Synanthropic rodents as virus reservoirs and transmitters

Abstract This review focuses on reports of hepatitis E virus, hantavirus, rotavirus, coronavirus, and arenavirus in synanthropic rodents (Rattus rattus, Rattus norvegicus, and Mus musculus) within urban environments. Despite their potential impact on human health, relatively few studies have addressed the monitoring of these viruses in rodents. Comprehensive control and preventive activities should include actions such as the elimination or reduction of rat and mouse populations, sanitary education, reduction of shelters for the animals, and restriction of the access of rodents to residences, water, and food supplies.

Hepatitis E virus prevalence in Egyptian children with transfusion-dependent thalassemia

ABSTRACT Hepatitis E virus (HEV) infection is one of the major public health problems in developing countries. HEV can cause chronic infections in immunocompromised individuals e.g. thalassemic patients with increased risk of morbidity and mortality. In addition there is possibility of HEV transmission through blood transfusion. Therefore, the present study aimed to investigate the seroprevalence and risk factors of HEV infection in β-thalassemic children. Methods: This cross-sectional study was conducted on 140 Egyptian children suffering from β-thalassemia, attending the hematology outpatient clinic from April to October 2016. Serum samples from patients were collected and anti-HEV antibodies; Immunoglobulin G (IgG) and Immunoglobulin M (IgM)were measured by enzyme-linked immunosorbent assay (ELISA). Results: The seroprevalence of HEV in β-thalassemic chidren was relatively high (27.15%). Anti-HEV IgG prevalence was 24.29% while that of IgM was 2.86%. There was significant association between HEV infection and age, residence, liver enzymes and amount of blood transfusion per year. Conclusions: Thalasemic patients are vulnerable to chronicity and increased risk of morbidity and mortality from HEV infection. Frequent assessment of liver enzymes in thalassemic patients to monitor subclinical HEV is recommended. Close monitoring and HEV screening of blood donations should be taken in consideration. Public awareness about HEV endemicity, modes of transmission, and risk hazards especially in high risk group should be done to reduce the disease burden.

High Clinical Manifestation Rate in an Imported Outbreak of Hepatitis E Genotype 1 Infection in a German Group of Travellers Returning from India

Abstract: Background. There are only few reports about travel-associated, imported tropical hepatitis E virus (HEV) genotype 1 infections within Western travellers. We describe the clinical course of a single outbreak of hepatitis E in a German travellers group returning from India and compare the results of two commercial HEV-seroassays. Material and methods. After identifying hepatitis E in an index patient returning from a journey to India all 24 members of this journey were tested for anti-HEV-IgG and IgM using two commercial seroassays (Wantai and Mikrogen), for HEV-RNA by PCR and HEV-Ag by an antigen-assay (Wantai). Results. 5/24 (21%) individuals were viraemic with viral loads between 580-4,800,000 IU/mL. Bilirubin and ALT levels in these patients ranged from 1.3-14.9 mg/dL (mean 7.3 mg/dL, SD 5.6 mg/dL) and 151-4,820 U/L (mean 1,832U/L, SD 1842U/L), respectively and showed significant correlations with viral loads (r = 0.863, p < 0.001; r = 0.890, p < 0.001). No risk factor for food-borne HEV-transmission was identified. All viraemic patients (5/5) tested positive for anti-HEV-IgG and IgM in the Wantai-assay but only 4/5 in the Mikrogen-assay. Wantai-HEV-antigen-assay was negative in all patients. Six months later all previously viraemic patients tested positive for anti-HEV-IgG and negative for IgM in both assays. However, two non-viremic individuals who initially tested Wantai-IgM-positive stayed positive indicating false positive results. Conclusions. Despite the exact number of exposed individuals could not be determined HEV genotype 1 infections have a high manifestation rate of more than 20%.The Wantai-antigen-test failed, the Wantai-IgMrapid-test and the Mikrogen-IgM-recomblot showed a better performance but still they cannot replace real-time PCR for diagnosing ongoing HEV-infections.

