An epidemiologic investigation of a case of acute hepatitis e

Souvik Sarkar, Elenita M. Rivera, Ronald E. Engle, Hanh T. Nguyen, Cathy A. Schechterly, Harvey J. Alter, T. Jake Liang, Robert H. Purcell, Jay H. Hoofnagle, Marc G. Ghany

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7 Scopus citations


Hepatitis E virus (HEV) is considered a zoonotic infection in developed nations. A case of acute hepatitis E in a researcher following a scalpel injury while working on a pig prompted a seroepidemiologic study to identify potential modes of transmission and determine the seroprevalence of HEV among animal handlers at the institute. Sera from personnel (n=64) in two animal facilities and age/sex-matched blood donors (n=63) as controls were tested for IgG anti-HEV and, if positive, for IgM anti-HEV and HEV RNA. Sera and stool from pigs aged 6 to 12 weeks from the breeding farm and older pigs from animal facilities were tested similarly. The median age of personnel was 36 years, 74% were white, 56% were male, and 74% had direct exposure to pigs. The prevalence of anti-HEV was 3.1% among personnel compared to 3.2% among blood donors; none were positive for IgM anti-HEV or HEV RNA. IgG anti-HEV was detected in sera from 10% of pigs aged 6 to 8 weeks, 80% aged 10 weeks, 100% aged 12 weeks, and 76% aged>12 weeks. HEV RNA was detected in stool but not sera from three 12-week-old pigs. Sequencing revealed HEV genotype 3 with=10% difference between the patient and pig sequences. Parenteral transmission is a potential mode of acute HEV infection. The low and similar seroprevalence of anti-HEV between the at-risk group and age-matched blood donors suggests low transmission risk with universal precautions among animal handlers.

Original languageEnglish (US)
Pages (from-to)3547-3552
Number of pages6
JournalJournal of Clinical Microbiology
Issue number11
StatePublished - Nov 1 2015
Externally publishedYes

ASJC Scopus subject areas

  • Microbiology (medical)


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