans and represents an emerging public health concern worldwide. In developed countries, zoonotic transmission of HEV genotypes 3 and 4 is caused by ingestion of raw or undercooked meat of infected swine or wild boars, the main reservoirs of HEV. However, in the last few years, molecular and serological evidence seem to indicate that several other animal species may act as HEV host, including domestic and wild ruminants. In this study, serum and fecal specimens from sheep, goats, red deer, roe deer, chamois, and Alpine ibex collected in two northwestern Italian regions (Piemonte and Valle d’Aosta) were screened molecularly and serologically. With the exception of chamois, HEV antibodies were found both in the domestic and wild ruminant species investigated with the highest rates in sheep and goats. These findings demonstrate that wild also domestic ruminants may be implicated in the viral cycle transmission.

Abstract

In industrialized countries, increasing autochthonous infections of hepatitis E virus (HEV) are caused by zoonotic transmission of genotypes (Gts) 3 and 4, mainly through consumption of contaminated raw or undercooked pork meat. Although swine and wild boar are recognized as the main reservoir for Gt3 and Gt4, accumulating evidence indicates that other animal species, including domestic and wild ruminants, may harbor HEV. Herein, we screened molecularly and serologically serum and fecal samples from two domestic and four wild ruminant species collected in Valle d’Aosta and Piemonte regions (northwestern Italy. HEV antibodies were found in sheep (21.6%), goats (11.4%), red deer (2.6%), roe deer (3.1%), and in Alpine ibex (6.3%). Molecular screening was performed using different primer sets targeting highly conserved regions of hepeviruses and HEV RNA, although at low viral loads, was detected in four fecal specimens (3.0%, 4/134) collected from two HEV seropositive sheep herds. Taken together, the data obtained document the circulation of HEV in the geographical area assessed both in wild and domestic ruminants, but with the highest seroprevalence in sheep and goats. Consistently with results from other studies conducted in southern Italy, circulation of HEV among small domestic ruminants seems to occur more frequently than expected.

Antibodies Against Hepatitis E Virus (HEV) in European Moose and White-Tailed Deer in Finland

The main animal reservoirs of zoonotic hepatitis E virus (HEV) are domestic pigs and wild boars, but HEV also infects cervids. In this study, we estimated the prevalence of HEV in Finnish cervid species that are commonly hunted for human consumption. We investigated sera from 342 European moose (Alces alces), 70 white-tailed deer (Odocoileus virginianus), and 12 European roe deer (Capreolus capreolus). The samples had been collected from legally hunted animals from different districts of Finland during 2008-2009. We analysed the samples for total anti-HEV antibodies using a double-sandwich ELISA assay. Seropositive sera were analysed with RT-qPCR for HEV RNA. HEV seroprevalence was 9.1% (31/342) in moose and 1.4% (1/70) in white-tailed deer. None of the European roe deer were HEV seropositive (0/12). No HEV RNA was detected from samples of seropositive animals. HEV seropositive moose were detected in all districts. Statistically, HEV seroprevalence in moose was significantly higher (p < 0.05) in the North-East area compared to the South-West area. The highest HEV seroprevalence (20.0%) in district level was more than six times higher than the lowest (3.1%). We demonstrated the presence of total anti-HEV antibodies in European moose and white-tailed deer in Finland. Our results suggest that HEV is circulating among the moose population. Infections may occur also in white-tailed deer. We were the first to report a HEV seropositive white-tailed deer from Europe. Further studies are needed to demonstrate the HEV genotypes in cervids in Finland and to evaluate the importance of the findings in relation to food safety.

Wild Boar as a Sylvatic Reservoir of Hepatitis E Virus in Poland: A Cross-Sectional Population Study

The most important wildlife species in the epidemiology of hepatitis E virus (HEV) infections are wild boars, which are also the main reservoir of the virus in a sylvatic environment. The aim of the study was a serological and molecular assessment of the prevalence of HEV infections in wild boars in Poland. In total, 470 pairs of samples (wild boar blood and livers) and 433 samples of faeces were tested. An ELISA (ID.vet, France) was used for serological analysis. For the detection of HEV RNA, real-time (RT)-qPCR was employed. The presence of specific anti-HEV IgG antibodies was found in 232 (49.4%; 95%CI: 44.7–54%) sera, with regional differences observed in the seroprevalence of infections. HEV RNA was detected in 57 (12.1%, 95%CI: 9.3–15.4%) livers and in 27 (6.2%, 95%CI: 4.1–8.9%) faecal samples, with the viral load ranging from 1.4 to 1.7 × 10¹¹ G.C./g and 38 to 9.3 × 10⁷ G.C./mL, respectively. A correlation between serological and molecular results of testing of wild boars infected with HEV was shown. HEV infections in wild boars appeared to be common in Poland.

