1
|
Fantilli AC, Masachessi G, Cola GD, Castro G, Sicilia P, Marinzalda MDLA, Cachi AM, Moreno C, Borda M, Ibarra G, Rojas RM, Parreño VG, Barbás MG, Nates SV, Pisano MB, Ré VE. Integrated hepatitis e virus monitoring in central Argentina: a six-year analysis of clinical surveillance and wastewater-based epidemiology. WATER RESEARCH 2024; 261:122004. [PMID: 38991242 DOI: 10.1016/j.watres.2024.122004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Revised: 06/05/2024] [Accepted: 06/26/2024] [Indexed: 07/13/2024]
Abstract
Wastewater-based epidemiology (WBE) has gained prominence worldwide as a powerful tool in public health. This study aimed to monitor the circulation of Hepatitis E Virus (HEV) from wastewater samples collected during a six-year period and compare these results with clinical surveillance in the central region of Argentina. From 2017 to 2022, 1008 raw wastewater samples were analyzed, including four wastewater treatment plants from four cities (n=319), and 7 local neighborhood collector sewers in Córdoba city (n=689). Serum and/or stool samples from patients suspected of HEV infection were also analyzed (n=48). HEV molecular detection and viral load quantification were performed by real time RT-qPCR, and genetic characterization by two RT-Nested PCRs (targeting partial ORF-1 and ORF-2 genomic regions), sequencing and phylogenetic analysis. Fifty-three (5.3%) wastewater samples were RNA-HEV positive by real time RT-qPCR, with variations according to the location and year (0.0% - 21.6%). Out of these, ORF-2 genomic region was amplified in 20 samples (37.7%) and ORF-1 partial region in 12 (22.6%), and eighteen sequences were obtained. Throughout the study period, two (4.2%) HEV confirmed infections were reported, and one sequence was obtained. Phylogenetic analyses for both genomic regions showed that all the isolates were genotype HEV-3 clade abchijklm. Our study detected HEV in wastewater over a six-year period, despite a low number of clinical cases, emphasizing WBE as a valuable tool that complements clinical surveillance, by detecting pathogens' presence; identifying their transmission, circulation dynamics and excretion hotspots; and revealing changes in their genomic diversity.
Collapse
Affiliation(s)
- Anabella Clara Fantilli
- Instituto de Virología "Dr. J. M. Vanella", Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Enfermera Gordillo Gómez s/n, Ciudad Universitaria, Córdoba X5000, Argentina; Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Godoy Cruz 2290, CABA C1425FQB, Argentina.
| | - Gisela Masachessi
- Instituto de Virología "Dr. J. M. Vanella", Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Enfermera Gordillo Gómez s/n, Ciudad Universitaria, Córdoba X5000, Argentina; Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Godoy Cruz 2290, CABA C1425FQB, Argentina
| | - Guadalupe Di Cola
- Instituto de Virología "Dr. J. M. Vanella", Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Enfermera Gordillo Gómez s/n, Ciudad Universitaria, Córdoba X5000, Argentina; Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Godoy Cruz 2290, CABA C1425FQB, Argentina
| | - Gonzalo Castro
- Departamento Laboratorio Central, Ministerio de Salud de la Provincia de Córdoba, T. Cáceres de Allende 421, Córdoba X5000HVE, Argentina
| | - Paola Sicilia
- Departamento Laboratorio Central, Ministerio de Salud de la Provincia de Córdoba, T. Cáceres de Allende 421, Córdoba X5000HVE, Argentina
| | - María de Los Angeles Marinzalda
- Instituto Nacional de Medicina Aeronáutica y Espacial, FAA, Av. Fuerza Aérea Argentina Km 6 1/2 S/N B.0 Cívico, Córdoba X5010, Argentina. Facultad de la Fuerza Aérea, Universidad de la Defensa Nacional, Av. Fuerza Aérea Argentina 5011, Córdoba X5000, Argentina; Planta Municipal de tratamiento de efluente cloacales Bajo Grande-Laboratorio de análisis fisicoquímicos, bacteriológicos EDAR Bajo Grande, Cam. Chacra de la Merced 901, Córdoba X5000, Argentina
| | - Ariana Mariela Cachi
- Instituto Nacional de Medicina Aeronáutica y Espacial, FAA, Av. Fuerza Aérea Argentina Km 6 1/2 S/N B.0 Cívico, Córdoba X5010, Argentina. Facultad de la Fuerza Aérea, Universidad de la Defensa Nacional, Av. Fuerza Aérea Argentina 5011, Córdoba X5000, Argentina; Planta Municipal de tratamiento de efluente cloacales Bajo Grande-Laboratorio de análisis fisicoquímicos, bacteriológicos EDAR Bajo Grande, Cam. Chacra de la Merced 901, Córdoba X5000, Argentina
| | - Claudia Moreno
- Departamento Laboratorio Central, Ministerio de Salud de la Provincia de Córdoba, T. Cáceres de Allende 421, Córdoba X5000HVE, Argentina
| | - Mariel Borda
- Departamento Laboratorio Central, Ministerio de Salud de la Provincia de Córdoba, T. Cáceres de Allende 421, Córdoba X5000HVE, Argentina
| | - Gustavo Ibarra
- Planta Municipal de tratamiento de efluente cloacales Bajo Grande-Laboratorio de análisis fisicoquímicos, bacteriológicos EDAR Bajo Grande, Cam. Chacra de la Merced 901, Córdoba X5000, Argentina
| | - Ricardo Manuel Rojas
- Cooperativa Integral Regional de Provisión de Servicios Públicos, Vivienda y Consumo Limitada (COOPI), Moreno 78, Villa Carlos Paz, X5152 Córdoba, Argentina
| | - Viviana Gladys Parreño
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Godoy Cruz 2290, CABA C1425FQB, Argentina; INCUINTA; Instituto de Virología e Innovaciones Tecnológicas (IVIT), Instituto Nacional de Tecnología Agropecuaria (INTA), Hurlingham, Provincia de Buenos Aires 1686, Argentina
| | - María Gabriela Barbás
- Departamento Laboratorio Central, Ministerio de Salud de la Provincia de Córdoba, T. Cáceres de Allende 421, Córdoba X5000HVE, Argentina
| | - Silvia Viviana Nates
- Instituto de Virología "Dr. J. M. Vanella", Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Enfermera Gordillo Gómez s/n, Ciudad Universitaria, Córdoba X5000, Argentina
| | - María Belén Pisano
- Instituto de Virología "Dr. J. M. Vanella", Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Enfermera Gordillo Gómez s/n, Ciudad Universitaria, Córdoba X5000, Argentina; Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Godoy Cruz 2290, CABA C1425FQB, Argentina
| | - Viviana Elizabeth Ré
- Instituto de Virología "Dr. J. M. Vanella", Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Enfermera Gordillo Gómez s/n, Ciudad Universitaria, Córdoba X5000, Argentina; Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Godoy Cruz 2290, CABA C1425FQB, Argentina
| |
Collapse
|
2
|
Ferri G, Giantomassi G, Tognetti D, Olivastri A, Vergara A. Hepatitis E Virus RNA Detection in Liver and Muscle Tissues Sampled from Home Slaughtered Domestic Pigs in Central Italy. FOOD AND ENVIRONMENTAL VIROLOGY 2024:10.1007/s12560-024-09606-2. [PMID: 38862750 DOI: 10.1007/s12560-024-09606-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Accepted: 05/23/2024] [Indexed: 06/13/2024]
Abstract
Hepatitis E virus is a worldwide emerging foodborne pathogen; raw or undercooked meats and liver pork products can cause infection through the orofecal route. In Central-Southern Italy, small traditional farming method, associated with the possibility of environmental sharing with wild species, can facilitate HEV diffusion and persistence. The aim of this study was to determine HEV genotype and subtype in Marche region from home slaughtered domestic pigs involved in small and traditional food chains. A total of 236 liver and muscle tissues and 6 pooled salami samples were screened. Laboratory workflow started with homogenization, followed by RNA extraction. Nested reverse transcription PCR and qRT-PCR were used to amplify specific parts of overlapping open reading frames belonging to the HEV genome. A total of 42/236 (17.79%) liver and 8/236 (3.39%) diaphragm specimens were positive; none of the pooled salami specimens showed positive HEV signal. The discovered HEV3c presented high nucleotide similarities with ones amplified from wild boar populations hunted in the same province. Extensive farming methods and environmental sharing with wild animal species support cross-infection infections, as observed in the present study. Although salami resulted negative for HEV RNA detection, the effects of food technologies on viral loads remain unclear. Therefore, further scientific investigations coupled with efficacious standardized laboratory procedures will be the next challenge.
Collapse
Affiliation(s)
- Gianluigi Ferri
- Department of Veterinary Medicine, Specialization School in Food Inspection "G. Tiecco", University of Teramo, Piano d'Accio, Strada Porvinciale 18, 64100, Teramo, Italy.
| | | | | | | | - Alberto Vergara
- Department of Veterinary Medicine, Specialization School in Food Inspection "G. Tiecco", University of Teramo, Piano d'Accio, Strada Porvinciale 18, 64100, Teramo, Italy
| |
Collapse
|
3
|
Santos-Silva S, Moraes DFDSD, López-López P, Paupério J, Queirós J, Rivero-Juarez A, Lux L, Ulrich RG, Gonçalves HMR, Van der Poel WHM, Nascimento MSJ, Mesquita JR. Detection of hepatitis E virus genotype 3 in an Algerian mouse (Mus spretus) in Portugal. Vet Res Commun 2024; 48:1803-1812. [PMID: 38243141 PMCID: PMC11147874 DOI: 10.1007/s11259-024-10293-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 01/03/2024] [Indexed: 01/21/2024]
Abstract
Virus monitoring in small mammals is central to the design of epidemiological control strategies for rodent-borne zoonotic viruses. Synanthropic small mammals are versatile and may be potential carriers of several microbial agents. In the present work, a total of 330 fecal samples of small mammals were collected at two sites in the North of Portugal and screened for zoonotic hepatitis E virus (HEV, species Paslahepevirus balayani). Synanthropic small mammal samples (n = 40) were collected in a city park of Porto and belonged to the species Algerian mouse (Mus spretus) (n = 26) and to the greater white-toothed shrew (Crocidura russula) (n = 14). Furthermore, additional samples were collected in the Northeast region of Portugal and included Algerian mouse (n = 48), greater white-toothed shrew (n = 47), wood mouse (Apodemus sylvaticus) (n = 43), southwestern water vole (Arvicola sapidus) (n = 52), Cabrera's vole (Microtus cabrerae) (n = 49) and Lusitanian pine vole (Microtus lusitanicus) (n = 51). A nested RT-PCR targeting a part of open reading frame (ORF) 2 region of the HEV genome was used followed by sequencing and phylogenetic analysis. HEV RNA was detected in one fecal sample (0.3%; 95% confidence interval, CI: 0.01-1.68) from a synanthropic Algerian mouse that was genotyped as HEV-3, subgenotype 3e. This is the first study reporting the detection of HEV-3 in a synanthropic rodent, the Algerian mouse. The identified HEV isolate is probably the outcome of either a spill-over infection from domestic pigs or wild boars, or the result of passive viral transit through the intestinal tract. This finding reinforces the importance in the surveillance of novel potential hosts for HEV with a particular emphasis on synanthropic animals.
Collapse
Affiliation(s)
- Sérgio Santos-Silva
- School of Medicine and Biomedical Sciences (ICBAS), University of Porto, Porto, Portugal
| | | | - Pedro López-López
- Unit of Infectious Diseases, Clinical Virology and Zoonoses, Instituto Maimonides de Investigación Biomédica de Córdoba (IMIBIC), Hospital Universitario Reina Sofia, Universidad de Córdoba (UCO), Cordoba, Spain
- Center for Biomedical Research Network (CIBER) in Infectious Diseases, Health Institute Carlos III, Madrid, Spain
| | - Joana Paupério
- European Molecular Biology Laboratory, European Bioinformatics Institute, Welcome Genome Campus, Hinxton, CB10 1SD, UK
| | - João Queirós
- CIBIO-Centro de Investigação em Biodiversidade e Recursos Genéticos, InBIO Laboratório Associado, Universidade do Porto, Campus de Vairão, Vairão, 4485-661, Portugal
- BIOPOLIS Program in Genomics, Biodiversity and Land Planning, CIBIO, Campus de Vairão, Vairão, 4485-661, Portugal
- Departamento de Biologia, Faculdade de Ciências, Universidade do Porto, Rua Campo Alegre s/n, Porto, 4169-007, Portugal
- EBM, Estação Biológica de Mértola, Mértola, 7750-329, Portugal
| | - António Rivero-Juarez
- Unit of Infectious Diseases, Clinical Virology and Zoonoses, Instituto Maimonides de Investigación Biomédica de Córdoba (IMIBIC), Hospital Universitario Reina Sofia, Universidad de Córdoba (UCO), Cordoba, Spain
- Center for Biomedical Research Network (CIBER) in Infectious Diseases, Health Institute Carlos III, Madrid, Spain
| | - Laura Lux
- University of Greifswald, Domstraße 11, 17489, Greifswald, Germany
| | - Rainer G Ulrich
- Institute of Novel and Emerging Infectious Diseases, Friedrich-Loeffler-Institut (FLI), Federal Research Institute for Animal Health, Südufer 10, 17493, Greifswald-Insel Riems, Germany
| | - Helena M R Gonçalves
- REQUIMTE, Instituto Superior de Engenharia do Porto, Porto, Portugal
- Biosensor NTech - Nanotechnology Services, Avenida da Liberdade, 249, 1º Andar, Lda, Lisboa, 1250-143, Portugal
| | - Wim H M Van der Poel
- Quantitative Veterinary Epidemiology, Wageningen University, Wageningen, The Netherlands
- Department Virology & Molecular Biology, Wageningen Bioveterinary Research, Lelystad, The Netherlands
| | | | - João R Mesquita
- School of Medicine and Biomedical Sciences (ICBAS), University of Porto, Porto, Portugal.
- Epidemiology Research Unit (EPIUnit), Instituto de Saúde Pública da Universidade do Porto, Porto, Portugal.
- Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal.
| |
Collapse
|
4
|
La Bella G, Basanisi MG, Nobili G, D’Antuono AM, Suffredini E, La Salandra G. Duplex Droplet Digital PCR Assay for Quantification of Hepatitis E Virus in Food. Viruses 2024; 16:413. [PMID: 38543778 PMCID: PMC10975721 DOI: 10.3390/v16030413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Revised: 02/29/2024] [Accepted: 03/05/2024] [Indexed: 05/23/2024] Open
Abstract
Hepatitis E virus (HEV) represents an emerging risk in industrialized countries where the consumption of contaminated food plays a pivotal role. Quantitative real-time RT-PCR (RT-qPCR) is one of the most suitable methods for the detection and quantification of viruses in food. Nevertheless, quantification using RT-qPCR has limitations. Droplet digital PCR (ddPCR) provides the precise quantification of nucleic acids without the need for a standard curve and a reduction in the effect on virus quantification due to the presence of inhibitors. The objectives of the present work were (i) to develop a method for the absolute quantification of HEV in swine tissues based on ddPCR technology and provide internal process control for recovery assessment and (ii) to evaluate the performance of the method by analyzing a selection of naturally contaminated wild boar muscle samples previously tested using RT-qPCR. The method was optimized using a set of in vitro synthesized HEV RNA and quantified dsDNA. The limit of detection of the developed ddPCR assay was 0.34 genome copies/µL. The analysis of the wild boar samples confirmed the validity of the ddPCR assay. The duplex ddPCR method showed no reduction in efficiency compared to individual assays. The method developed in the present study could represent a sensitive assay for the detection and absolute quantification of HEV RNA in food samples with the advantage of presenting the co-amplification of internal process control.
