Hokkaido Institute of Public Health, Sapporo, Japan.
Asahikawa City Center of Public Health, Asahikawa, Japan.
J Clin Virol. 2018 Apr;101:23-28. doi: 10.1016/j.jcv.2018.01.009. Epub 2018 Jan 31.
Infection with hepatitis E virus (HEV) genotypes 3 and 4 are usually asymptomatic but can occasionally result in life-threatening acute hepatitis. To date, only sporadic cases together with a few outbreaks have been documented. Seroprevalence studies with assays for the detection of HEV IgG antibodies, suggest that HEV is more prevalent than previously thought, even in non-endemic regions.
The aim of this study was to characterize an outbreak of hepatitis E (HE) in a nursing home for aged people between February and March 2016.
After the identification of two cases living in the same nursing home, the presence of antibodies against HEV and HEV RNA were examined in serum samples collected from the other residents and staff members to identify any additional cases. An epidemiological investigation was also carried out.
Only 4 patients showed mild symptoms such as anorexia, abdominal pain and fatigue. Among the 125 persons tested, 28 residents and one dietitian were confirmed positive for anti-HEV IgA or IgM antibodies, and/or HEV RNA. Eight samples had only IgG antibodies. Finally, 22 cases were notified with HE on the basis of the presence of IgA antibodies. All HEV isolates obtained were 99.8-100% identical and belonged to genotype 3.
HEV infections seem to be under-reported or underestimated possibly due to cases being generally asymptomatic. Testing for the presence of both anti-HEV antibodies and HEV RNA would be beneficial for both the comprehensive diagnosis of HE infections and the prevention of further infections.
感染戊型肝炎病毒（HEV）基因型 3 和 4 通常无症状，但偶尔会导致危及生命的急性肝炎。迄今为止，仅记录了散发病例和少数暴发疫情。使用检测抗 HEV IgG 抗体的检测方法进行的血清流行率研究表明，HEV 的流行率比以前认为的要高，即使在非流行地区也是如此。
本研究旨在描述 2016 年 2 月至 3 月期间一家老年人疗养院发生的戊型肝炎（HE）暴发情况。
在发现居住在同一疗养院的两例病例后，对从其他居民和工作人员采集的血清样本中检测抗 HEV 和 HEV RNA 的存在，以确定任何其他病例。还进行了流行病学调查。
仅有 4 名患者表现出轻度症状，如食欲不振、腹痛和疲劳。在 125 名测试者中，28 名居民和 1 名营养师被证实抗 HEV IgA 或 IgM 抗体以及/或 HEV RNA 阳性。8 个样本仅有 IgG 抗体。最终，根据 IgA 抗体的存在，有 22 例被报告为 HE。获得的所有 HEV 分离株均为 99.8-100%相同，属于基因型 3。
HEV 感染似乎报告不足或低估，可能是因为病例通常无症状。同时检测抗 HEV 抗体和 HEV RNA 的存在将有利于全面诊断 HE 感染并预防进一步感染。