Increasing Hepatitis E Virus Seroprevalence in Domestic Pigs and Wild Boar in Bulgaria

Simple Summary

Hepatitis E virus (HEV) is a lesser-known hepatitis virus, but its worldwide spread is undisputed and has increased in recent years. The zoonotic spread of HEV, mainly due to genotype (gt) 3, emerged in developed countries in the past decade. In addition, transmission via contaminated meat from pigs and boars was also established. Detailed analysis of viral dynamics and distribution is needed in order to identify associated risk factors. The aim of the current study is to present new and additional data on the HEV distribution among pigs, and for the first-time, also among the wild boar population in Bulgaria.

Abstract

(1) Background: Hepatitis E virus (HEV) is a causative agent of acute viral hepatitis, predominantly transmitted by the fecal–oral route. In developed countries, HEV is considered to be an emerging pathogen since the number of autochthonous cases is rising. Hepatitis E is a viral disease with a proven zoonotic potential for some of its genotypes. The main viral reservoirs are domestic pigs and wild boar. Consumption of undercooked meat, as well as occupational exposure, are key factors for the spread of HEV. In order to evaluate the risks of future viral evolution, a detailed examination of the ecology and distribution of the virus is needed. The aim of the present study is to investigate the prevalence of anti-HEV IgG Ab in domestic pigs and wild boar in Bulgaria; (2) Methods: In this study, during the period of three years between 2017 and 2019, 433 serum samples from 19 different pig farms and 1 slaughterhouse were collected and analyzed. In addition, 32 samples from wild boar were also collected and analyzed during the 2018–2019 hunting season. All samples were analyzed by commercial indirect ELISA; (3) Results: Overall, HEV seroprevalence was 60% (95% CI 42.7–77.1) in domestic pigs and 12.5% (4/32) in wild boar. The observed seroprevalence of the slaughter-aged pigs was 73.65% (95% Cl 58.7–87.3). Prevalence in domestic pigs was significantly higher in the samples collected during 2019 (98% (95% Cl 96.1–99.9)) compared to those collected during 2017 (45.33% (95% CI 2.7–87.3)) and 2018 (38.46% (95% CI 29.1–49.7.); (4) Conclusions: Our findings suggest that domesticated pigs and wild boar might be the reason for the increased HEV transmission across Bulgaria. The genotypic characterization of HEV found in pigs, wild boar and humans will give a more accurate view of the zoonotic transmission of this virus.

Geographical restriction of Hepatitis E virus circulation in wild boars (Sus scrofa) in Emilia-Romagna region, Northern Italy

Hepatitis E virus (HEV) is a singlestrand RNA virus that causes an acute viral hepatitis in humans. Among its eight recognized genotypes, HEV-3 and HEV-4 are zoonotic, infecting humans, pigs and wild boars. Recently, HEV-3 has been also detected in red deer, which represents another reservoir of HEV. Consumption of raw pork products (mainly liver sausages), undercooked wild boar meat, raw wild boar liver and deer meat has been responsible for foodborne HEV human worldwide. From November 2018 to March 2019, liver samples collected from 97 wild boars hunted in Emilia-Romagna region (Northern Italy) were tested for HEV RNA. The hunting area included two territories for an extension of 33 km2, named A (about 13 km2,natural park, deciduous wood) and B (about 20 km2, cultivated fields in proximity of a river) areas. Distance between the two areas ranged between 8 to 10 km. A total of 73 wild boars were hunted in area A, and 24 in area B. HEV RNA was detected by Real-time RT- PCR in 23/73 liver samples of wild boars living in area A only (31.5% - 95% CI: 22.0-42.8%). The HEV sequences (n=13) clustered within genotype 3. The majority of positives belonged to animals < 12 months (12/25; 48%), followed by subadults (13-24 months) (7/16; 43.8%) and adults (4/32; 12.5%). This difference was found to be statistically significant (p=0.0024). In absence of pig farms, the restriction of HEV-positive animals to a well-defined territory of 13 km2 (Boschi di Carrega Regional Park) could hypothetically be related to the presence of red deer (Cervus elaphus), which lived in area A at the beginning of the hunting season. Further studies are needed to confirm or deny our hypothesis.