Collapse
Affiliation(s)
- Gianfranco La Bella
- Istituto Zooprofilattico Sperimentale della Puglia e della Basilicata, Via Manfredonia 20, 71121 Foggia, Italy (G.N.); (A.M.D.); (G.L.S.)
| | - Maria Grazia Basanisi
- Istituto Zooprofilattico Sperimentale della Puglia e della Basilicata, Via Manfredonia 20, 71121 Foggia, Italy (G.N.); (A.M.D.); (G.L.S.)
| | - Gaia Nobili
- Istituto Zooprofilattico Sperimentale della Puglia e della Basilicata, Via Manfredonia 20, 71121 Foggia, Italy (G.N.); (A.M.D.); (G.L.S.)
| | - Anna Mattea D’Antuono
- Istituto Zooprofilattico Sperimentale della Puglia e della Basilicata, Via Manfredonia 20, 71121 Foggia, Italy (G.N.); (A.M.D.); (G.L.S.)
| | - Elisabetta Suffredini
- Department of Food Safety Nutrition and Veterinary Public Health, Istituto Superiore di Sanità, 00161 Rome, Italy;
| | - Giovanna La Salandra
- Istituto Zooprofilattico Sperimentale della Puglia e della Basilicata, Via Manfredonia 20, 71121 Foggia, Italy (G.N.); (A.M.D.); (G.L.S.)
| |
Collapse
|
5
|
Modiyinji AF, Tankeu LTA, Monamele CG, Yifomnjou Moumbeket MH, Tagnouokam Ngoupo PA, Tchetgna Simo H, Njei Ngu A, Mirdad K, Njouom R. Hepatitis E virus infections among patients with acute febrile jaundice in two regions of Cameroon: First molecular characterization of hepatitis E virus genotype 4. PLoS One 2024; 19:e0298723. [PMID: 38346054 PMCID: PMC10861035 DOI: 10.1371/journal.pone.0298723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 01/29/2024] [Indexed: 02/15/2024] Open
Abstract
BACKGROUND Febrile jaundice is a common indicator of certain infectious diseases, including hepatitis E. In Cameroon, the yellow fever virus is the only pathogen that is monitored in patients who present with this symptom. However, more than 90% of the samples received as part of this surveillance are negative for yellow fever. This study aimed to describe the prevalence and hepatitis E virus (HEV) genotype among yellow fever-negative patients in the Far North and West regions of Cameroon. METHODS In a cross-sectional study, yellow fever surveillance-negative samples collected between January 2021 and January 2023 were retrospectively analyzed. Anti-HEV IgM and IgG antibodies were tested using commercially available ELISA kits. Anti-HEV IgM and/or IgG positive samples were tested for HEV RNA by real-time RT-PCR, followed by nested RT-PCR, sequencing and phylogenetic analysis. RESULTS Overall, 121 of the 543 samples (22.3%, 95% CI: 19.0% - 26.0%) were positive for at least one anti-HEV marker. Amongst these, 8.1% (44/543) were positive for anti-HEV IgM, 5.9% (32/543) for anti-HEV IgG, and 8.3% (45/544) for both markers. A total of 15.2% (12/79) samples were positive for HEV RNA real-time RT-PCR and 8 samples were positive for HEV RNA by nested RT-PCR. Phylogenetic analysis showed that the retrieved sequences clustered within HEV genotypes/subtypes 1/1e, 3/3f and 4/4b. CONCLUSION Our results showed that HEV is one of the causes of acute febrile jaundice in patients enrolled in the yellow fever surveillance program in two regions of Cameroon. We described the circulation of three HEV genotypes, including two zoonotic genotypes. Further studies will be important to elucidate the transmission routes of these zoonotic HEV genotypes to humans in Cameroon.
Collapse
Affiliation(s)
| | | | | | | | | | | | - Abanda Njei Ngu
- Virology Unit, Centre Pasteur du Cameroun, Yaoundé, Cameroon
| | - Kazanji Mirdad
- Virology Unit, Centre Pasteur du Cameroun, Yaoundé, Cameroon
| | - Richard Njouom
- Virology Unit, Centre Pasteur du Cameroun, Yaoundé, Cameroon
| |
Collapse
|
6
|
Milojević L, Velebit B, Janković V, Mitrović R, Betić N, Simunović S, Dimitrijević M. Prevalence, Genetic Diversity, and Quantification of the RNA Genome of the Hepatitis E Virus in Slaughtered Pigs in Serbia. Animals (Basel) 2024; 14:586. [PMID: 38396554 PMCID: PMC10886375 DOI: 10.3390/ani14040586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 02/02/2024] [Accepted: 02/06/2024] [Indexed: 02/25/2024] Open
Abstract
The goal of this study conducted in Serbia was to detect HEV in pig liver samples from slaughterhouses, retail outlets, and environmental swabs over the course of a year. All positive HEV samples were measured and expressed as HEV gene copy numbers per gram of sample, and a representative number of samples were sequenced using the Sanger approach. A total of 45 HEV-positive samples were re-amplified using nested RT-PCR employing CODEHOP primers targeting ORF2 (493 nucleotides). The average prevalence of the HEV genotype 3 in all pig liver samples from the slaughterhouses was 29%, while HEV prevalence was 44% in liver samples from animals younger than 3 months. HEV RNA was found in thirteen out of sixty (22%) environmental swab samples that were taken from different surfaces along the slaughter line. Our findings confirmed seasonal patterns in HEV prevalence, with two picks (summer and winter periods) during the one-year examination. Among HEV-positive samples, the average viral particles for all positive liver samples was 4.41 ± 1.69 log10 genome copies per gram. Phylogenetic analysis revealed the majority of HEV strains (43/45) from Serbia were grouped in the HEV-3a subtype, while two strains were classified into the HEV-3c subtype, and one strain could not be classified into any of the HEV-3 subtypes.
Collapse
Affiliation(s)
- Lazar Milojević
- Institute of Meat Hygiene and Technology, Kaćanskog 13, 11040 Belgrade, Serbia; (B.V.); (V.J.); (R.M.); (S.S.)
| | - Branko Velebit
- Institute of Meat Hygiene and Technology, Kaćanskog 13, 11040 Belgrade, Serbia; (B.V.); (V.J.); (R.M.); (S.S.)
| | - Vesna Janković
- Institute of Meat Hygiene and Technology, Kaćanskog 13, 11040 Belgrade, Serbia; (B.V.); (V.J.); (R.M.); (S.S.)
| | - Radmila Mitrović
- Institute of Meat Hygiene and Technology, Kaćanskog 13, 11040 Belgrade, Serbia; (B.V.); (V.J.); (R.M.); (S.S.)
| | - Nikola Betić
- Institute of Meat Hygiene and Technology, Kaćanskog 13, 11040 Belgrade, Serbia; (B.V.); (V.J.); (R.M.); (S.S.)
| | - Sara Simunović
- Institute of Meat Hygiene and Technology, Kaćanskog 13, 11040 Belgrade, Serbia; (B.V.); (V.J.); (R.M.); (S.S.)
| | - Mirjana Dimitrijević
- Faculty of Veterinary Medicine, University of Belgrade, Bulevar Oslobođenja 18, 11000 Belgrade, Serbia
| |
Collapse
|
7
|
La Bella G, Basanisi MG, Nobili G, Coppola R, Damato AM, Donatiello A, Occhiochiuso G, Romano AC, Toce M, Palazzo L, Pellegrini F, Fanelli A, Di Martino B, Suffredini E, Lanave G, Martella V, La Salandra G. Evidence of Circulation and Phylogenetic Analysis of Hepatitis E Virus (HEV) in Wild Boar in South-East Italy. Viruses 2023; 15:2021. [PMID: 37896798 PMCID: PMC10611066 DOI: 10.3390/v15102021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 09/21/2023] [Accepted: 09/27/2023] [Indexed: 10/29/2023] Open
Abstract
Hepatitis E virus (HEV) is an important cause of acute viral hepatitis in humans worldwide. The food-borne transmission of HEV appears to be a major route in Europe through the consumption of pork and wild boar meat. HEV epidemiology in wild boars has been investigated mainly in Northern and Central Italian regions, whilst information from Southern Italy is limited. We investigated the occurrence of HEV in wild boar in the Apulia and Basilicata regions (Southern Italy). Thirteen (10.4%) out of one hundred and twenty-five wild boar samples tested positive for HEV using a quantitative reverse transcription PCR. HEV prevalence was 12% in Apulia and 9.3% in Basilicata. Seven samples were genotyped, and different subtypes (c, f, m) of genotype 3 were identified. The complete genome of a 3m strain was determined, and the virus showed the highest nucleotide identity to a human HEV strain identified in France in 2017. These findings demonstrate the substantial circulation of HEV in the wild boar population in Italian Southern regions. Gathering information on the HEV strains circulating in different geographical areas is useful for tracking the origin of HEV outbreaks and assessing the epidemiological role of wild boar as a potential virus reservoir for domestic pigs.
Collapse
Affiliation(s)
- Gianfranco La Bella
- Istituto Zooprofilattico Sperimentale della Puglia e della Basilicata, 71121 Foggia, Italy
| | - Maria Grazia Basanisi
- Istituto Zooprofilattico Sperimentale della Puglia e della Basilicata, 71121 Foggia, Italy
| | - Gaia Nobili
- Istituto Zooprofilattico Sperimentale della Puglia e della Basilicata, 71121 Foggia, Italy
| | - Rosa Coppola
- Istituto Zooprofilattico Sperimentale della Puglia e della Basilicata, 71121 Foggia, Italy
| | - Annita Maria Damato
- Istituto Zooprofilattico Sperimentale della Puglia e della Basilicata, 71121 Foggia, Italy
| | - Adelia Donatiello
- Istituto Zooprofilattico Sperimentale della Puglia e della Basilicata, 71121 Foggia, Italy
| | - Gilda Occhiochiuso
- Istituto Zooprofilattico Sperimentale della Puglia e della Basilicata, 71121 Foggia, Italy
| | | | - Mariateresa Toce
- Istituto Zooprofilattico Sperimentale della Puglia e della Basilicata, 71121 Foggia, Italy
| | - Lucia Palazzo
- Istituto Zooprofilattico Sperimentale della Puglia e della Basilicata, 71121 Foggia, Italy
| | - Francesco Pellegrini
- Department of Veterinary Medicine, University of Bari Aldo Moro, 70010 Bari, Italy
| | - Angela Fanelli
- Department of Veterinary Medicine, University of Bari Aldo Moro, 70010 Bari, Italy
| | - Barbara Di Martino
- Department of Veterinary Medicine, Università degli Studi di Teramo, 64100 Teramo, Italy
| | - Elisabetta Suffredini
- Department of Food Safety Nutrition and Veterinary Public Health, Istituto Superiore di Sanità, 00161 Rome, Italy
| | - Gianvito Lanave
- Department of Veterinary Medicine, University of Bari Aldo Moro, 70010 Bari, Italy
| | - Vito Martella
- Department of Veterinary Medicine, University of Bari Aldo Moro, 70010 Bari, Italy
| | - Giovanna La Salandra
- Istituto Zooprofilattico Sperimentale della Puglia e della Basilicata, 71121 Foggia, Italy
| |
Collapse
|
8
|
Zahmanova G, Takova K, Tonova V, Koynarski T, Lukov LL, Minkov I, Pishmisheva M, Kotsev S, Tsachev I, Baymakova M, Andonov AP. The Re-Emergence of Hepatitis E Virus in Europe and Vaccine Development. Viruses 2023; 15:1558. [PMID: 37515244 PMCID: PMC10383931 DOI: 10.3390/v15071558] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 07/11/2023] [Accepted: 07/13/2023] [Indexed: 07/30/2023] Open
Abstract
Hepatitis E virus (HEV) is one of the leading causes of acute viral hepatitis. Transmission of HEV mainly occurs via the fecal-oral route (ingesting contaminated water or food) or by contact with infected animals and their raw meat products. Some animals, such as pigs, wild boars, sheep, goats, rabbits, camels, rats, etc., are natural reservoirs of HEV, which places people in close contact with them at increased risk of HEV disease. Although hepatitis E is a self-limiting infection, it could also lead to severe illness, particularly among pregnant women, or chronic infection in immunocompromised people. A growing number of studies point out that HEV can be classified as a re-emerging virus in developed countries. Preventative efforts are needed to reduce the incidence of acute and chronic hepatitis E in non-endemic and endemic countries. There is a recombinant HEV vaccine, but it is approved for use and commercially available only in China and Pakistan. However, further studies are needed to demonstrate the necessity of applying a preventive vaccine and to create conditions for reducing the spread of HEV. This review emphasizes the hepatitis E virus and its importance for public health in Europe, the methods of virus transmission and treatment, and summarizes the latest studies on HEV vaccine development.
Collapse
Affiliation(s)
- Gergana Zahmanova
- Department of Plant Physiology and Molecular Biology, University of Plovdiv, 4000 Plovdiv, Bulgaria
- Department of Technology Transfer and IP Management, Center of Plant Systems Biology and Biotechnology, 4000 Plovdiv, Bulgaria
| | - Katerina Takova
- Department of Plant Physiology and Molecular Biology, University of Plovdiv, 4000 Plovdiv, Bulgaria
| | - Valeria Tonova
- Department of Plant Physiology and Molecular Biology, University of Plovdiv, 4000 Plovdiv, Bulgaria
| | - Tsvetoslav Koynarski
- Department of Animal Genetics, Faculty of Veterinary Medicine, Trakia University, 6000 Stara Zagora, Bulgaria
| | - Laura L Lukov
- Faculty of Sciences, Brigham Young University-Hawaii, Laie, HI 96762, USA
| | - Ivan Minkov
- Department of Technology Transfer and IP Management, Center of Plant Systems Biology and Biotechnology, 4000 Plovdiv, Bulgaria
- Institute of Molecular Biology and Biotechnologies, 4108 Markovo, Bulgaria
| | - Maria Pishmisheva
- Department of Infectious Diseases, Pazardzhik Multiprofile Hospital for Active Treatment, 4400 Pazardzhik, Bulgaria
| | - Stanislav Kotsev
- Department of Infectious Diseases, Pazardzhik Multiprofile Hospital for Active Treatment, 4400 Pazardzhik, Bulgaria
| | - Ilia Tsachev
- Department of Microbiology, Infectious and Parasitic Diseases, Faculty of Veterinary Medicine, Trakia University, 6000 Stara Zagora, Bulgaria
| | - Magdalena Baymakova
- Department of Infectious Diseases, Military Medical Academy, 1606 Sofia, Bulgaria
| | - Anton P Andonov
- Department of Medical Microbiology and Infectious Diseases, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB R3T 2N2, Canada
| |
Collapse
|
9
|
Locus T, Lambrecht E, Peeters M, Suin V, Verhaegen B, Van Hoorde K, Lamoral S, Vanwolleghem T, Van Gucht S. Hepatitis E virus in pork meat products and exposure assessment in Belgium. Int J Food Microbiol 2023; 397:110198. [PMID: 37086528 DOI: 10.1016/j.ijfoodmicro.2023.110198] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 03/30/2023] [Accepted: 03/31/2023] [Indexed: 04/24/2023]
Abstract
Zoonotic hepatitis E virus (HEV) genotype 3 infections are the predominant cause of acute viral hepatitis in Europe, mostly associated with the consumption of HEV contaminated pork meat. In this study we looked at the HEV RNA positivity rate of pork meat products readily available from Belgian supermarkets and evaluated the overall HEV consumer exposure in a Belgian context. Two basic assessments were performed in a 'worst-case' scenario setting: one solely focusing on the contamination level of the product itself (ingredients and processing parameters) and another estimating the overall consumer exposure, taking into account consumption habits in Belgium. Non-thermal-processed ready-to-eat (i.e. ready for consumption without additional cooking step by consumer) pork meat products (e.g. raw dried sausages), had a high estimated HEV contamination level, while thermal-processed ready-to-eat pork meat products (e.g. pork liver pâté) had the highest overall consumer exposure estimates. Following these assessments, pork liver pâtés, raw dried hams and raw dried sausages (n = 54) were purchased from Belgian supermarkets (n = 3) and analyzed for HEV RNA by RT-PCR. In total, 31 % (n = 17) products tested positive. HEV RNA was found in 65 % of the pork liver pâtés, 15 % of raw dried hams and 0 % of raw dried sausages. Phylogenetic analysis of four isolates (all gt3c) from pork liver pâté samples showed similarities with human clinical cases from Germany and Belgium.
Collapse
Affiliation(s)
- Tatjana Locus
- Sciensano, Infectious Diseases in Humans, Viral Diseases, Engelandstraat 642, 1180 Ukkel, Belgium; ILVO, Flemish Research Institute for Agriculture, Fisheries and Food, Technology and Food Unit, Brusselsesteenweg 370, 9090 Melle, Belgium; University of Antwerp, Laboratory of Experimental Medicine and Pediatrics, Viral Hepatitis Research Group, Drie Eikenstraat 655, 2650 Edegem, Belgium
| | - Ellen Lambrecht
- ILVO, Flemish Research Institute for Agriculture, Fisheries and Food, Technology and Food Unit, Brusselsesteenweg 370, 9090 Melle, Belgium
| | - Michael Peeters
- Sciensano, Infectious Diseases in Humans, Viral Diseases, Engelandstraat 642, 1180 Ukkel, Belgium
| | - Vanessa Suin
- Sciensano, Infectious Diseases in Humans, Viral Diseases, Engelandstraat 642, 1180 Ukkel, Belgium
| | - Bavo Verhaegen
- Sciensano, Infectious Diseases in Humans, Foodborne Pathogens, Juliette Wytsmanstraat 14, 1050 Elsene, Belgium
| | - Koenraad Van Hoorde
- Sciensano, Infectious Diseases in Humans, Foodborne Pathogens, Juliette Wytsmanstraat 14, 1050 Elsene, Belgium
| | - Sophie Lamoral
- Sciensano, Infectious Diseases in Humans, Viral Diseases, Engelandstraat 642, 1180 Ukkel, Belgium
| | - Thomas Vanwolleghem
- University of Antwerp, Laboratory of Experimental Medicine and Pediatrics, Viral Hepatitis Research Group, Drie Eikenstraat 655, 2650 Edegem, Belgium
| | - Steven Van Gucht
- Sciensano, Infectious Diseases in Humans, Viral Diseases, Engelandstraat 642, 1180 Ukkel, Belgium.
| |
Collapse
|
10
|
Patrizio L, Elisabetta B, Annamaria P, Giancarlo B, Roberta P, Alessio M, Valentina T. Epidemiological and genetic evaluation of HEV in swine slaughtered in Sicily region (Italy). Int J Food Microbiol 2023; 388:110068. [PMID: 36623337 DOI: 10.1016/j.ijfoodmicro.2022.110068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 12/21/2022] [Accepted: 12/26/2022] [Indexed: 01/03/2023]
Abstract
Hepatitis E virus (HEV) is the etiological agent of acute viral hepatitis, a disease transmitted by the oral-faecal route. In Europe, zoonotic transmission of HEV-3 genotype is associated with the consumption of raw or slightly cooked meat of pigs and wild boars that are considered the main reservoirs. This work aims to assess the occurrence of swines' HEV RNA liver samples and rectal swabs slaughtered in Sicily using biomolecular methods. HEV-RNA was detected in 17.5 % (21/120) liver samples analyzed and in 3.7 % (3/81) rectal swabs examined. All positive samples were predicted as genotype 3 and subtype 3c (75 %). These data suggest a potential HEV transmission to humans through close contact with pig breeders, veterinarians, slaughterhouse personnel, and pork meat product consumption. Moreover, there are few scientific data evaluating the HEV spread around pigs and humans in Sicily. Therefore, further studies are necessary to correlate humans with swine serotypes and to assess the HEV presence and persistence in food and the risk during the slaughtering process. These surveys allow to clarify the role of the swine species as a potential source of infection for other domestic or wild animals and humans and to establish possible control measures throughout the food chain.