Análise do controle viral e caracterização de subpopulações de células imunes em infecções pelo Vírus da hepatite E genótipo 3 de origem suína e humana em macacos cynomolgus (Macaca fascicularis) na fase de convalescência / Analysis of viral control and characterization of immune cell subpopulations in infections by hepatitis e genotype 3 of swine and human origin in cynomolgus monkeys (macaca fascicularis) in convalescence phase

O vírus da Hepatite E (HEV) apresenta-se relacionado à crescente ocorrência de casos da doença em países industrializados. Os achados deste em inúmeras espécies animais e sua transmissão associada ao consumo de produtos de origem animal, o definem como um agente zoonótico de importância para a Saúde Pública. Frente à escassez de informações sobre a patogenia da hepatite E, optou-se por avaliar o controle viral e caracterizar as células imunes envolvidas na resposta intra-hepática na fase de convalescência da infecção experimental com o HEV3 recuperado de suínos e humanos em macacos cynomolgus (Macaca fascicularis). No diagnóstico molecular por qRT-PCR em tecidos coletados 67 dpi, pôde-se detectar o RNA viral indicativo de permanência do vírus no trato biliar de dois animais e no fígado de um animal, inoculados com HEV suíno. Em imunomarcações específicas para a detecção do antígeno viral, todos os animais expressaram HEV Ag na fase tardia de infecção, principalmente em células sinusoidais. A discordância na detecção do HEV RNA e do HEV Ag sugere sensibilidades diferentes dos ensaios durante a fase da convalescência. A hiperplasia das células de Kupffer não foi observada no período de estudo, entretanto, a frequência elevada de células de kupffer comarcadas com HEV no grupo suíno sugere uma maior imunoreatividade tecidual ao HEV3 suíno em fase tardia da infecção. Quanto à expressão da enzima iNOS, observou-se pouca presença em células de Kupffer e maior expressão em células circulantes sinusoidais e hepatócitos, envolvidos na resposta inflamatória convalescente da hepatite E, com maior produção de iNOS nos animais inoculados com HEV suíno...

Hepatitis E virus (HEV) is presented related to the increasing occurrence of the disease in industrialized countries. The findings of this in several animal species and their associated transmission by consumption of animal products, define it as a zoonoticagent of importance to public health. Facing the lacking of information on thepathogenesis of hepatitis E, we chose to evaluate the viral control and characterize the immune cells involved in intrahepatic response during convalescence phase ofexperimental infection with HEV3 recovered from pigs and humans in cynomolgus monkeys (Macaca fascicularis). Through molecular diagnostics by qRT - PCR intissues collected 67 dpi, we could detect viral RNA indicative of virus persistence in the biliary tract of two animals and the liver of one animal inoculated with swine HEV. In specific immunostaining for the detection of viral antigen, all animals expressed HEVAg in the late phase of infection, especially sinusoidal cells. The discrepancy in thedetection of HEV RNA and HEV Ag suggests different sensitivities of the tests during the period of convalescence. The hyperplasia of Kupffer cells was not observed duringthe study period, however, the high frequency of Kupffer cells stained with HEV in the swine group suggests a greater tissue immunoreactivity for swine HEV3 in late stage of infection. Regarding the expression of iNOS, low presence was observed on Kupffer cells and higher expression in sinusoidal circulating cells and hepatocytes, involved in the inflammatory response of convalescent hepatitis E, with greater production of iNOS in animals inoculated with swine HEV...

Molecular analysis of swine hepatitis E virus from north India.

Background & objectives: Hepatitis E is the main cause of enterically transmitted non-A, non-B hepatitis in developing countries. In the developed countries such as the USA, Japan and Taiwan, the viruses infecting humans and swine share the same genotype with a high sequence similarity. Genotype 1 circulates in humans whereas genotype 4 in pigs in India. The present study was designed to investigate the presence of anti-HEV antibodies and HEV-RNA in swine population from north India, to investigate the genotype prevalent in it, and to compare it with other swine and human HEV strains from India. Methods: A total of 67 serum samples were collected from pigs of age period (1-6 months) from Indian Veterinary Research Institute (IVRI), Izatnagar, Bareily and subjected to anti-HEV IgG and HEV RNA detection. A phylogenetic tree was constructed using the neighbor-joining method and evaluated using the interior branch test method with MEGA 4 software. Results: Anti-HEV IgG and HEV RNA was found in 38.8 and 4.5 per cent of swine samples studied respectively. The above samples were observed to be of genotype 4e. The three new sequences had nucleotide similarity with other swine sequences in genotype 4 ranging from 80-98 per cent. Interpretation & conclusions: The three sequences observed in the present study showed nucleotide similarity with other swine sequences from southern and western India. The present study suggests that genotype 4 ‘e’ is prevalent in the north India.

