Arankalle V A, Chadha M S, Mehendale S M, Tungatkar S P
National Institute of Virology, Pune.
Indian J Gastroenterol. 2000 Jan-Mar;19(1):24-8.
Hepatitis E presents as epidemic as well as sporadic disease. Fecal contamination of drinking water results in epidemics of hepatitis E. The extent of intrafamilial spread needs to be assessed employing serological assays.
To understand the dynamics of intrafamilial spread of the disease.
The study was conducted using blood samples collected during the 1988 and 1989 epidemics of viral hepatitis in Kudal and Atit villages of Maharashtra state; the epidemics were subsequently shown to be due to hepatitis E virus (HEV). The one-time collection carried out at the end of the Kudal epidemic was from 184 apparently healthy individuals irrespective of family history of jaundice during the epidemic. In the Atit epidemic, 153 family contacts of 49 IgM anti-HEV positive patients were bled. An additional 151 blood samples were collected from apparently healthy individuals irrespective of family history of jaundice during the epidemic. One month later, blood samples were collected from 64 of the 153 family contacts. Relevant history was recorded each time. All serum samples were tested for ALT levels and for IgM and IgG antibodies to hepatitis E virus employing ELISA.
IgM anti-HEV positivity among persons with family history of jaundice was not different from those without such a history (8/62 [12.9%] and 11/122 [9%] at Kudal; 9/57 [15.8%] and 22/94 [23.4%] at Atit; p > 0.1). Excluding IgG anti-HEV positive samples from the analysis also yielded non-significant results. Of the 32 follow-up samples collected from family contacts without IgG or IgM antibodies to HEV in the initial blood sample, 31 remained IgM and IgG anti-HEV negative at the end of 1 month. One of the family contacts was found to be IgG anti-HEV positive in the second blood sample. The disease was not related to the index case.
Intrafamilial spread of HEV is negligible.
戊型肝炎既表现为流行性疾病，也表现为散发性疾病。饮用水的粪便污染会导致戊型肝炎的流行。需要采用血清学检测方法评估家庭内部传播的程度。
了解该疾病在家庭内部传播的动态情况。
本研究使用了1988年和1989年在马哈拉施特拉邦库达尔村和阿蒂特村病毒性肝炎流行期间采集的血液样本；随后证明这些流行是由戊型肝炎病毒（HEV）引起的。在库达尔流行结束时进行的一次性采集是针对184名明显健康的个体，无论其在流行期间是否有黄疸家族史。在阿蒂特流行中，对49名抗HEV IgM阳性患者的153名家庭接触者进行了采血。另外还从151名明显健康的个体采集了血液样本，无论其在流行期间是否有黄疸家族史。一个月后，从153名家庭接触者中的64人采集了血液样本。每次都记录相关病史。所有血清样本均采用ELISA法检测ALT水平以及抗戊型肝炎病毒的IgM和IgG抗体。
有黄疸家族史的人群中抗HEV IgM阳性率与无此家族史的人群无差异（在库达尔分别为8/62 [12.9%] 和11/122 [9%]；在阿蒂特分别为9/57 [15.8%] 和22/94 [23.4%]；p>0.1）。从分析中排除抗HEV IgG阳性样本也得到无显著差异的结果。在最初血液样本中无抗HEV IgG或IgM抗体的家庭接触者采集的32份随访样本中，31份在1个月末抗HEV IgM和IgG仍为阴性。其中一名家庭接触者在第二次血液样本中被发现抗HEV IgG阳性。该疾病与索引病例无关。
戊型肝炎病毒在家庭内部的传播可以忽略不计。