Collapse
Affiliation(s)
- Lorusso Patrizio
- Department of Veterinary Medicine- University of Bari, Provincial Road to Casamassima Km 3, 70010 Valenzano, Bari, Italy
| | - Bonerba Elisabetta
- Department of Veterinary Medicine- University of Bari, Provincial Road to Casamassima Km 3, 70010 Valenzano, Bari, Italy
| | - Pandiscia Annamaria
- Department of Veterinary Medicine- University of Bari, Provincial Road to Casamassima Km 3, 70010 Valenzano, Bari, Italy.
| | - Bozzo Giancarlo
- Department of Veterinary Medicine- University of Bari, Provincial Road to Casamassima Km 3, 70010 Valenzano, Bari, Italy
| | - Piredda Roberta
- Department of Veterinary Medicine- University of Bari, Provincial Road to Casamassima Km 3, 70010 Valenzano, Bari, Italy
| | - Manfredi Alessio
- Department of Veterinary Medicine- University of Bari, Provincial Road to Casamassima Km 3, 70010 Valenzano, Bari, Italy
| | - Terio Valentina
- Department of Veterinary Medicine- University of Bari, Provincial Road to Casamassima Km 3, 70010 Valenzano, Bari, Italy
| |
Collapse
|
11
|
Phylodynamic Analysis Suggests That Deer Species May Be a True Reservoir for Hepatitis E Virus Genotypes 3 and 4. Microorganisms 2023; 11:microorganisms11020375. [PMID: 36838340 PMCID: PMC9967072 DOI: 10.3390/microorganisms11020375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 01/30/2023] [Accepted: 01/31/2023] [Indexed: 02/05/2023] Open
Abstract
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.
Collapse
|
12
|
Characterization of a Near Full-Length Hepatitis E Virus Genome of Subtype 3c Generated from Naturally Infected South African Backyard Pigs. Pathogens 2022; 11:pathogens11091030. [PMID: 36145462 PMCID: PMC9506134 DOI: 10.3390/pathogens11091030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 08/25/2022] [Accepted: 09/08/2022] [Indexed: 11/17/2022] Open
Abstract
Eight genotypes of the hepatitis E virus (Orthohepevirus A; HEV) designated HEV-1 to HEV-8 have been reported from various mammalian hosts. Notably, domestic pigs and wild boars are the natural reservoirs of HEV-3 and HEV-4 genotypes with zoonotic propensity. Since HEV infection in domestic pigs is usually subclinical, it may remain undetected, facilitating zoonotic spillover of HEV to the exposed human populations. A previous study from our group in 2021, using deep sequencing of a pooled saliva sample, generated various swine enteric virus genomes, including a near full-length swine HEV genome (7040 nt; 97.7% genome coverage) from five-month-old grower pigs at a backyard pig farm in the uMgungundlovu District, KwaZulu-Natal, South Africa. In the present study, we describe the further characterization, including genotyping and subtyping of the swine HEV isolate using phylogenetics and ‘HEVnet Typing Tool’. Our analyses confirmed that the South African swine HEV genome characterized in this study belonged to HEV genotype 3 subtype 3c (HEV-3c). While HEV-3c infections in domestic pigs have been previously reported from Brazil, Germany, Italy, and the Netherlands, they only generated partial genome sequences of open reading frame 1 (ORF1) and/or ORF2. To our knowledge, this is the first near full-length swine HEV-3c genome generated from naturally infected domestic pigs (Sus scrofa domesticus) in South Africa. However, due to the gap in the information on the HEV-3c genome sequences in various geographical locations worldwide, including South Africa, the epidemiology of the South African swine HEV genome characterized in this study remains inconclusive. Molecular and genomic surveillance of HEV in domestic pig populations in South Africa would be useful to determine their prevalence, circulating subtypes, and zoonosis risk.
Collapse
|
13
|
Rivero-Juarez A, Frias M, Perez AB, Pineda JA, Reina G, Fuentes-Lopez A, Freyre-Carrillo C, Ramirez-Arellano E, Alados JC, Rivero A. Orthohepevirus C infection as an emerging cause of acute hepatitis in Spain: First report in Europe. J Hepatol 2022; 77:326-331. [PMID: 35167911 DOI: 10.1016/j.jhep.2022.01.028] [Citation(s) in RCA: 60] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Revised: 01/22/2022] [Accepted: 01/31/2022] [Indexed: 12/20/2022]
Abstract
BACKGROUND & AIM Hepatitis E virus (HEV) was considered the only member of the Hepeviridae family with zoonotic potential. Nevertheless, this consideration has been reassessed owing to several reported cases of acute and chronic hepatitis linked to the Orthohepevirus C genus. Because the circulation of Orthohepevirus C in rodents has been described worldwide, the risk of zoonotic transmission is plausibly global. METHODS Orthohepevirus C RNA was retrospectively evaluated in 2 cohorts of patients in Spain. The first cohort included patients with acute hepatitis without etiological diagnosis after screening for hepatotropic virus infection. The second cohort included patients diagnosed with acute HEV infection, defined as positivity for anti-HEV-IgM antibodies and/or detectable HEV RNA in serum. RESULTS Cohort 1 comprised 169 patients (64.4% male, median age 43 years) and cohort 2 comprised 98 individuals (68.3% male, median age 45 years). Of the individuals included in Cohort 1, two (1.18%; 95% CI 0.2-3.8) had detectable Orthohepevirus C RNA in serum. In Cohort 2, of the 98 included patients, 58 showed detectable HEV RNA, while 40 only showed positivity for IgM antibodies. Among those bearing only IgM antibodies, Orthohepevirus C RNA was detected in 1 (2.5%; 95% CI 0.06-13.1) individual. All strains were consistent with genotype C1. The infection resulted in mild self-limiting acute hepatitis in 2 patients. Infection caused severe acute hepatitis in the remaining patient who died as a result of liver and renal failure. CONCLUSIONS We described 3 cases of Orthohepevirus C in patients with acute hepatitis, resulting in the first description of this infection in Europe. The prevalence obtained in our study suggests that Orthohepevirus C could be an emerging disease in Europe. LAY SUMMARY We describe the first cases of acute hepatitis related to rat hepatitis E virus in Europe. The prevalence found in our study suggest that rat hepatitis E virus could be considered an emerging disease in Europe.
Collapse
Affiliation(s)
- Antonio Rivero-Juarez
- Unit of Infectious Diseases, Hospital Universitario Reina Sofía, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Universidad de Córdoba (UCO), Córdoba, Spain; CIBERINFEC, ISCIII - CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III, Madrid, Spain.
| | - Mario Frias
- Unit of Infectious Diseases, Hospital Universitario Reina Sofía, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Universidad de Córdoba (UCO), Córdoba, Spain; CIBERINFEC, ISCIII - CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III, Madrid, Spain
| | - Ana Belen Perez
- CIBERINFEC, ISCIII - CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III, Madrid, Spain; Clinical Microbiology Unit, Hospital Universitario Reina Sofía, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, Spain
| | - Juan Antonio Pineda
- CIBERINFEC, ISCIII - CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III, Madrid, Spain; Unit of Infectious Diseases and Microbiology, Hospital Universitario de Valme, Seville, Spain
| | - Gabriel Reina
- Microbiology Department, Clínica Universidad de Navarra, STUN, Institute of Tropical Health, Universidad de Navarra, diSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - Ana Fuentes-Lopez
- CIBERINFEC, ISCIII - CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III, Madrid, Spain; Clinical Microbiology Unit, Hospital Universitario Clínico San Cecilio, Granada, Spain; Instituto de Investigación Biosanitaria Ibs.Granada, Granada, Spain
| | | | - Encarnación Ramirez-Arellano
- Infectious Diseases, Microbiology and Preventive Medicine Unit, Virgen Macarena Univ. Hospital, and Department of Medicine, University of Sevilla / Biomedicine Institute of Sevilla, Sevilla, Spain
| | - Juan Carlos Alados
- Clinical Microbiology Unit, Hospital Universitario de Jerez, Cádiz, Spain
| | - Antonio Rivero
- Unit of Infectious Diseases, Hospital Universitario Reina Sofía, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Universidad de Córdoba (UCO), Córdoba, Spain; CIBERINFEC, ISCIII - CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III, Madrid, Spain
| |
Collapse
|
14
|
Boxman ILA, Verhoef L, Dop PY, Vennema H, Dirks RAM, Opsteegh M. High prevalence of acute hepatitis E virus infection in pigs in Dutch slaughterhouses. Int J Food Microbiol 2022; 379:109830. [PMID: 35908493 DOI: 10.1016/j.ijfoodmicro.2022.109830] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 05/19/2022] [Accepted: 07/03/2022] [Indexed: 11/28/2022]
Abstract
Hepatitis E is caused by hepatitis E virus (HEV), one of the causes of acute viral hepatitis. Domestic pigs are considered as the main reservoir of HEV-3. The recently reported high prevalence of HEV in liver- and meat products on the Dutch market warranted a cross-sectional prevalence study on HEV infection among 5-6 months old pigs slaughtered in the Netherlands (n = 250). For this, liver, caecum content and blood samples were analyzed for the presence of genomic HEV RNA by RT-PCR. In addition, a serological test was performed to detect HEV IgG. Background information was retrieved on the corresponding farms to evaluate potential risk factors for HEV at pig slaughter age. HEV IgG was detected in sera from 167 pigs (67.6 %). HEV RNA was detected in 64 (25.6 %) caecum content samples, in 40 (16.1 %) serum samples and in 25 (11.0 %) liver samples. The average level of viral contamination in positive samples was log10 4.6 genome copies (gc)/g (range 3.0-8.2) in caecum content, log10 3.3 gc/ml (range 2.4-5.9) in serum and log10 3.2 gc/0.1 g (range 1.7-6.2) in liver samples. Sequence analyses revealed HEV-3c only. Ten times an identical strain was detected in two or three samples obtained from the same pig. Each animal in this study however appeared to be infected with a unique strain. The presence of sows and gilts and welfare rating at the farm of origin had a significant effect (p < 0.05) on the distribution over the four groups representing different stages of HEV infection based on IgG or RNA in caecum and/or serum. The observed proportion of tested pigs with viremia (16 %) was higher than in other reported studies and was interestingly often observed in combination with a high number of HEV genome copies in liver and caecum content as detected by RT-qPCR. Data provided will be useful for risk assessment for food safety of pork products, will provide baseline data for future monitoring of HEV infections in pigs and new thoughts for mitigation strategies.
Collapse
Affiliation(s)
- Ingeborg L A Boxman
- WFSR, Wageningen Food Safety Research, Wageningen University and Research, Mailbox 230, 6700 AE Wageningen, the Netherlands.
| | - Linda Verhoef
- NVWA, Netherlands Food and Consumer Product Safety Authority, Utrecht, the Netherlands
| | - Petra Y Dop
- NVWA, Netherlands Food and Consumer Product Safety Authority, Utrecht, the Netherlands
| | - Harry Vennema
- RIVM, National Institute of Public Health and the Environment, Bilthoven, the Netherlands
| | - René A M Dirks
- WFSR, Wageningen Food Safety Research, Wageningen University and Research, Mailbox 230, 6700 AE Wageningen, the Netherlands
| | - Marieke Opsteegh
- RIVM, National Institute of Public Health and the Environment, Bilthoven, the Netherlands
| |
Collapse
|
15
|
Muñoz-Chimeno M, Bartúren S, García-Lugo MA, Morago L, Rodríguez Á, Galán JC, Pérez-Rivilla A, Rodríguez M, Millán R, Del Álamo M, Alonso R, Molina L, Aguinaga A, Avellón A. Hepatitis E virus genotype 3 microbiological surveillance by the Spanish Reference Laboratory: geographic distribution and phylogenetic analysis of subtypes from 2009 to 2019. EURO SURVEILLANCE : BULLETIN EUROPEEN SUR LES MALADIES TRANSMISSIBLES = EUROPEAN COMMUNICABLE DISEASE BULLETIN 2022; 27. [PMID: 35686567 PMCID: PMC9198656 DOI: 10.2807/1560-7917.es.2022.27.23.2100542] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Background Hepatitis E virus genotype 3 (HEV-3) is widely distributed throughout Europe, with incidence of infections increasing in many countries. Belgium, Bulgaria, France, Germany, Italy, the Netherlands and the United Kingdom have reported the distribution of HEV-3 subtypes in cohorts of patients with hepatic disease. Aim To describe the distribution of the HEV-3 subtypes in Spain at national and autonomous community (AC) levels between 2009 and 2019. The study was also extended to Andorra. Methods Of 5,197 samples received by the National Reference Laboratory during the study, 409 were HEV-RNA-positive. Among these, 294 (71.9%) were further typed based on an ORF2 sequence fragment, or, for a subset of 74, based on the full-coding genome sequence. Results HEV-3 was detected in 291 samples. The dominant subtype in Spain was HEV-3f (88.3%; 257/291), which occurred in all ACs, with no change in detection level over time. Within this subtype, three subclusters were characterised: HEV-3f-B, HEV-3f-A1 and HEV-3f-A2. The second most common HEV subtype was the recently described HEV-3m (7%; 21/291), with two subclusters identified: HEV-3m-A, which has been known since 2010, and HEV-3m-B, since 2014. The third most encountered subtype was HEV-3c (4.1%; 12/291), with a frequency not increasing over time, unlike observations in some European countries. Conclusion The importance of the surveillance of HEV-3 subtype and subcluster circulation is yet to be assessed. This surveillance together with the comprehensive epidemiological characterisation of clinical cases, could support the identification of sources of transmission and the establishment of control measures nationally and internationally.
Collapse
Affiliation(s)
- Milagros Muñoz-Chimeno
- Hepatitis Unit, National Centre of Microbiology, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain
| | - Silvia Bartúren
- Hepatitis Unit, National Centre of Microbiology, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain
| | | | - Lucia Morago
- Hepatitis Unit, National Centre of Microbiology, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain
| | - Álvaro Rodríguez
- Hepatitis Unit, National Centre of Microbiology, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain
| | - Juan Carlos Galán
- CIBERESP, Madrid, Spain.,Servicio de Microbiología, Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
| | | | - Mercedes Rodríguez
- Hospital Universitario Central de Asturias, Grupo de Microbiología Traslacional (ISPA) Oviedo, Asturias, Spain
| | - Rosario Millán
- Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain
| | | | - Roberto Alonso
- Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Laura Molina
- Hospital Universitario de Fuenlabrada, Madrid, Spain
| | | | - Ana Avellón
- CIBERESP, Madrid, Spain.,Hepatitis Unit, National Centre of Microbiology, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain
| |
Collapse
|
16
|
Occurrence of hepatitis E virus (HEV) in Calabrian wild boars. Int J Food Microbiol 2022; 371:109671. [DOI: 10.1016/j.ijfoodmicro.2022.109671] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 03/14/2022] [Accepted: 04/03/2022] [Indexed: 11/24/2022]
|
17
|
Fonti N, Pacini MI, Forzan M, Parisi F, Periccioli M, Mazzei M, Poli A. Molecular and Pathological Detection of Hepatitis E Virus in Roe Deer (Capreolus capreolus) and Fallow Deer (Dama dama) in Central Italy. Vet Sci 2022; 9:vetsci9030100. [PMID: 35324829 PMCID: PMC8950858 DOI: 10.3390/vetsci9030100] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 02/10/2022] [Accepted: 02/22/2022] [Indexed: 12/14/2022] Open
Abstract
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.