Detection of Hepatitis E Virus in Livers and Muscle Tissues of Wild Boars in Italy

In industrialized countries, hepatitis E is now recognized as an emerging zoonosis. Autochthonous cases have been increased over recent years in Europe and are mainly associated with HEV-3 infections. Pigs and wild boars are considered the main reservoirs of the zoonotic HEV-3 and HEV-4 genotypes. Over the past decade, the number of wild boars has drastically increased in Europe. Due to habitats closer to humans and domestic animals, the role of wild boar as a reservoir of the zoonotic HEV is considered to be an emerging issue. In this study, we investigated the presence of HEV RNA by a real-time RT-PCR assay in paired liver and muscle samples collected from 196 wild boars (Sus scrofa) hunted in the two areas of Central and Southern Italy. Twenty animals (10.2%) were HEV RNA positive in livers, 11 of which were also positive in muscles. The ORF2 and ORF1 partial viral sequences were obtained for nine paired livers and muscles, and when aligned were identical to each other. Phylogenetic analyses confirmed detection of different HEV-3 subtypes: 3c, 3f, 3i and some that were not assigned to any subtypes that have so far been identified. Results need further investigation because they are based on analyses of sequences of short genome regions. Nevertheless, we observed that the same strains were circulating in the wild boar populations from the two investigated areas, confirming persistence of the same HEV strains in the wild boar population over time.

Low Serologic Prevalences Suggest Sporadic Infections of Hepatitis E Virus in Chamois (Rupicapra rupicapra) and Red Deer (Cervus elaphus) in the Italian Alps

Hepatitis E virus (HEV) is a worldwide public health concern, with an increase in human autochthonous cases in Europe. Although domestic pigs and wild boar (Sus scrofa) are the main reservoirs of HEV, the constant expansion of wild ruminants increases the potential for HEV transmission. We investigated HEV infection in chamois (Rupicapra rupicapra) and red deer (Cervus elaphus) in the Italian Alps using an enzyme-linked immunosorbent assay (ELISA). We detected HEV antibodies from 2013 to 2015 in both host species, with seroprevalences of 1.2% and 0.8% in chamois and red deer, respectively. All serum samples that were positive to HEV antibodies by ELISA were negative when tested by real-time reverse-transcriptase PCR to detect HEV RNA. The observed low seroprevalence of HEV suggested a sporadic circulation of HEV in the alpine environment, and it was consistent with the low seroprevalence observed in wild boar in the Alps. Our observations supported the role of chamois and red deer as spillover hosts of HEV infections in the Italian Alps.

Mode and tempo of human hepatitis virus evolution

Human viral hepatitis, a major cause of morbidity and mortality worldwide, is caused by highly diverse viruses with different genetic, ecological, and pathogenetic features. Technological advances that allow throughput sequencing of viral genomes, as well as the development of computational tools to analyze such genome data, have largely expanded our knowledge on the host range and evolutionary history of human hepatitis viruses. Thus, with the exclusion of hepatitis D virus, close or distant relatives of these human pathogens were identified in a number of domestic and wild mammals. Also, sequences of human viral strains isolated from different geographic locations and over different time-spans have allowed the application of phylogeographic and molecular dating approaches to large viral phylogenies. In this review, we summarize the most recent insights into our understanding of the evolutionary events and ecological contexts that determined the origin and spread of human hepatitis viruses.

Wild Boar: A Reservoir of Foodborne Zoonoses

Wild boar populations around the world have increased dramatically over past decades. Climate change, generating milder winters with less snow, may affect their spread into northern regions. Wild boars can serve as reservoirs for a number of bacteria, viruses, and parasites, which are transmissible to humans and domestic animals through direct interaction with wild boars, through contaminated food or indirectly through contaminated environment. Disease transmission between wild boars, domestic animals, and humans is an increasing threat to human and animal health, especially in areas with high wild boar densities. This article reviews important foodborne zoonoses, including bacterial diseases (brucellosis, salmonellosis, tuberculosis, and yersiniosis), parasitic diseases (toxoplasmosis and trichinellosis), and the viral hepatitis E. The focus is on the prevalence of these diseases and the causative microbes in wild boars. The role of wild boars in transmitting these pathogens to humans and livestock is also briefly discussed.