Seroprevalence of emerging hepatitis E virus in patients with acute hepatitis between 2004 and 2018 in Csongrád County, Hungary

OBJECTIVES

Hepatitis E virus (HEV) has recently become endemic in Europe, however, it is often a remnant neglected by clinicians as the causative agent of acute and chronic hepatitis and is often misdiagnosed as a drug-induced liver injury. The infection rate in European pig farms is estimated to be around 15-20%, therefore, the primary source of HEV infections might be poorly prepared pork meat. As HEV infections may occur more often in clinical practice than previously thought, the present paper aims to analyse the seroprevalence of HEV in patients with acute hepatitis over a period of 14 years in Csongrád County, Hungary.

METHODS

The sera of 4,270 hepatitis patients collected between 2004-2018 were tested for cumulative anti-HEV IgG/IgM. Furthermore, 170 IgM positive sera were tested for the presence of viral RNA by RT-qPCR.

RESULTS

Between 2012-2018, the cumulative seroprevalence has increased 9.18 times, and between 2013-2018, IgM prevalence has increased 12.49 times. Viral RNA was detectable in 12.35% of IgM positive sera.

CONCLUSION

The present paper presents data showing that the seroprevalence of hepatitis E virus has increased markedly over the course of the last decade in Hungary and in other European countries as well. The exact reason behind this phenomenon is yet to be determined. To assess the dynamics and the reason for this increase in prevalence, pan-European, multicentre studies should be conducted.

[Summary and lessons of the European and Hungarian measles situation]

Measles is one of the most serious preventable infectious diseases, which in our country were among the rare diseases in the last 10 to 20 years. One of the reasons for this is that the Hungarian population born after 1969 was vaccinated in almost 99 percent. The other reason is that in the period prior to vaccination era, the often-occurring measles epidemics left life-long immunity in the affected persons. Thus, natural and artificial immunizations provided extensive herd immunity. However, the ongoing measles epidemics in Europe have highlighted the fact that the symptoms and differential diagnosis related to measles have been relegated to the negligible category for the last 20 years. In addition to reviewing the consequences of the European measles pandemics in Hungary, the purpose of this paper is to revise and summarize the clinical and laboratory knowledge required to establish a definitive epidemiological control of measles. Orv Hetil. 2019; 160(20): 767-773.

Epidemiological situation of measles in Romania, Italy, and Hungary: On what threats should we focus nowadays?

Although the prevalence of wild-type measles virus infection has decreased by >90% in Europe, the disease is still not eliminated and has even reemerged with recurrent outbreaks in different countries, including Romania and Italy. Minor outbreaks of Romanian origin were reported from Hungary as well. In Romania, an outbreak has been ongoing since February 2016. As of October 2017, 9,670 measles cases and 35 deaths were registered in the country. The three most affected counties are located next to the Hungarian border. In Italy, until the end of August 2017, 4,477 cases were reported to the surveillance system. The outbreak affected most of the Italian administrative regions. Until October 2017, three minor measles outbreaks were also detected in Hungary. All of these outbreaks were derived from Romanian cases. Although in these countries, there are vaccination programs running, the spread of the disease raises the possibility of secondary vaccine failure.