Collapse
Affiliation(s)
- Niccolò Fonti
- Dipartimento di Scienze Veterinarie, Università di Pisa, Viale delle Piagge, 2-56124 Pisa, Italy; (N.F.); (M.I.P.); (M.F.); (F.P.); (M.M.)
| | - Maria Irene Pacini
- Dipartimento di Scienze Veterinarie, Università di Pisa, Viale delle Piagge, 2-56124 Pisa, Italy; (N.F.); (M.I.P.); (M.F.); (F.P.); (M.M.)
| | - Mario Forzan
- Dipartimento di Scienze Veterinarie, Università di Pisa, Viale delle Piagge, 2-56124 Pisa, Italy; (N.F.); (M.I.P.); (M.F.); (F.P.); (M.M.)
| | - Francesca Parisi
- Dipartimento di Scienze Veterinarie, Università di Pisa, Viale delle Piagge, 2-56124 Pisa, Italy; (N.F.); (M.I.P.); (M.F.); (F.P.); (M.M.)
| | - Marcello Periccioli
- Unità Funzionale di Sanità Pubblica Veterinaria e Sicurezza Alimentare Zona Distretto Grossetana, Dipartimento di Prevenzione, Azienda USL Toscana Sud Est, Amiata Grossetana e Colline Metallifere, Viale Cimabue, 109-58100 Grosseto, Italy;
| | - Maurizio Mazzei
- Dipartimento di Scienze Veterinarie, Università di Pisa, Viale delle Piagge, 2-56124 Pisa, Italy; (N.F.); (M.I.P.); (M.F.); (F.P.); (M.M.)
| | - Alessandro Poli
- Dipartimento di Scienze Veterinarie, Università di Pisa, Viale delle Piagge, 2-56124 Pisa, Italy; (N.F.); (M.I.P.); (M.F.); (F.P.); (M.M.)
- Correspondence:
| |
Collapse
|
18
|
Wu JY, Lau EH, Lu ML, Guo C, Guo ZM, Yuan J, Lu JH. An occupational risk of hepatitis E virus infection in the workers along the meat supply chains in Guangzhou, China. One Health 2022; 14:100376. [PMID: 35252529 PMCID: PMC8891999 DOI: 10.1016/j.onehlt.2022.100376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 02/19/2022] [Accepted: 02/19/2022] [Indexed: 02/07/2023] Open
|
19
|
Cordes AK, Goudeva L, Lütgehetmann M, Wenzel JJ, Behrendt P, Wedemeyer H, Heim A. Risk of transfusion-transmitted hepatitis E virus infection from pool-tested platelets and plasma. J Hepatol 2022; 76:46-52. [PMID: 34461207 DOI: 10.1016/j.jhep.2021.08.018] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 08/02/2021] [Accepted: 08/04/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND AIMS Immunocompromised patients are at risk of chronic hepatitis E which can be acquired by blood transfusions. Currently, screening of blood donors (BDs) for HEV RNA with a limit of detection (LOD) of 2,000 IU/ml is required in Germany. However, this may result in up to 440,000 IU of HEV RNA in blood products depending on their plasma volume. We studied the residual risk of transfusion-transmitted (tt) HEV infection when an LOD of 2,000 IU/ml is applied. METHODS Highly sensitive individual donor testing for HEV RNA on the Grifols Procleix Panther system (LOD 7.89 IU/ml) was performed. HEV loads were quantified by real-time PCR. RESULTS Of 16,236 donors, 31 (0.19%) were HEV RNA positive. Three BDs had viral loads between 710 and 2,000 IU/ml, which pose a significant risk of tt hepatitis E with any type of blood product. Eight BDs had viral loads of >32 to 710 IU/ml, which pose a risk of tt hepatitis E with platelet or plasma transfusions because of their higher plasma volume compared to red blood cell concentrates. Eight of these 11 potentially infectious BDs were seronegative for HEV, indicating a recent infection. Only 8 of 31 donors had viral loads >2,000 IU/ml that would also have been detected by the required screening procedure and 12 had very low HEV loads (<32 IU/ml). CONCLUSIONS Screening of BDs with an LOD of 2,000 IU/ml reduced the risk of tt HEV infection by about 73% for red blood cell concentrates but by just 42% for platelet and fresh frozen plasma transfusions. Single donor screening (LOD <32 IU/ml) should lead to an almost 100% risk reduction. LAY SUMMARY Immunocompromised patients, such as solid organ or hematopoietic stem cell recipients, are at risk of chronic hepatitis E, which can be acquired via blood transfusions. The risk of transfusion-transmitted hepatitis E in these patients may not be sufficiently controlled by (mini-)pool hepatitis E virus RNA screening of blood donors. Single donor screening should be considered to improve the safety of blood products.
Collapse
Affiliation(s)
- Anne K Cordes
- Institute of Virology, Hannover Medical School, Hannover, Germany
| | - Lilia Goudeva
- Institute of Transfusion Medicine and Transplant Engineering, Hannover Medical School, Hannover, Germany
| | - Marc Lütgehetmann
- Institute of Microbiology, Virology and Hygiene, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Jürgen J Wenzel
- Institute of Clinical Microbiology and Hygiene, National Consultant Laboratory for HAV and HEV, University Medical Center Regensburg, Regensburg, Germany
| | - Patrick Behrendt
- Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hannover, Germany
| | - Heiner Wedemeyer
- Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hannover, Germany
| | - Albert Heim
- Institute of Virology, Hannover Medical School, Hannover, Germany.
| |
Collapse
|
20
|
Baylis SA, Adlhoch C, Childs L. An Evaluation of Hepatitis E Virus Molecular Typing Methods. Clin Chem 2021; 68:181-191. [PMID: 34969109 DOI: 10.1093/clinchem/hvab186] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 07/29/2021] [Indexed: 11/13/2022]
Abstract
BACKGROUND Hepatitis E virus (HEV) is a major cause of acute viral hepatitis. Better understanding of HEV subtypes involved in hepatitis E infections is essential. Investigation of sources and routes of transmission and the identification of potential clusters/outbreaks rely upon molecular typing of viral strains. A study was carried out to evaluate the ability of laboratories to undertake molecular typing with genotype and subtype determination. METHODS A blinded panel of 11 different Orthohepevirus A strains was distributed to 28 laboratories performing HEV sequence analysis. Laboratories used their routine HEV sequencing and genotyping methods. RESULTS Results were returned by 25 laboratories. Overall, 93% samples were assigned to the correct genotype and 81% were assigned to the correct subtype. Fragments amplified for typing ranged in size and the sequencing assays targeted both the structural and non-structural protein-coding regions. There was good agreement between the reported sequences where methods targeted overlapping fragments. In some cases, incorrect genotypes/subtypes were reported, including those not contained in the panel, and in one case, a genotype was reported for a blinded control sample containing Zika virus; collectively these data indicate contamination problems. CONCLUSIONS In general, identification of genotypes was good; however, in a small number of cases, there was a failure to generate sequences from some of the samples. There was generally broad agreement between the use of online typing tools such as the one provided by HEVnet and curated lists of published HEV reference sequences; however, going forward harmonization between these resources is essential.
Collapse
Affiliation(s)
- Sally A Baylis
- Viral Safety Section, Paul-Ehrlich-Institut, Langen, Germany
| | - Cornelia Adlhoch
- Disease Programmes Unit, European Centre for Disease Prevention and Control, Solna, Sweden
| | - Liam Childs
- Host-Pathogen Interactions, Paul-Ehrlich-Institut, Langen, Germany
| | | |
Collapse
|
21
|
Shirazi R, Pozzi P, Gozlan Y, Wax M, Lustig Y, Linial M, Mendelson E, Bardenstein S, Mor O. Identification of Hepatitis E Virus Genotypes 3 and 7 in Israel: A Public Health Concern? Viruses 2021; 13:v13112326. [PMID: 34835132 PMCID: PMC8625709 DOI: 10.3390/v13112326] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 11/16/2021] [Accepted: 11/20/2021] [Indexed: 12/12/2022] Open
Abstract
Background: Hepatitis E (HEV) is an emerging cause of viral hepatitis worldwide. Swine carrying hepatitis E genotype 3 (HEV-3) are responsible for the majority of chronic viral hepatitis cases in developed countries. Recently, genotype 7 (HEV-7), isolated from a dromedary camel in the United Arab Emirates, was also associated with chronic viral hepatitis in a transplant recipient. In Israel, chronic HEV infection has not yet been reported, although HEV seroprevalence in humans is ~10%. Camels and swine are >65% seropositive. Here we report on the isolation and characterization of HEV from local camels and swine. Methods: Sera from camels (n = 142), feces from swine (n = 18) and blood from patients suspected of hepatitis E (n = 101) were collected during 2017–2020 and used to detect and characterize HEV sequences. Results: HEV-3 isolated from local swine and the camel-derived HEV-7 sequence were highly similar to HEV-3f and HEV-7 sequences (88.2% and 86.4%, respectively) related to viral hepatitis. The deduced amino acid sequences of both isolates were also highly conserved (>98%). Two patients were HEV-RNA positive; acute HEV-1 infection could be confirmed in one of them. Discussion: The absence of any reported HEV-3 and HEV-7 infection in humans remains puzzling, especially considering the reported seroprevalence rates, the similarity between HEV sequences related to chronic hepatitis and the HEV genotypes identified in swine and camels in Israel.
Collapse
Affiliation(s)
- Rachel Shirazi
- Central Virology Laboratory, Ministry of Health, Public Health Services, The Chaim Sheba Medical Center, Tel Hashomer, Ramat-Gan 52620, Israel; (R.S.); (Y.G.); (M.W.); (Y.L.); (E.M.)
| | - Paolo Pozzi
- Department of Veterinary Sciences, University of Torino, 10095 Grugliasco, Italy;
| | - Yael Gozlan
- Central Virology Laboratory, Ministry of Health, Public Health Services, The Chaim Sheba Medical Center, Tel Hashomer, Ramat-Gan 52620, Israel; (R.S.); (Y.G.); (M.W.); (Y.L.); (E.M.)
| | - Marina Wax
- Central Virology Laboratory, Ministry of Health, Public Health Services, The Chaim Sheba Medical Center, Tel Hashomer, Ramat-Gan 52620, Israel; (R.S.); (Y.G.); (M.W.); (Y.L.); (E.M.)
| | - Yaniv Lustig
- Central Virology Laboratory, Ministry of Health, Public Health Services, The Chaim Sheba Medical Center, Tel Hashomer, Ramat-Gan 52620, Israel; (R.S.); (Y.G.); (M.W.); (Y.L.); (E.M.)
- Sackler School of Medicine, Tel-Aviv University, Tel-Aviv 69978, Israel
| | - Michal Linial
- Institute of Life Sciences, The Hebrew University of Jerusalem, Jerusalem 91904, Israel;
| | - Ella Mendelson
- Central Virology Laboratory, Ministry of Health, Public Health Services, The Chaim Sheba Medical Center, Tel Hashomer, Ramat-Gan 52620, Israel; (R.S.); (Y.G.); (M.W.); (Y.L.); (E.M.)
- Sackler School of Medicine, Tel-Aviv University, Tel-Aviv 69978, Israel
| | | | - Orna Mor
- Central Virology Laboratory, Ministry of Health, Public Health Services, The Chaim Sheba Medical Center, Tel Hashomer, Ramat-Gan 52620, Israel; (R.S.); (Y.G.); (M.W.); (Y.L.); (E.M.)
- Sackler School of Medicine, Tel-Aviv University, Tel-Aviv 69978, Israel
- Correspondence: ; Tel.: +972-3-530-2458
| |
Collapse
|
22
|
Genetic Diversity of Hepatitis E Virus Type 3 in Switzerland-From Stable to Table. Animals (Basel) 2021; 11:ani11113177. [PMID: 34827909 PMCID: PMC8614342 DOI: 10.3390/ani11113177] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 11/03/2021] [Accepted: 11/05/2021] [Indexed: 12/21/2022] Open
Abstract
Simple Summary The main hosts of hepatitis E virus (HEV) genotype 3 are porcine species. Transmission of the virus to humans, for example via undercooked meat, may cause acute or chronic hepatitis. To determine sources and routes of infection, comparing the viruses present in humans to the ones present in main hosts is a helpful tool. However, it requires knowledge of the genetic diversity of the circulating viruses. Therefore, we tested Swiss pigs and wild boars for HEV and determined the virus subtype and part of its genome. In addition, we determined the HEV subtype present in 11 positive meat products. One pig liver from the slaughterhouses (0.3%) and seven livers from a carcass collection (13%) as well as seven wild boar livers (5.8%) were found HEV positive. The same virus subtypes were found in Swiss pigs, wild boars, and meat products. Most of the viruses belonged to a Swiss-specific cluster within the subtype 3h. In addition, one pig liver and one wild boar liver were found positive for 3l and two meat products from Germany for 3c. Our data indicate that Switzerland has its “own” HEV viruses that circulate independent from the rest of Europe. Abstract Hepatitis E caused by hepatitis E viruses of the genotype 3 (HEV-3) is a major health concern in industrialized countries and due to its zoonotic character requires a “One Health” approach to unravel routes and sources of transmission. Knowing the viral diversity present in reservoir hosts, i.e., pigs but also wild boars, is an important prerequisite for molecular epidemiology. The aim of this study was to gain primary information on the diversity of HEV-3 subtypes present along the food chain in Switzerland, as well as the diversity within these subtypes. To this end, samples of domestic pigs from slaughterhouses and carcass collection points, as well as from hunted wild boars, were tested for HEV RNA and antibodies. HEV positive meat products were provided by food testing labs. The HEV subtypes were determined using Sanger and next generation sequencing. The genetic analyses confirmed the predominance of a Swiss-specific cluster within subtype HEV-3h in pigs, meat products, and wild boars. This cluster, which may result from local virus evolution due to the isolated Swiss pig industry, supports fast differentiation of domestic and imported infections with HEV.
Collapse
|
23
|
Lienhard J, Vonlanthen-Specker I, Sidler X, Bachofen C. Screening of Swiss Pig Herds for Hepatitis E Virus: A Pilot Study. Animals (Basel) 2021; 11:3050. [PMID: 34827782 PMCID: PMC8614339 DOI: 10.3390/ani11113050] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 10/20/2021] [Accepted: 10/21/2021] [Indexed: 12/14/2022] Open
Abstract
Hepatitis E virus (HEV) is an important cause of acute hepatitis in humans worldwide. In industrialised countries, most infections are caused by the zoonotic genotype 3. The main reservoir was found in pigs, with fattening pigs as the main shedders. The aim of this study was to establish a screening tool to detect HEV in pig farms. HEV-positive samples were sequenced using Sanger sequencing. First, different sample materials, including floor swabs, slurry, dust swabs and faeces were tested for HEV. Floor swabs turned out to give the best results and, in the form of sock swabs, were used for the screening of Swiss pig herds. A total of 138 pig farms were tested, with a focus on fattening pigs. Overall, 81 farms (58.8%) were HEV positive. Most sequences belonged to subtype 3h, in which they formed a specific cluster (Swiss cluster). In addition, subtype 3l and two unassigned sequences were detected. As a conclusion, sock swabs were found to be a helpful tool to screen pig herds for HEV and establish a sequence collection that may enable molecular epidemiology and support outbreak investigation and prevention.
Collapse
Affiliation(s)
- Julia Lienhard
- Institute of Virology, Vetsuisse Faculty, University of Zurich, 8057 Zurich, Switzerland; (J.L.); (I.V.-S.)
| | | | - Xaver Sidler
- Division of Swine Medicine, Department of Farm Animals, Vetsuisse Faculty, University of Zurich, 8057 Zurich, Switzerland;
| | - Claudia Bachofen
- Institute of Virology, Vetsuisse Faculty, University of Zurich, 8057 Zurich, Switzerland; (J.L.); (I.V.-S.)
| |
Collapse
|
24
|
Aarestrup FM, Bonten M, Koopmans M. Pandemics- One Health preparedness for the next. LANCET REGIONAL HEALTH-EUROPE 2021; 9:100210. [PMID: 34642673 PMCID: PMC8495373 DOI: 10.1016/j.lanepe.2021.100210] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The majority of emerging infectious diseases originate in animals. Current routine surveillance is focused on known diseases and clinical syndromes, but the increasing likelihood of emerging disease outbreaks shows the critical importance of early detection of unusual illness or circulation of pathogens - prior to human disease manifestation. In this Viewpoint, we focus on one key pillar of preparedness—the need for early warning surveillance at the human, animal, environmental interface. The COVID-19 pandemic has revolutionized the scale of sequencing of pathogen genomes, and the current investments in global genomic surveillance offer great potential for a novel, truly integrated Disease X (with epidemic or pandemic potential) surveillance arm provided we do not make the mistake of developing them solely for the case at hand. Generic tools include metagenomic sequencing as a catch-all technique, rather than detection and sequencing protocols focusing on what we know. Developing agnostic or more targeted metagenomic sequencing to assess unusual disease in humans and animals, combined with random sampling of environmental samples capturing pathogen circulation is technically challenging, but could provide a true early warning system. Rather than rebuilding and reinforcing the pre-existing silo's, a real step forward would be to take the lessons learned and bring in novel essential partnerships in a One Health approach to preparedness.
Collapse
Affiliation(s)
| | - Marc Bonten
- Utrecht University Medical Centre, Utrecht, The Netherlands
| | | |
Collapse
|
25
|
Casares-Jimenez M, Lopez-Lopez P, Caballero-Gomez J, Frias M, Perez-Hernando B, Oluremi AS, Risalde MA, Ruiz-Caceres I, Opaleye OO, Garcia-Bocanegra I, Rivero-Juarez A, Rivero A. Global molecular diversity of Hepatitis E virus in wild boar and domestic pig. One Health 2021; 13:100304. [PMID: 34466650 PMCID: PMC8385159 DOI: 10.1016/j.onehlt.2021.100304] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 08/06/2021] [Accepted: 08/06/2021] [Indexed: 01/05/2023] Open
Abstract
Our study aim was to describe and characterize the global Hepatitis E virus (HEV) molecular and genotype geographical distribution in domestic pig and wild boar, which could facilitate the traceability of human cases. We performed a systematic sequence search for HEVs identified in domestic pig and wild boar from the available data in GenBank. Only sequences with lengths greater than 300 nt were included. For all sequences, the sequence length, host (i.e., domestic pig or wild boar), country of origin, and HEV genotype/subtype were recorded. Genotypes were assigned by the HEVnet typing tool. The genotype distributions were described by country and host. In countries with sequences available for both species, the genotype coincidences between both animal populations were analyzed. A total of 1404 viral sequences were included: 32.6% from wild boar and 67.4% from domestic pig. Most sequences were consistent with HEV genotype 3 (n = 1165). Genotype 4 was represented by 193 sequences, while genotypes 5 and 6 were represented by only 6 sequences. Sequences were identified in 39 countries, which included all continents except Antarctica. The genotypes with a wide distribution were 3a and 3f. Twenty-five countries had sequences that were found only in domestic pig, three countries only in wild boar, and 11 countries had sequences in both populations. In all countries with available sequences in both populations, the same viral genotype was identified. Our study shows that the number of swine HEV sequences is small, which limits direct comparisons with the sequences identified in humans. The global distribution of genotype 3, together with the wide distribution of genotype 4 in Asia, strongly limits the interpretation of the molecular analysis in the absence of an epidemiological survey of the cases. Increased HEV sequencing in swine should be a priority. Our study shows that the number of swine HEV sequences is small. The global distribution of genotype 3 strongly limits the interpretation of the molecular analysis. Increased HEV sequencing in swine should be a priority.
Collapse
Affiliation(s)
- Maria Casares-Jimenez
- Unidad de Enfermedades Infecciosas, Grupo de Virología Clínica y Zoonosis, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Hospital Reina Sofía, Universidad de Córdoba (UCO), Córdoba, Spain
| | - Pedro Lopez-Lopez
- Unidad de Enfermedades Infecciosas, Grupo de Virología Clínica y Zoonosis, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Hospital Reina Sofía, Universidad de Córdoba (UCO), Córdoba, Spain
| | - Javier Caballero-Gomez
- Unidad de Enfermedades Infecciosas, Grupo de Virología Clínica y Zoonosis, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Hospital Reina Sofía, Universidad de Córdoba (UCO), Córdoba, Spain.,Grupo de Investigación en Sanidad Animal y Zoonosis (GISAZ), Departamento de Sanidad Animal, Facultad de Veterinaria, Universidad de Córdoba (UCO), Córdoba, Spain
| | - Mario Frias
- Unidad de Enfermedades Infecciosas, Grupo de Virología Clínica y Zoonosis, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Hospital Reina Sofía, Universidad de Córdoba (UCO), Córdoba, Spain
| | - Belen Perez-Hernando
- Unidad de Enfermedades Infecciosas, Grupo de Virología Clínica y Zoonosis, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Hospital Reina Sofía, Universidad de Córdoba (UCO), Córdoba, Spain
| | - Adeolu Sunday Oluremi
- Unidad de Enfermedades Infecciosas, Grupo de Virología Clínica y Zoonosis, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Hospital Reina Sofía, Universidad de Córdoba (UCO), Córdoba, Spain.,Department of Medical Microbiology and Parasitology, Ladoke Akintola University of Technology, Ogbomoso, Nigeria
| | - Maria A Risalde
- Unidad de Enfermedades Infecciosas, Grupo de Virología Clínica y Zoonosis, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Hospital Reina Sofía, Universidad de Córdoba (UCO), Córdoba, Spain.,Grupo de Investigación en Sanidad Animal y Zoonosis (GISAZ), Departamento de Anatomía y Anatomía Patológica Comparadas y Toxicología, Facultad de Veterinaria, Universidad de Córdoba (UCO), Córdoba, Spain
| | - Inmaculada Ruiz-Caceres
- Unidad de Enfermedades Infecciosas, Grupo de Virología Clínica y Zoonosis, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Hospital Reina Sofía, Universidad de Córdoba (UCO), Córdoba, Spain
| | - Oluyinka Oladele Opaleye
- Department of Medical Microbiology and Parasitology, Ladoke Akintola University of Technology, Ogbomoso, Nigeria
| | - Ignacio Garcia-Bocanegra
- Grupo de Investigación en Sanidad Animal y Zoonosis (GISAZ), Departamento de Sanidad Animal, Facultad de Veterinaria, Universidad de Córdoba (UCO), Córdoba, Spain
| | - Antonio Rivero-Juarez
- Unidad de Enfermedades Infecciosas, Grupo de Virología Clínica y Zoonosis, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Hospital Reina Sofía, Universidad de Córdoba (UCO), Córdoba, Spain
| | - Antonio Rivero
- Unidad de Enfermedades Infecciosas, Grupo de Virología Clínica y Zoonosis, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Hospital Reina Sofía, Universidad de Córdoba (UCO), Córdoba, Spain
| |
Collapse
|
26
|
Rivero-Juarez A, Risalde MA, Gortázar C, Lopez-Lopez P, Barasona JA, Frias M, Caballero-Gomez J, de la Fuente J, Rivero A. Detection of Hepatitis E Virus in Hyalomma lusitanicum Ticks Feeding on Wild Boars. Front Microbiol 2021; 12:692147. [PMID: 34305854 PMCID: PMC8299481 DOI: 10.3389/fmicb.2021.692147] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 06/11/2021] [Indexed: 11/13/2022] Open
Abstract
Little is known about the role of ticks in maintaining highly prevalent zoonotic viruses in wildlife, such as hepatitis E virus (HEV), which do not require ticks for transmission between animals and humans. In this cross-sectional study, adult female ticks were collected from Eurasian wild boar (Sus scrofa) in autumn 2015 in Spain. HEV RNA in both ticks and wild boar was evaluated by RT-qPCR. Twenty-nine adult Hyalomma lusitanicum ticks were collected from 29 wild boars. HEV RNA was detected in a total of 10 tick (34.4%) and 11 wild boar serum samples (37.9%). In two cases, detectable HEV RNA was found in a wild boar but not in the tick collected from them. In contrast, one HEV-positive tick was collected from an HEV-negative wild boar. All viral sequences were consistent with genotype 3f. We describe for the first time the presence of HEV RNA in adult Hyalomma lusitanicum ticks.
Collapse
Affiliation(s)
- Antonio Rivero-Juarez
- Grupo de Virología Clínica y Zoonosis, Unidad de Enfermedades Infecciosas, Instituto Maimónides de Investigación Biomédica de Córdoba, Hospital Reina Sofía, Universidad de Córdoba, Córdoba, Spain
| | - María A Risalde
- Grupo de Virología Clínica y Zoonosis, Unidad de Enfermedades Infecciosas, Instituto Maimónides de Investigación Biomédica de Córdoba, Hospital Reina Sofía, Universidad de Córdoba, Córdoba, Spain.,Departamento de Anatomía y Anatomía Patológica Comparadas y Toxicología, Facultad de Veterinaria, Universidad de Córdoba, Córdoba, Spain
| | - Christian Gortázar
- Sanidad y Biotecnología, Instituto de Investigación en Recursos Cinegéticos (UCLM-CSIC-JCCM), Ciudad Real, Spain
| | - Pedro Lopez-Lopez
- Grupo de Virología Clínica y Zoonosis, Unidad de Enfermedades Infecciosas, Instituto Maimónides de Investigación Biomédica de Córdoba, Hospital Reina Sofía, Universidad de Córdoba, Córdoba, Spain
| | - Jose A Barasona
- VISAVET, Animal Health Department, Veterinary School, Complutense University of Madrid, Madrid, Spain
| | - Mario Frias
- Grupo de Virología Clínica y Zoonosis, Unidad de Enfermedades Infecciosas, Instituto Maimónides de Investigación Biomédica de Córdoba, Hospital Reina Sofía, Universidad de Córdoba, Córdoba, Spain
| | - Javier Caballero-Gomez
- Grupo de Virología Clínica y Zoonosis, Unidad de Enfermedades Infecciosas, Instituto Maimónides de Investigación Biomédica de Córdoba, Hospital Reina Sofía, Universidad de Córdoba, Córdoba, Spain.,Departamento de Sanidad Animal, Facultad de Veterinaria, Universidad de Córdoba, Córdoba, Spain
| | - José de la Fuente
- Sanidad y Biotecnología, Instituto de Investigación en Recursos Cinegéticos (UCLM-CSIC-JCCM), Ciudad Real, Spain.,Department of Veterinary Pathobiology, Center for Veterinary Health Sciences, Oklahoma State University, Stillwater, OK, United States
| | - Antonio Rivero
- Grupo de Virología Clínica y Zoonosis, Unidad de Enfermedades Infecciosas, Instituto Maimónides de Investigación Biomédica de Córdoba, Hospital Reina Sofía, Universidad de Córdoba, Córdoba, Spain
| |
Collapse
|
27
|
Limited Value of Single Sampling for IgM Antibody Determination as a Diagnostic Approach for Acute Hepatitis E Virus Infection. Microbiol Spectr 2021; 9:e0038221. [PMID: 34232097 PMCID: PMC8552658 DOI: 10.1128/spectrum.00382-21] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The objective was to evaluate the accuracy of a single determination of IgM antibodies for hepatitis E virus (HEV) diagnosis in patients with acute hepatitis. A prospective study included patients with suspicion of HEV infection, defined as individuals with acute hepatitis showing negative results for serological and molecular markers of other hepatitis viruses. All patients were evaluated for hepatitis E virus infection, including both IgM antibodies and viral RNA determinations. Hepatitis E virus infection was defined as positivity for any of these markers. A total of 182 patients were included in the study, of whom 68 (37.4%) were diagnosed with HEV infection. Of these, 29 (42.6%) were positive for both IgM and HEV RNA, 25 (36.8%) were positive only for IgM antibodies, and 14 (20.6%) were positive only for HEV RNA. Considering only those individuals who were positive for IgM antibodies, 54 of the 68 total cases (79.4%) could be identified, showing a percentage of false-negative individuals of 20.6%. The diagnostic algorithm of hepatitis E virus infection in patients with acute hepatitis should include the determination of both IgM antibodies and HEV RNA because single sampling for IgM antibody determination led to an important proportion of misdiagnosed cases. IMPORTANCE In immunocompetent patients with a suspicion of hepatitis E virus (HEV) infection, single IgM antibody testing is typically applied. In this prospective study, we aimed to evaluate the accuracy of three different HEV screening approaches in patients with acute hepatitis, including approaches based on IgM determination, HEV RNA detection, and the combination of both. Our study shows that any diagnostic algorithm for HEV infection in patients with acute hepatitis should be based on the determination of both markers (IgM antibodies and HEV RNA) because single sampling for IgM antibodies results in an unacceptable number of false-negative results (20%). According to our results, the determination of HEV RNA should not be limited to immunosuppressed individuals because a high proportion of cases could be misdiagnosed.
Collapse
|
28
|
Velavan TP, Pallerla SR, Johne R, Todt D, Steinmann E, Schemmerer M, Wenzel JJ, Hofmann J, Shih JWK, Wedemeyer H, Bock CT. Hepatitis E: An update on One Health and clinical medicine. Liver Int 2021; 41:1462-1473. [PMID: 33960603 DOI: 10.1111/liv.14912] [Citation(s) in RCA: 65] [Impact Index Per Article: 21.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Revised: 03/09/2021] [Accepted: 04/08/2021] [Indexed: 12/12/2022]
Abstract
The hepatitis E virus (HEV) is one of the main causes of acute hepatitis and the de facto global burden is underestimated. HEV-related clinical complications are often undetected and are not considered in the differential diagnosis. Convincing findings from studies suggest that HEV is clinically relevant not only in developing countries but also in industrialized countries. Eight HEV genotypes (HEV-1 to HEV-8) with different human and animal hosts and other HEV-related viruses are in circulation. Transmission routes vary by genotype and location, with large waterborne outbreaks in developing countries and zoonotic food-borne infections in developed countries. An acute infection can be aggravated in pregnant women, organ transplant recipients, patients with pre-existing liver disease and immunosuppressed patients. HEV during pregnancy affects the fetus and newborn with an increased risk of vertical transmission, preterm and stillbirth, neonatal jaundice and miscarriage. Hepatitis E is associated with extrahepatic manifestations that include neurological disorders such as neuralgic amyotrophy, Guillain-Barré syndrome and encephalitis, renal injury and haematological disorders. The risk of transfusion-transmitted HEV is increasingly recognized in Western countries where the risk may be because of a zoonosis. RNA testing of blood components is essential to determine the risk of transfusion-transmitted HEV. There are currently no approved drugs or vaccines for HEV infections. This review focuses on updating the latest developments in zoonoses, screening and diagnostics, drugs in use and under development, and vaccines.
Collapse
Affiliation(s)
- Thirumalaisamy P Velavan
- Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany.,Vietnamese-German Center for Medical Research, VG-CARE, Hanoi, Vietnam.,Faculty of Medicine, Duy Tan University, Da Nang, Vietnam
| | - Srinivas R Pallerla
- Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany.,Vietnamese-German Center for Medical Research, VG-CARE, Hanoi, Vietnam
| | - Reimar Johne
- German Federal Institute for Risk Assessment, Berlin, Germany
| | - Daniel Todt
- Department of Molecular and Medical Virology, Ruhr University Bochum, Bochum, Germany.,European Virus Bioinformatics Center (EVBC), Jena, Germany
| | - Eike Steinmann
- Department of Molecular and Medical Virology, Ruhr University Bochum, Bochum, Germany
| | - Mathias Schemmerer
- Institute of Clinical Microbiology and Hygiene, National Consultant Laboratory for HAV and HEV, University Medical Center Regensburg, Regensburg, Germany
| | - Jürgen J Wenzel
- Institute of Clinical Microbiology and Hygiene, National Consultant Laboratory for HAV and HEV, University Medical Center Regensburg, Regensburg, Germany
| | - Jörg Hofmann
- Institute of Virology, Charité Universitätsmedizin Berlin, Labor Berlin-Charité-Vivantes GmbH, Berlin, Germany
| | | | - Heiner Wedemeyer
- Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hannover, Germany.,German Center for Infection Research, Partner Hannover-Braunschweig, Braunschweig, Germany
| | - Claus-Thomas Bock
- Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany.,Division of Viral Gastroenteritis and Hepatitis Pathogens and Enteroviruses, Department of Infectious Diseases, Robert Koch Institute, Berlin, Germany
| |
Collapse
|
29
|
Genetic Diversity and Epidemiological Significance of Wild Boar HEV-3 Strains Circulating in Poland. Viruses 2021; 13:v13061176. [PMID: 34205456 PMCID: PMC8235543 DOI: 10.3390/v13061176] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 05/24/2021] [Accepted: 06/15/2021] [Indexed: 01/06/2023] Open
Abstract
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.
Collapse
|
30
|
Espeschit IDF, Santana CM, Moreira MAS. Public Policies and One Health in Brazil: The Challenge of the Disarticulation. Front Public Health 2021; 9:644748. [PMID: 34150698 PMCID: PMC8213203 DOI: 10.3389/fpubh.2021.644748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 04/27/2021] [Indexed: 11/28/2022] Open
Abstract
Working the One health strategy in developing countries is a challenge, due to structural weaknesses or deprivation of financial, human, and material resources. Brazil has policies and programs that would allow continuous and systematic monitoring of human, animal, and environmental health, recommending strategies for control and prevention. For animals, there are components of the Epidemiological Surveillance of zoonosis and Animal Health Programs. To guarantee food safety, there are Health Surveillance services and support of the Agropecuary Defense in the inspection of these products, productive environments, and their inputs. Environmental Surveillance Services monitor water and air quality, which may influence health. For human health, these and other services related to Health Surveillance, such as Worker Health and Epidemiological Surveillance, which has a training program responsible for forming professionals groups to respond effectively to emergencies in public health are available. Therefore, Brazil has instruments that may allow integrated planning and intervention based on the One Health initiative. However, the consolidation of this faces several challenges, such as insufficient resources, professional alienation, and lack of the recognition of the importance of animal and environmental health for the maintenance of human and planetary well-being. This culminates in disarticulation, lack of communication, and integration between organizations. Thus, efforts to share attributions and responsibilities must be consolidated, overcoming the verticality of the actions, promoting efficiency and effectiveness. Finally, this perspective aims to describe the government instruments that constitute potential national efforts and the challenges for the consolidation of the One Health initiative in Brazil.
Collapse
Affiliation(s)
- Isis de Freitas Espeschit
- Laboratory of Bacterial Diseases, Preventive Veterinary Medicine and Public Health Sector, Veterinary Department, Universidade Federal de Viçosa, Viçosa, Brazil
| | | | - Maria Aparecida Scatamburlo Moreira
- Laboratory of Bacterial Diseases, Preventive Veterinary Medicine and Public Health Sector, Veterinary Department, Universidade Federal de Viçosa, Viçosa, Brazil
| |
Collapse
|
31
|
Wang B, Meng XJ. Structural and molecular biology of hepatitis E virus. Comput Struct Biotechnol J 2021; 19:1907-1916. [PMID: 33995894 PMCID: PMC8079827 DOI: 10.1016/j.csbj.2021.03.038] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 03/26/2021] [Accepted: 03/29/2021] [Indexed: 02/07/2023] Open
Abstract
Hepatitis E virus (HEV) is one of the most common causes of acute viral hepatitis, mainly transmitted by fecal-oral route but has also been linked to fulminant hepatic failure, chronic hepatitis, and extrahepatic neurological and renal diseases. HEV is an emerging zoonotic pathogen with a broad host range, and strains of HEV from numerous animal species are known to cross species barriers and infect humans. HEV is a single-stranded, positive-sense RNA virus in the family Hepeviridae. The genome typically contains three open reading frames (ORFs): ORF1 encodes a nonstructural polyprotein for virus replication and transcription, ORF2 encodes the capsid protein that elicits neutralizing antibodies, and ORF3, which partially overlaps ORF2, encodes a multifunctional protein involved in virion morphogenesis and pathogenesis. HEV virions are non-enveloped spherical particles in feces but exist as quasi-enveloped particles in circulating blood. Two types of HEV virus-like particles (VLPs), small T = 1 (270 Å) and native virion-sized T = 3 (320-340 Å) have been reported. There exist two distinct forms of capsid protein, the secreted form (ORF2S) inhibits antibody neutralization, whereas the capsid-associated form (ORF2C) self-assembles to VLPs. Four cis-reactive elements (CREs) containing stem-loops from secondary RNA structures have been identified in the non-coding regions and are critical for virus replication. This mini-review discusses the current knowledge and gaps regarding the structural and molecular biology of HEV with emphasis on the virion structure, genomic organization, secondary RNA structures, viral proteins and their functions, and life cycle of HEV.
Collapse
Affiliation(s)
- Bo Wang
- Center for Emerging, Zoonotic and Arthropod-borne Pathogens, Department of Biomedical Sciences and Pathobiology, Virginia-Maryland College of Veterinary Medicine, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA
| | - Xiang-Jin Meng
- Center for Emerging, Zoonotic and Arthropod-borne Pathogens, Department of Biomedical Sciences and Pathobiology, Virginia-Maryland College of Veterinary Medicine, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA
| |
Collapse
|
32
|
O’Keefe J, Tracy L, Yuen L, Bonanzinga S, Li X, Chong B, Nicholson S, Jackson K. Autochthonous and Travel Acquired Hepatitis E Virus in Australia. Front Microbiol 2021; 12:640325. [PMID: 33633719 PMCID: PMC7901960 DOI: 10.3389/fmicb.2021.640325] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 01/18/2021] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Hepatitis E virus (HEV) is a common cause of acute viral hepatitis with significant morbidity and mortality, particularly in pregnant women. There are four major genotypes which can cause disease in humans. Genotypes 1 and 2 are usually associated with outbreaks and spread via facal/oral route or contaminated water. Genotypes 3 and 4 are zoonotic and usually associated with handling of pigs or consumption of contaminated pork. The strains circulating in Australia have never been characterized. RATIONALE/AIMS The aims for this project are to identify the HEV genotypes found in Australia and link them to possible sources of transmission by phylogenetic analysis. MATERIALS AND METHODS Between 2015 and 2020, 91 HEV isolates were sequenced and genotyped using an in-house PCR. Sixty-six of these were also sequenced by using the international HEVnet primers. Genotypes were determined using the BLASTn program. Relatedness to other strains in Australia was determined by phylogenetic analyses of the HEVnet sequences. Isolates were also stratified by state of origin, gender, age, predisposing factors and travel history (if known). RESULTS Of the 91 HEV isolates sequenced, 55 (60.4%) were genotype 1. There were 34 (37.4%) genotype 3 strains and two genotype 4 (2.2%). At least 20 of the genotype 1 strains have been linked to travel in India, and another three with Pakistan. Five of the "Indian" strains were closely related and are suspected to have originated in Gujarat. Phylogenetic analysis also showed that 12 genotype 3 strains were genetically related and potentially acquired in/from New South Wales, Australia. The two genotype 4 strains may have originated in China. DISCUSSION This is the first study to describe the HEV isolates identified in Australia. The results infer that HEV may be acquired during overseas travel as well as locally, presumably from consumption of pork or pork-related products. The phylogenetic analyses also reveal clusters of infection originating from India and Pakistan. This study provides some insight into the source and epidemiology of HEV infection in Australia which may be used to guide public health procedure and enable the implementation of measures to deal with potential outbreaks of infection.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | - Kathy Jackson
- Victorian Infectious Diseases Reference Laboratory, Royal Melbourne Hospital, Doherty Institute for Infection and Immunity, Melbourne, VIC, Australia
| |
Collapse
|
33
|
Ripellino P, Pianezzi E, Martinetti G, Zehnder C, Mathis B, Giannini P, Forrer N, Merlani G, Dalton HR, Petrini O, Bihl F, Fontana S, Gobbi C. Control of Raw Pork Liver Sausage Production Can Reduce the Prevalence of HEV Infection. Pathogens 2021; 10:pathogens10020107. [PMID: 33498993 PMCID: PMC7911891 DOI: 10.3390/pathogens10020107] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Revised: 01/15/2021] [Accepted: 01/20/2021] [Indexed: 01/06/2023] Open
Abstract
After an acute hepatitis E (HEV) outbreak in Southern Switzerland, in January 2017 the local public health authorities started an active program of food chain control and public education. In this retrospective study, we analysed all laboratory-confirmed acute cases of HEV infection diagnosed between 2014 and 2020. In the period before the public health intervention, the number of cases increased steadily from 2014 (4 of 40 tests, 10%) reaching a peak in the last quarter of 2016 (42 of 285 tests, 14.7 %). Afterwards, the number of positive cases decreased steadily, reaching its lowest value (0.3%) in the second quarter of 2019. There was a statistically significant difference between the frequency of positive cases and period of testing, i.e., before and after the introduction of the public health interventions. Our study shows that active public health measures to control sausages containing raw pork liver can reduce the prevalence of HEV infection.
Collapse
Affiliation(s)
- Paolo Ripellino
- Neurocenter of Southern Switzerland, 6900 Lugano, Switzerland;
- Correspondence:
| | - Enea Pianezzi
- Laboratory of Microbiology, Ente Ospedaliero Cantonale, 6500 Bellinzona, Switzerland; (E.P.); (G.M.)
| | - Gladys Martinetti
- Laboratory of Microbiology, Ente Ospedaliero Cantonale, 6500 Bellinzona, Switzerland; (E.P.); (G.M.)
| | | | | | - Petra Giannini
- Cantonal Food Control Authority, 6500 Bellinzona, Switzerland; (P.G.); (N.F.)
| | - Nicola Forrer
- Cantonal Food Control Authority, 6500 Bellinzona, Switzerland; (P.G.); (N.F.)
| | | | - Harry R. Dalton
- University of Applied Sciences and Arts of Southern Switzerland, 6501 Bellinzona, Switzerland;
| | | | - Florian Bihl
- San Giovanni Hospital, 6500 Bellinzona, Switzerland;
- Hôpitaux Universitaires de Genève, 1205 Genève, Switzerland
| | - Stefano Fontana
- Blood Transfusion Service CRS Southern Switzerland, 6900 Lugano, Switzerland;
| | - Claudio Gobbi
- Neurocenter of Southern Switzerland, 6900 Lugano, Switzerland;
- Faculty of Biomedical Sciences, Università della Svizzera Italiana (USI), 6900 Lugano, Switzerland
| |
Collapse
|
34
|
Hepatitis E Virus Occurrence in Pigs Slaughtered in Italy. Animals (Basel) 2021; 11:ani11020277. [PMID: 33499160 PMCID: PMC7911034 DOI: 10.3390/ani11020277] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 01/19/2021] [Accepted: 01/19/2021] [Indexed: 12/11/2022] Open
Abstract
Simple Summary Hepatitis E is now recognized as an emerging zoonotic disease in Europe caused by an RNA virus (HEV) and foodborne is the main route of transmission. Human cases have been linked to the consumption of contaminated pig liver sausages, raw venison, or undercooked wild boar meat. The zoonotic genotype HEV-3 is widespread in pigs at farm level but little information is available on the occurrence of HEV-positive pigs at the slaughterhouse. The aim of this study was to investigate the prevalence of HEV-positive pigs during slaughtering, to understand which biological samples (feces and organs) were more frequently HEV positive. Our results showed that pigs positive for HEV can be slaughtered and that the percentage of positive animals depends on the age of animals. The other main result is the presence of the virus in the plasma of animals, which may contribute to the contamination of meat (muscle). Nevertheless, muscles are rarely contaminated by HEV-RNA compared to liver, which is the organ of replication. Abstract In Europe, foodborne transmission has been clearly associated to sporadic cases and small clusters of hepatitis E in humans linked to the consumption of contaminated pig liver sausages, raw venison, or undercooked wild boar meat. In Europe, zoonotic HEV-genotype 3 strains are widespread in pig farms but little information is available on the prevalence of HEV positive pigs at slaughterhouse. In the present study, the prevalence of HEV-RNA positive pigs was assessed on 585 animals from 4 abattoirs located across Italy. Twenty-one pigs (3.6%) tested positive for HEV in either feces or liver by real-time RT-PCR. In these 21 pigs, eight diaphragm muscles resulted positive for HEV-RNA. Among animals collected in one abattoir, 4 out of 91 plasma tested positive for HEV-RNA. ELISA tests for the detection of total antibodies against HEV showed a high seroprevalence (76.8%), confirming the frequent exposure of pigs to the virus. The phylogenetic analyses conducted on sequences of both ORF1 and ORF2 fragments, shows the circulation of HEV-3c and of a novel unclassified subtype. This study provides information on HEV occurrence in pigs at the slaughterhouse, confirming that muscles are rarely contaminated by HEV-RNA compared to liver, which is the most frequently positive for HEV.
Collapse
|
35
|
Development and Clinical Validation of a Pangenotypic PCR-Based Assay for the Detection and Quantification of Hepatitis E Virus ( Orthohepevirus A Genus). J Clin Microbiol 2021; 59:JCM.02075-20. [PMID: 33148702 DOI: 10.1128/jcm.02075-20] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Accepted: 10/22/2020] [Indexed: 01/01/2023] Open
Abstract
The objective of this study was to design a pangenotypic PCR-based assay for the detection and quantification of hepatitis E virus (HEV) RNA from across the entire spectrum of described genotypes belonging to the Orthohepevirus A genus. The optimal conditions and the performance of the assay were determined by testing the WHO standard strain (6219/10) and the WHO HEV panel (8578/13). Similarly, performance comparisons were made with two commercial assays (Real Star HEV RT-PCR 2.0 and ampliCube HEV 2.0 Quant) to detect HEV RNA at concentrations below 1,000 IU/ml with viral strains from the WHO and to test samples from 54 patients with acute hepatitis. The assay presented in this study was able to detect the entire spectrum of described genotypes belonging to the Orthohepevirus A genus, demonstrating better performance than both commercial kits. This procedure may represent a significant improvement in the molecular diagnosis of HEV infection.
Collapse
|
36
|
Aprea G, Scattolini S, D’Angelantonio D, Chiaverini A, Di Lollo V, Olivieri S, Marcacci M, Mangone I, Salucci S, Antoci S, Cammà C, Di Pasquale A, Migliorati G, Pomilio F. Whole Genome Sequencing Characterization of HEV3- e and HEV3- f Subtypes among the Wild Boar Population in the Abruzzo Region, Italy: First Report. Microorganisms 2020; 8:microorganisms8091393. [PMID: 32932776 PMCID: PMC7565956 DOI: 10.3390/microorganisms8091393] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Revised: 08/18/2020] [Accepted: 09/08/2020] [Indexed: 01/26/2023] Open
Abstract
Hepatitis E virus (HEV) is an emergent zoonotic pathogen, causing worldwide acute and chronic hepatitis in humans. HEV comprises eight genotypes and several subtypes. HEV genotypes 3 and 4 (HEV3 and HEV4) are zoonotic. In Italy, the most part of HEV infections (80%) is due to autochthonous HEV3 circulation of the virus, and the key role played by wild animals is generally accepted. Abruzzo is an Italian region officially considered an HEV "hot spot", with subtype HEV3-c being up to now the only one reported among wild boars. During the year 2018-2019, a group of wild boars in Abruzzo were screened for HEV; positive RNA liver samples were subjected to HEV characterization by using the whole genome sequencing (WGS) approach methodology. This represents the first report about the detection of HEV-3 subtypes e and f in the wild boar population in this area. Since in Italy human infections from HEV 3-e and f have been associated with pork meat consumption, our findings deserve more in-depth analysis with the aim of evaluating any potential correlation between wild animals, the pork chain production and HEV human infections.
Collapse
Affiliation(s)
- Giuseppe Aprea
- Istituto Zooprofilattico Sperimentale dell’Abruzzo e del Molise “G. Caporale”, 64100 Teramo, Italy; (D.D.); (A.C.); (V.D.L.); (S.O.); (M.M.); (I.M.); (S.S.); (C.C.); (A.D.P.); (G.M.); (F.P.)
- Correspondence: (G.A.); (S.S.)
| | - Silvia Scattolini
- Istituto Zooprofilattico Sperimentale dell’Abruzzo e del Molise “G. Caporale”, 64100 Teramo, Italy; (D.D.); (A.C.); (V.D.L.); (S.O.); (M.M.); (I.M.); (S.S.); (C.C.); (A.D.P.); (G.M.); (F.P.)
- Correspondence: (G.A.); (S.S.)
| | - Daniela D’Angelantonio
- Istituto Zooprofilattico Sperimentale dell’Abruzzo e del Molise “G. Caporale”, 64100 Teramo, Italy; (D.D.); (A.C.); (V.D.L.); (S.O.); (M.M.); (I.M.); (S.S.); (C.C.); (A.D.P.); (G.M.); (F.P.)
| | - Alexandra Chiaverini
- Istituto Zooprofilattico Sperimentale dell’Abruzzo e del Molise “G. Caporale”, 64100 Teramo, Italy; (D.D.); (A.C.); (V.D.L.); (S.O.); (M.M.); (I.M.); (S.S.); (C.C.); (A.D.P.); (G.M.); (F.P.)
| | - Valeria Di Lollo
- Istituto Zooprofilattico Sperimentale dell’Abruzzo e del Molise “G. Caporale”, 64100 Teramo, Italy; (D.D.); (A.C.); (V.D.L.); (S.O.); (M.M.); (I.M.); (S.S.); (C.C.); (A.D.P.); (G.M.); (F.P.)
| | - Sabrina Olivieri
- Istituto Zooprofilattico Sperimentale dell’Abruzzo e del Molise “G. Caporale”, 64100 Teramo, Italy; (D.D.); (A.C.); (V.D.L.); (S.O.); (M.M.); (I.M.); (S.S.); (C.C.); (A.D.P.); (G.M.); (F.P.)
| | - Maurilia Marcacci
- Istituto Zooprofilattico Sperimentale dell’Abruzzo e del Molise “G. Caporale”, 64100 Teramo, Italy; (D.D.); (A.C.); (V.D.L.); (S.O.); (M.M.); (I.M.); (S.S.); (C.C.); (A.D.P.); (G.M.); (F.P.)
| | - Iolanda Mangone
- Istituto Zooprofilattico Sperimentale dell’Abruzzo e del Molise “G. Caporale”, 64100 Teramo, Italy; (D.D.); (A.C.); (V.D.L.); (S.O.); (M.M.); (I.M.); (S.S.); (C.C.); (A.D.P.); (G.M.); (F.P.)
| | - Stefania Salucci
- Istituto Zooprofilattico Sperimentale dell’Abruzzo e del Molise “G. Caporale”, 64100 Teramo, Italy; (D.D.); (A.C.); (V.D.L.); (S.O.); (M.M.); (I.M.); (S.S.); (C.C.); (A.D.P.); (G.M.); (F.P.)
| | | | - Cesare Cammà
- Istituto Zooprofilattico Sperimentale dell’Abruzzo e del Molise “G. Caporale”, 64100 Teramo, Italy; (D.D.); (A.C.); (V.D.L.); (S.O.); (M.M.); (I.M.); (S.S.); (C.C.); (A.D.P.); (G.M.); (F.P.)
| | - Adriano Di Pasquale
- Istituto Zooprofilattico Sperimentale dell’Abruzzo e del Molise “G. Caporale”, 64100 Teramo, Italy; (D.D.); (A.C.); (V.D.L.); (S.O.); (M.M.); (I.M.); (S.S.); (C.C.); (A.D.P.); (G.M.); (F.P.)
| | - Giacomo Migliorati
- Istituto Zooprofilattico Sperimentale dell’Abruzzo e del Molise “G. Caporale”, 64100 Teramo, Italy; (D.D.); (A.C.); (V.D.L.); (S.O.); (M.M.); (I.M.); (S.S.); (C.C.); (A.D.P.); (G.M.); (F.P.)
| | - Francesco Pomilio
- Istituto Zooprofilattico Sperimentale dell’Abruzzo e del Molise “G. Caporale”, 64100 Teramo, Italy; (D.D.); (A.C.); (V.D.L.); (S.O.); (M.M.); (I.M.); (S.S.); (C.C.); (A.D.P.); (G.M.); (F.P.)
| |
Collapse
|
37
|
Rivero-Juarez A, Frias M, Lopez-Lopez P, Berenguer J, García F, Macias J, Alcaraz B, Castro-Iglesias A, Caballero-Gomez J, Rivero A. Hepatitis E 3ra Genotype Infection in People Living With HIV in Spain. Front Microbiol 2020; 11:564486. [PMID: 33716992 PMCID: PMC7945038 DOI: 10.3389/fmicb.2020.564486] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Accepted: 08/18/2020] [Indexed: 12/26/2022] Open
Abstract
Background The objective of our study was to assess the prevalence and incidence of HEV in people living with HIV (PLWH) in a Spanish national cohort. Methods Retrospective longitudinal study including PLWH recruited in the cohort of adult HIV-infected patients of the AIDS Research Network in follow-up at 28 Spanish hospitals with available serum samples in 2014 and 2015. All samples were tested for HEV IgG, IgM, and RNA. Samples with detectable HEV viral loads were genotyped. Prevalence and incidence of HEV infection were calculated. Results The study sample comprised 845 PLWH. At baseline, 101 patients were positive for HEV IgG antibodies (11.9%), none had HEV IgM antibodies, and 2 presented detectable HEV RNA (0.23%). Forty-two seroconverted for IgG, supposing a cumulative incidence of 5.7%. One subject was positive for IgM (0.13%), and 2 showed detectable HEV RNA (0.27%). One case was infected by the emergent HEV genotype 3ra. Conclusion Our study identifies one case of HEV 3ra genotype infection, the main host of which is rabbit, showing a potential zoonotic role of this emerging genotype in Spain.
Collapse
Affiliation(s)
- Antonio Rivero-Juarez
- Instituto Maimonides de Investigación Biomédica de Córdoba, Hospital Universitario Reina Sofía de Córdoba, Universidad de Córdoba, Córdoba, Spain
| | - Mario Frias
- Instituto Maimonides de Investigación Biomédica de Córdoba, Hospital Universitario Reina Sofía de Córdoba, Universidad de Córdoba, Córdoba, Spain
| | - Pedro Lopez-Lopez
- Instituto Maimonides de Investigación Biomédica de Córdoba, Hospital Universitario Reina Sofía de Córdoba, Universidad de Córdoba, Córdoba, Spain
| | - Juan Berenguer
- Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - Federico García
- Hospital Universitario San Cecilio, Instituto de Investigación Biosantaria Ibs, Granada, Spain
| | - Juan Macias
- Hospital Nuestra Señora de Valme, Seville, Spain
| | - Begoña Alcaraz
- Hospital General Universitario Santa Lucía, Cartagena, Spain
| | | | - Javier Caballero-Gomez
- Instituto Maimonides de Investigación Biomédica de Córdoba, Hospital Universitario Reina Sofía de Córdoba, Universidad de Córdoba, Córdoba, Spain.,University of Córdoba - Agrifood Excellence International Campus, Córdoba, Spain
| | - Antonio Rivero
- Instituto Maimonides de Investigación Biomédica de Córdoba, Hospital Universitario Reina Sofía de Córdoba, Universidad de Córdoba, Córdoba, Spain
| |
Collapse
|
38
|
Abstract
PURPOSE OF REVIEW Hepatitis E virus (HEV) has gained increased global recognition in recent years, particularly in developed countries. We summarized here a selection of the literature published since the 1st of June, 2017. RECENT FINDINGS Longitudinal studies are increasingly conducted in Europe, to determine trends in HEV prevalence. The spectrum of mammals infected with HEV and potentially capable to transmit it to humans has widened. New virological data on HEV repCon and pathogenicity have been reported and clinical features of HEV infections have been precised or newly described. Finally, there are some new data on the therapeutic management of HEV infections in various clinical settings. SUMMARY HEV emergence in developed countries appears to be based on improved diagnosis tools and increased awareness of clinicians that HEV transmission is essentially autochthonous and is a possible cause of life-threatening acute hepatitis, chronic hepatitis, cirrhosis, and extra-hepatic symptoms. In addition, the distribution of HEV strains evolves. Ribavirin remains to date the only specific treatment recommended for HEV infection, being efficient in the majority but not in all cases.
Collapse
|
39
|
Boxman ILA, Jansen CCC, Zwartkruis-Nahuis AJT, Hägele G, Sosef NP, Dirks RAM. Detection and quantification of hepatitis E virus RNA in ready to eat raw pork sausages in the Netherlands. Int J Food Microbiol 2020; 333:108791. [PMID: 32758861 DOI: 10.1016/j.ijfoodmicro.2020.108791] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Revised: 06/24/2020] [Accepted: 07/12/2020] [Indexed: 12/27/2022]
Abstract
The aim of the present study was to assess raw pork sausages collected on the Dutch market for the presence of hepatitis E virus (HEV) RNA. 46 of 316 (14.6%) products sampled from Dutch retail stores in 2017-2019 were positive for HEV RNA. HEV RNA was detected in 10.8% of "cervelaat" (n = 74), 18.5% of salami (n = 92), 26.1% of "metworst" (n = 46), 16.3% of "snijworst" (n = 43) samples. This was significantly more often than in other raw pork sausages like dried sausages, fuet or chorizo (3.3%, n = 61). The percentage of HEV RNA positive products was not significantly different for products sold as either sliced or unsliced deli meat. The average viral load in positive tested products was 2.76 log10 genome copies per 5 g, incidentally reaching up to 4.5 log10 genome copies per 5 g. The average HEV RNA level was significantly higher in samples collected in 2017 than those in samples collected in 2018, and most of the samples in 2019. Typing by sequence analysis was successful for 33 samples, all revealing genotype 3c. The results support recent epidemiological studies that identified specific raw pork sausages as risk factor for hepatitis E virus infection in the Netherlands. Persons at risk, including Dutch transplant recipients, have been advised to avoid the consumption of raw pork sausages. The study warrants a continuation of monitoring to follow the HEV RNA levels in pork products for use in risk assessments and risk management.
Collapse
Affiliation(s)
- Ingeborg L A Boxman
- Wageningen Food Safety Research, Wageningen University and Research, Mailbox 230, 6700 AE Wageningen, the Netherlands.
| | - Claudia C C Jansen
- Wageningen Food Safety Research, Wageningen University and Research, Mailbox 230, 6700 AE Wageningen, the Netherlands
| | - Ans J T Zwartkruis-Nahuis
- Wageningen Food Safety Research, Wageningen University and Research, Mailbox 230, 6700 AE Wageningen, the Netherlands
| | - Geke Hägele
- Wageningen Food Safety Research, Wageningen University and Research, Mailbox 230, 6700 AE Wageningen, the Netherlands
| | - Nils P Sosef
- Wageningen Food Safety Research, Wageningen University and Research, Mailbox 230, 6700 AE Wageningen, the Netherlands
| | - René A M Dirks
- Wageningen Food Safety Research, Wageningen University and Research, Mailbox 230, 6700 AE Wageningen, the Netherlands
| |
Collapse
|
40
|
Maticic M, Mondelli M. Elimination of viral hepatitis: where do we stand in the year 2020? Clin Microbiol Infect 2020; 26:816-817. [DOI: 10.1016/j.cmi.2020.02.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2020] [Revised: 02/18/2020] [Accepted: 02/22/2020] [Indexed: 11/28/2022]
|
41
|
Smith DB, Izopet J, Nicot F, Simmonds P, Jameel S, Meng XJ, Norder H, Okamoto H, van der Poel WH, Reuter G, Purdy MA. Update: proposed reference sequences for subtypes of hepatitis E virus (species Orthohepevirus A). J Gen Virol 2020; 101:692-698. [PMID: 32469300 PMCID: PMC7660235 DOI: 10.1099/jgv.0.001435] [Citation(s) in RCA: 231] [Impact Index Per Article: 57.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
In this recommendation, we update our 2016 table of reference sequences of subtypes of hepatitis E virus (HEV; species Orthohepevirus A, family Hepeviridae) for which complete genome sequences are available (Smith et al., 2016). This takes into account subsequent publications describing novel viruses and additional proposals for subtype names; there are now eight genotypes and 36 subtypes. Although it remains difficult to define strict criteria for distinguishing between virus subtypes, and is not within the remit of the International Committee on Taxonomy of Viruses (ICTV), the use of agreed reference sequences will bring clarity and stability to researchers, epidemiologists and clinicians working with HEV.
Collapse
Affiliation(s)
- Donald B. Smith
- Nuffield Department of Medicine, University of Oxford, Oxford, UK,*Correspondence: Donald B. Smith,
| | | | | | - Peter Simmonds
- Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Shahid Jameel
- The Wellcome Trust/DBT India Alliance, Hyderabad, India
| | - Xiang-Jin Meng
- College of Veterinary Medicine, Virginia Polytechnic Institute and State University, Blacksburg, Virginia, USA
| | - Heléne Norder
- Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, 41345 Gothenburg, Sweden
| | - Hiroaki Okamoto
- Division of Virology, Department of Infection and Immunity, Jichi Medical University School of Medicine, Tochigi-ken, Japan
| | - Wim H.M. van der Poel
- Wageningen Bioveterinary Research, Wageningen University and Research, Lelystad, The Netherlands
| | - Gábor Reuter
- Department of Medical Microbiology and Immunology, Medical School, University of Pécs, Pécs, Hungary
| | - Michael A. Purdy
- Centers for Disease Control and Prevention, National Center for HIV/Hepatitis/STD/TB Prevention, Division of Viral Hepatitis, Atlanta, Georgia, USA
| |
Collapse
|
42
|
Desdouits M, de Graaf M, Strubbia S, Oude Munnink BB, Kroneman A, Le Guyader FS, Koopmans MPG. Novel opportunities for NGS-based one health surveillance of foodborne viruses. ONE HEALTH OUTLOOK 2020; 2:14. [PMID: 33829135 PMCID: PMC7993515 DOI: 10.1186/s42522-020-00015-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Accepted: 05/01/2020] [Indexed: 05/15/2023]
Abstract
Foodborne viral infections rank among the top 5 causes of disease, with noroviruses and hepatitis A causing the greatest burden globally. Contamination of foods by infected food handlers or through environmental pollution are the main sources of foodborne illness, with a lesser role for consumption of products from infected animals. Viral partial genomic sequencing has been used for more than two decades to track foodborne outbreaks and whole genome or metagenomics next-generation-sequencing (NGS) are new additions to the toolbox of food microbiology laboratories. We discuss developments in the field of targeted and metagenomic NGS, with an emphasis on application in food virology, the challenges and possible solutions towards future routine application.
Collapse
Affiliation(s)
- Marion Desdouits
- IFREMER, Laboratoire de Microbiologie, LSEM/SG2M, Nantes, France
| | - Miranda de Graaf
- Viroscience Department, Erasmus Medical Centre, Molewaterplein 40, 3015 GD Rotterdam, The Netherlands
| | - Sofia Strubbia
- IFREMER, Laboratoire de Microbiologie, LSEM/SG2M, Nantes, France
| | - Bas B. Oude Munnink
- Viroscience Department, Erasmus Medical Centre, Molewaterplein 40, 3015 GD Rotterdam, The Netherlands
| | - Annelies Kroneman
- Centre for Infectious Disease Control, National Institute of Public Health and the Environment, Bilthoven, The Netherlands
| | | | - Marion P. G. Koopmans
- Viroscience Department, Erasmus Medical Centre, Molewaterplein 40, 3015 GD Rotterdam, The Netherlands
| |
Collapse
|
43
|
De Sabato L, Amoroso MG, Ianiro G, Esposito C, De Grossi L, Fusco G, Barone A, Martini E, Ostanello F, Di Bartolo I. Detection of Hepatitis E Virus in Livers and Muscle Tissues of Wild Boars in Italy. FOOD AND ENVIRONMENTAL VIROLOGY 2020; 12:1-8. [PMID: 31506837 DOI: 10.1007/s12560-019-09405-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Accepted: 09/03/2019] [Indexed: 06/10/2023]
Abstract
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.
Collapse
Affiliation(s)
- Luca De Sabato
- Department of Food Safety, Nutrition and Veterinary Public Health, Istituto Superiore Di Sanità, Viale Regina Elena, 299, 00161, Rome, Italy
| | - Maria Grazia Amoroso
- Department of Animal Health, Experimental Zooprophylactic Institute of Southern Italy, Via Salute, 2, 80055, Portici, NA, Italy
| | - Giovanni Ianiro
- Department of Food Safety, Nutrition and Veterinary Public Health, Istituto Superiore Di Sanità, Viale Regina Elena, 299, 00161, Rome, Italy
| | - Claudia Esposito
- Department of Animal Health, Experimental Zooprophylactic Institute of Southern Italy, Via Salute, 2, 80055, Portici, NA, Italy
| | - Luigi De Grossi
- Experimental Zooprophylactic Institute of Latium and Tuscany "M. Aleandri", Strada Terme 4a, 01100, Viterbo, Italy
| | - Giovanna Fusco
- Department of Animal Health, Experimental Zooprophylactic Institute of Southern Italy, Via Salute, 2, 80055, Portici, NA, Italy
| | - Antonino Barone
- Experimental Zooprophylactic Institute of Latium and Tuscany "M. Aleandri", Strada Terme 4a, 01100, Viterbo, Italy
| | - Enrica Martini
- ASL Viterbo, via Enrico Fermi, 15, 01100, Viterbo, Italy
| | - Fabio Ostanello
- Department of Veterinary Medical Sciences, University of Bologna, Via Tolara di Sopra, 50, 40064, Ozzano dell'Emilia, BO, Italy
| | - Ilaria Di Bartolo
- Department of Food Safety, Nutrition and Veterinary Public Health, Istituto Superiore Di Sanità, Viale Regina Elena, 299, 00161, Rome, Italy.
| |
Collapse
|
44
|
De Sabato L, Di Bartolo I, Lapa D, Capobianchi MR, Garbuglia AR. Molecular Characterization of HEV Genotype 3 in Italy at Human/Animal Interface. Front Microbiol 2020; 11:137. [PMID: 32117156 PMCID: PMC7014918 DOI: 10.3389/fmicb.2020.00137] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Accepted: 01/21/2020] [Indexed: 12/17/2022] Open
Abstract
Hepatitis E virus (HEV) is an emerging public health issue in industrialized countries. In the last decade the number of autochthonous human infections has increased in Europe. Genotype 3 (HEV-3) is typically zoonotic, being foodborne the main route of transmission to humans, and is the most frequently detected in Europe in both humans and animals (mainly pigs and wild boars). In Italy, the first autochthonous human case was reported in 1999; since then, HEV-3 has been widely detected in both humans and animals. Despite the zoonotic characteristic of HEV-3 is well established, the correlation between animal and human strains has been poorly investigated in Italy. In the present study, we compared the subtype distribution of HEV-3 in humans and animals (swine and wild boar) in the period 2000-2018 from Italy. The dataset for this analysis included a total of 96 Italian ORF2 sequences (300 nt long), including both NCBI database-derived (n = 64) and recent sequences (2016-2018, n = 32) obtained in this study. The results show that subtype 3f is the most frequent in humans and pigs, followed by the HEV-3e, HEV-3c and other unassignable HEV-3 strains. Diversely, in wild boar a wider group of HEV-3 subtypes have been detected, including HEV-3a, which has also been detected for the first time in a human patient in Central Italy in 2017, and a wide group of unassignable HEV-3 strains. The phylogenetic analysis including, besides Italian strains, also sequences from other countries retrieved from the NCBI database, indicated that human Italian sequences, in particular those of HEV-3f and HEV-3e, form significant clusters mainly with sequences of animal origin from the same country. Nevertheless, for HEV-3c, rarely detected in Italian pigs, human sequences from Italy are more correlated to human sequences from other European countries. Furthermore, clusters of near-identical human strains identified in a short time interval in Lazio Region (Central Italy) can be recognized in the phylogenetic tree, suggesting that multiple infections originating from a common source have occurred, and confirming the importance of sequencing support to HEV surveillance.
Collapse
Affiliation(s)
- Luca De Sabato
- Department of Food Safety, Nutrition and Veterinary Public Health, Istituto Superiore di Sanità, Rome, Italy
| | - Ilaria Di Bartolo
- Department of Food Safety, Nutrition and Veterinary Public Health, Istituto Superiore di Sanità, Rome, Italy
| | - Daniele Lapa
- Laboratory of Virology, “L. Spallanzani” National Institute for Infectious Diseases, IRCCS, Rome, Italy
| | - Maria Rosaria Capobianchi
- Laboratory of Virology, “L. Spallanzani” National Institute for Infectious Diseases, IRCCS, Rome, Italy
| | - Anna Rosa Garbuglia
- Laboratory of Virology, “L. Spallanzani” National Institute for Infectious Diseases, IRCCS, Rome, Italy
| |
Collapse
|
45
|
Rituximab-Containing Treatment Regimens May Imply a Long-Term Risk for Difficult-To-Treat Chronic Hepatitis E. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17010341. [PMID: 31947836 PMCID: PMC6982013 DOI: 10.3390/ijerph17010341] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2019] [Revised: 12/23/2019] [Accepted: 12/31/2019] [Indexed: 02/05/2023]
Abstract
Hepatitis E virus (HEV) infection is an emerging disease in industrialized countries which is usually characterized by a self-limited course. However, there is an increased risk of HEV persistence in immunocompromised risk populations, comprising patients following solid organ transplantation or hematological malignancies. Recently, chronic HEV infection following rituximab-containing treatment regimens has been described. Here we report five patients with chronic hepatitis E after prior rituximab therapy for various indications. We determined the immunological characteristics of these patients and analyzed the development of ribavirin (RBV) treatment failure-associated mutations in the HEV genome. One patient became chronically HEV-infected 110 months after administration of rituximab (RTX). Immunological characterization revealed that all patients exhibited significant hypogammaglobulinemia and CD4+ T cell lymphopenia. One patient permanently cleared HEV following weight-based ribavirin treatment while three patients failed to reach a sustained virological response. In depth mutational analysis confirmed the presence of specific mutations associated with RBV treatment failure in these patients. Our cases indicate that rituximab-containing treatment regimens might imply a relevant risk for persistent HEV infection even years after the last rituximab application. Moreover, we provide further evidence to prior observations suggesting that chronically HEV infected patients following RTX-containing treatment regimens might be difficult to treat.
Collapse
|
46
|
Milojević L, Velebit B, Teodorović V, Kirbiš A, Petrović T, Karabasil N, Dimitrijević M. Screening and Molecular Characterization of Hepatitis E Virus in Slaughter Pigs in Serbia. FOOD AND ENVIRONMENTAL VIROLOGY 2019; 11:410-419. [PMID: 31243738 DOI: 10.1007/s12560-019-09393-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Accepted: 06/20/2019] [Indexed: 05/25/2023]
Abstract
Hepatitis E virus (HEV) is a zoonotic virus that can cause acute hepatitis in humans. Besides the fecal-oral route, transmission can occur by consumption of undercooked pig liver. Genotype 3 is the most frequent genotype found in Europe. Studies on HEV in slaughter-age pigs have not been conducted in Serbia so far. Pork meat production and consumption in Serbia is on average, higher than in the rest of Europe. With the aim to identify the circulating HEV genotypes, pig livers and swab samples from three pig slaughterhouses located in three different sub-regions of Serbia were collected. A nested RT-PCR was used to amplify the hypervariable HEV ORF-1 region (334 bp). The amplicons yielded in this study were sequenced, and a molecular phylogeny analysis based on the maximum likelihood method, including HEV sequences reported in several other countries, was performed. The average prevalence of HEV genotype 3 in 3-month-old pigs was 34%. Phylogenetic analysis revealed the majority of HEV amplification fragments from Serbia were grouped in four clades within sub-genotype 3a and were also genetically related to German, Italian, Slovenian, and American HEV sequences. Sub-genotypes 3b and 3j were also found in a single pig each. This study provides the first analysis of the genetic diversity and circulation dynamics of HEV in pigs at slaughterhouses in Serbia.
Collapse
Affiliation(s)
- Lazar Milojević
- Institute of Meat Hygiene and Technology, Kaćanskog 13, Belgrade, 11040, Serbia
| | - Branko Velebit
- Institute of Meat Hygiene and Technology, Kaćanskog 13, Belgrade, 11040, Serbia.
| | - Vlado Teodorović
- Faculty of Veterinary Medicine, University of Belgrade, Bulevar Oslobođenja 18, Belgrade, 11000, Serbia
| | - Andrej Kirbiš
- Veterinary Faculty, University of Ljubljana, Gerbičeva 60, 1000, Ljubljana, Slovenia
| | - Tamaš Petrović
- Scientific Veterinary Institute "Novi Sad", Rumenački put 20, Novi Sad, 21000, Serbia
| | - Neđeljko Karabasil
- Faculty of Veterinary Medicine, University of Belgrade, Bulevar Oslobođenja 18, Belgrade, 11000, Serbia
| | - Mirjana Dimitrijević
- Faculty of Veterinary Medicine, University of Belgrade, Bulevar Oslobođenja 18, Belgrade, 11000, Serbia
| |
Collapse
|
47
|
Montone AMI, De Sabato L, Suffredini E, Alise M, Zaccherini A, Volzone P, Di Maro O, Neola B, Capuano F, Di Bartolo I. Occurrence of HEV-RNA in Italian Regional Pork and Wild Boar Food Products. FOOD AND ENVIRONMENTAL VIROLOGY 2019; 11:420-426. [PMID: 31512058 DOI: 10.1007/s12560-019-09403-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Revised: 08/28/2019] [Accepted: 08/30/2019] [Indexed: 06/10/2023]
Abstract
Hepatitis E is an emerging threat in industrialized countries. The foodborne transmission linked to consumption of pork and game meat is considered the main source of autochthonous infection. In Europe, small outbreaks have been reported linked to the consumption of pork liver sausages and wild boar meat. Based on previous findings and on increasing evidence of pork and game meat as a vehicle for HEV infections, the present study investigated the occurrence of HEV in 99 pork and 63 wild boar sausages and salami sold in Southern Italy. The HEV genome was detected in four wild boar sausages. Sequencing from 2 wild boar sausages confirmed that the HEV strains detected belonged to HEV-3 genotype, not assigned to any defined subtype. Data obtained confirmed the possible occurrence of HEV in pork products and in game. Although the detection rate is low, these products are frequently consumed raw after curing, whose effect on virus viability is still unknown.
Collapse
Affiliation(s)
| | - Luca De Sabato
- Department of Food Safety, Nutrition and Veterinary Public Health, Istituto Superiore Di Sanità, Viale Regina Elena 299, 00161, Rome, Italy
| | - Elisabetta Suffredini
- Department of Food Safety, Nutrition and Veterinary Public Health, Istituto Superiore Di Sanità, Viale Regina Elena 299, 00161, Rome, Italy
| | - Mosè Alise
- Istituto Zooprofilattico Sperimentale del Mezzogiorno, Via Salute 2, 80055, Portici, NA, Italy
| | - Alessandra Zaccherini
- Istituto Zooprofilattico Sperimentale del Mezzogiorno, Via Salute 2, 80055, Portici, NA, Italy
| | - Palmiero Volzone
- Istituto Zooprofilattico Sperimentale del Mezzogiorno, Via Salute 2, 80055, Portici, NA, Italy
| | - Orlandina Di Maro
- Istituto Zooprofilattico Sperimentale del Mezzogiorno, Via Salute 2, 80055, Portici, NA, Italy
| | - Benedetto Neola
- Istituto Zooprofilattico Sperimentale del Mezzogiorno, Via Salute 2, 80055, Portici, NA, Italy
| | - Federico Capuano
- Istituto Zooprofilattico Sperimentale del Mezzogiorno, Via Salute 2, 80055, Portici, NA, Italy
| | - Ilaria Di Bartolo
- Department of Food Safety, Nutrition and Veterinary Public Health, Istituto Superiore Di Sanità, Viale Regina Elena 299, 00161, Rome, Italy.
| |
Collapse
|
48
|
Yasobant S, Bruchhausen W, Saxena D, Falkenberg T. One health collaboration for a resilient health system in India: Learnings from global initiatives. One Health 2019; 8:100096. [PMID: 31304229 PMCID: PMC6606562 DOI: 10.1016/j.onehlt.2019.100096] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 06/07/2019] [Accepted: 06/08/2019] [Indexed: 01/24/2023] Open
Abstract
Inter-sectoral collaborations are now recognized as key importance for health system strengthening and health system integration, globally; however, its application in the domain of One Health remains unclear. Over time, as the complexity of the health system has increased within the domain of One Health approach, there is an urgent need for developing collaboration for successful implementation of the One Health. This review focuses on the global One Health collaboration strategies and discusses which type of collaboration might work for the health system of India. We conducted a review in the following three steps: identification of key One Health Collaboration strategies, documentation of the global initiatives and scoping into the initiatives of India in the domain of One Health. We found three major types of collaborations discussed in the One Health literature: level-based collaboration (individual, population or research), solution-based collaboration, and third-party-based collaboration. Twenty-five key global and six Indian One Health initiatives or collaboration strategies are documented in the present review. Although, many initiatives are being undertaken globally for disease prevention and control from the viewpoint of One Health; however, in India, solution-based approaches during emergencies and outbreaks and some sort of level-based collaborations are in place. It is high time to develop a sustainable level-based collaboration integrated with third-party based collaboration within the larger domain of One Health for a resilient health system.
Collapse
Affiliation(s)
- Sandul Yasobant
- Center for Development Research (ZEF), University of Bonn, Germany
- Faculty of Medicine, University of Bonn, Germany
| | - Walter Bruchhausen
- Center for Development Research (ZEF), University of Bonn, Germany
- Institute of History and Ethics of Medicine, University of Cologne, Germany
| | - Deepak Saxena
- Indian Institute of Public Health Gandhinagar, Gujarat, India
| | - Timo Falkenberg
- Center for Development Research (ZEF), University of Bonn, Germany
- GeoHealth Centre, Institute for Hygiene and Public Health, University of Bonn, Germany
| |
Collapse
|
49
|
Adlhoch C, Manďáková Z, Ethelberg S, Epštein J, Rimhanen-Finne R, Figoni J, Baylis SA, Faber M, Mellou K, Murphy N, O'Gorman J, Tosti ME, Ciccaglione AR, Hofhuis A, Zaaijer H, Lange H, de Sousa R, Avellón A, Sundqvist L, Said B, Ijaz S. Standardising surveillance of hepatitis E virus infection in the EU/EEA: A review of national practices and suggestions for the way forward. J Clin Virol 2019; 120:63-67. [PMID: 31590112 PMCID: PMC6899520 DOI: 10.1016/j.jcv.2019.09.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Revised: 09/05/2019] [Accepted: 09/11/2019] [Indexed: 01/18/2023]
Abstract
BACKGROUND Hepatitis E virus (HEV) infection is not notifiable at EU/EEA level, therefore surveillance relies on national policies only. Between 2005 and 2015, more than 20,000 cases were reported in EU/EEA countries. HEV testing is established in 26 countries and 19 countries sequence HEV viruses. OBJECTIVE AND STUDY DESIGN WHO's European Action plan for viral hepatitis recommends harmonised surveillance objectives and case definitions. ECDC's HEV expert group developed minimal and optimal criteria for national hepatitis E surveillance to support EU/EEA countries in enhancing their capacity and to harmonise methods. RESULTS The experts agreed that the primary objectives of national surveillance for HEV infections should focus on the basic epidemiology of the disease: to monitor the incidence of acute cases and chronic infections. The secondary objectives should be to describe viral phylotypes or subtypes and to identify potential clusters/outbreaks and possible routes of transmission. Seventeen of 20 countries with existing surveillance systems collect the minimal data set required to describe the epidemiology of acute cases. Eleven countries test for chronic infections. Twelve countries collect data to identify potential clusters/outbreaks and information on possible routes of transmission. DISCUSSION Overall, the majority of EU/EEA countries collect the suggested data and meet the outlined requirements to confirm an acute case.
Collapse
Affiliation(s)
- Cornelia Adlhoch
- European Centre for Disease Prevention and Control (ECDC), Gustav III:s boulevard 40, 169 73, Solna, Sweden.
| | | | | | | | | | | | | | | | | | - Niamh Murphy
- Health Service Executive, Health Protection Surveillance Centre, Dublin, Ireland.
| | - Joanne O'Gorman
- Health Service Executive, Health Protection Surveillance Centre, Dublin, Ireland.
| | | | | | - Agnetha Hofhuis
- National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands.
| | - Hans Zaaijer
- Sanquin Blood Supply Foundation, Amsterdam, the Netherlands.
| | - Heidi Lange
- Norwegian Institute of Public Health, Oslo, Norway.
| | - Rita de Sousa
- Instituto Nacional de Saúde Doutor Ricardo Jorge, Lisbon, Portugal.
| | - Ana Avellón
- Viral Hepatitis Reference and Research Laboratory National Center of Microbiology Carlos III Health Institute, Madrid, Spain.
| | - Lena Sundqvist
- The Public Health Agency of Sweden (Folkhälsomyndigheten), Stockholm, Sweden.
| | - Bengü Said
- Public Health England, London, United Kingdom.
| | | |
Collapse
|
50
|
Caballero-Gómez J, Jiménez-Ruiz S, Lopez-Lopez P, Vicente J, Risalde MA, Cano-Terriza D, Frias M, Barasona JA, Rivero A, García-Bocanegra I, Rivero-Juarez A. Emergent subtype of hepatitis E virus genotype 3 in wild boar in Spain. Transbound Emerg Dis 2019; 66:1803-1808. [PMID: 31127865 DOI: 10.1111/tbed.13251] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Revised: 05/21/2019] [Accepted: 05/22/2019] [Indexed: 12/27/2022]
Abstract
Wild boar (Sus scrofa) is considered as the main wildlife reservoir of zoonotic hepatitis E virus (HEV) genotypes. The aim of this study was to evaluate the circulation of HEV in free-ranging wild boar in the Doñana National Park (DNP), Spain. Blood samples were collected from 99 wild boar in the DNP during 2015. Sera were analysed in parallel using indirect ELISA and real-time RT-PCR. A total of 57 of the 99 tested animals (57.6%; 95%CI: 47.8%-67.3%) had anti-HEV antibodies, indicating that this virus is widespread in wild boar in the DNP. HEV RNA was detected in one animal and phylogenetic analysis showed that the sequence isolated belonged to subtype 3r. The results suggest a potential risk of zoonotic transmission of this novel HEV-3 subtype, which could be of public health concern. Further studies are required to assess the role of wild boar in the epidemiology of HEV-3r and to determine the infectivity of this emergent HEV subtype in other species, including humans.
Collapse
Affiliation(s)
- Javier Caballero-Gómez
- Animal Health Department, University of Cordoba, Cordoba, Spain.,Infectious Diseases Unit and Clinical Virology and Zoonoses Unit, Maimonides Institute for Biomedical Research, Reina Sofia Hospital, University of Cordoba, Cordoba, Spain
| | - Saul Jiménez-Ruiz
- Animal Health Department, University of Cordoba, Cordoba, Spain.,Health & Biotechnology (SaBio) Group, Spanish Wildlife Research Institute (IREC; CSIC-UCLM-JCCCM), Ciudad Real, Spain
| | - Pedro Lopez-Lopez
- Infectious Diseases Unit and Clinical Virology and Zoonoses Unit, Maimonides Institute for Biomedical Research, Reina Sofia Hospital, University of Cordoba, Cordoba, Spain
| | - Joaquin Vicente
- Health & Biotechnology (SaBio) Group, Spanish Wildlife Research Institute (IREC; CSIC-UCLM-JCCCM), Ciudad Real, Spain
| | - Maria A Risalde
- Animal Pathology Department, University of Cordoba, Cordoba, Spain
| | | | - Mario Frias
- Infectious Diseases Unit and Clinical Virology and Zoonoses Unit, Maimonides Institute for Biomedical Research, Reina Sofia Hospital, University of Cordoba, Cordoba, Spain
| | - Jose A Barasona
- Health & Biotechnology (SaBio) Group, Spanish Wildlife Research Institute (IREC; CSIC-UCLM-JCCCM), Ciudad Real, Spain.,VISAVET Center and Animal Health Department, Veterinary School, Complutense University of Madrid, Madrid, Spain
| | - Antonio Rivero
- Infectious Diseases Unit and Clinical Virology and Zoonoses Unit, Maimonides Institute for Biomedical Research, Reina Sofia Hospital, University of Cordoba, Cordoba, Spain
| | | | - Antonio Rivero-Juarez
- Infectious Diseases Unit and Clinical Virology and Zoonoses Unit, Maimonides Institute for Biomedical Research, Reina Sofia Hospital, University of Cordoba, Cordoba, Spain
| |
Collapse
|