Hepatite virale E : Quoi de neuf ?

L'hepatite E est une infection virale qui pose un grand probleme de sante publique dans les pays ou le niveau socio-economique est faible du fait de sa transmission oro-fecale et du potentiel epidemique important. Cependant; cette infection est egalement grave; meme sous forme sporadique; a cause du risque de transmission parenterale; de passage vers la chronicite surtout chez l'immunodeprime et de la forte mortalite chez la femme enceinte. Ainsi; il est actuellement admis que plusieurs types d'individus constituent des groupes a risque; notamment les polytransfuses; les immunodeprimes et les femmes enceintes. Ces sujets necessitent une surveillance particuliere et une prevention efficace contre l'infection d'ou l'importance de la recherche vaccinale qui semble actuellement prometteuse puisque certains candidats vaccins semblent etre efficaces et sont en phase clinique III

Hepatitis E outbreak in Sudan

Between epidemiological week no: 9 and 20 of 2008 [week ending 22 May 2008], the Red sea state of Sudan reported 208 cases of Acute Jaundice Syndrome [AJS] including 16 deaths [CFR: 7.6%]. Five serum samples, collected from the suspected cases, have tested positive for Hepatitis E at the National Public Health Laboratory [NPHL] in Khartoum. Most of these reported cases are females [72%] and majority of the cases [86%] are in the 15-44 year age group. Amongst the female cases, pregnant women [90%] constituted the majority of cases. The case fatality rate amongst the pregnant women was reported to be 37.5%. A Task force has been established in the affected state with a senior official incharge from the Federal Ministry of Health of Sudan to coordinate the overall public health response to contain this outbreak. The WHO Country Office in Sudan has been actively supporting this task force in its response operations

Presencia de anti-VHE en un estudio de cohorte de porcinos ¿reservorio animal de hepatitis E en Chile? / Presence of anti hepatitis E virus antibodies in swine

Background: Swine hepatitis E virus (HEV) has a cross-reaction with human anti-HEV antibodies. Therefore, pigs could be an animal reservoir, rendering hepatitis E as a zoonosis. The spread of this infection among infected pigs across countries would be possible through trading. Previously, using an anti-human conjugate, we detected anti-HEV antobodies in adult pigs in Chile. Aim: To detect anti-HEV (ELISA) in a cohort of swine at different ages. Material and Methods: Two hundred pigs aged 42 to 360 days, divided in 20 groups of 10 animals were tested. Anti-HEV was detected by ELISA using anti-pig IgG horseradish peroxidase instead of anti-human conjugates. Results: Anti-HEV were detected in one animal aged 90 days, two animals aged 120 days, one animal aged 260 days and 2 animals aged 360 days, five pregnant sows and two old hogs. This represents a total of 14 animals or 7 percent of the sample. Conclusions: There is a significant prevalence of anti-HEV in pigs from 90 days of birth, suggesting that these swine are aprobable reservoir.

Prevalence of antibodies to hepatitis E virus among male blood donors in Tabriz, Islamic Republic of Iran

Serum samples from 399 voluntary male blood donors were tested for anti-hepatitis E virus [HEV] IgG during July and August 2004 at a blood transfusion centre in Tabriz city. The prevalence of anti-HEV IgG was 7.8% [95% CI: 5.2-10.4]. Risk factors for infection included age and a low educational level. Seroprevalence increased significantly with age, from 3.3% in subjects under 30 years of age to 37.5% in individuals 50 years and over. Illiterate individuals were at significantly higher risk for infection than educated persons. The high seropositive rate among our male blood donors is compatible with endemicity of HEV in the Islamic Republic of Iran

Hepatitis aguda por virus A, E y no A-E en adultos chilenos a fines de los años 90 / Acute hepatitis caused by virus A, E and non A-E in chilean adults

Background: Sanitary and socioeconomic changes and the identification of new causative virus, have changed the epidemiology of hepatitis in Chile. Aim: To study the natural history of acute hepatitis caused by virus A, E and non A-E in Chilean adults. Patients and methods: A special study protocol was followed for patients with a clinical picture of acute hepatitis. Anti HAV IgM, anti HBc IgM, anti HEV IgG and IgM and Anti HCV antibodies were determined by ELISA. Results: Fifty nine patients (30 male), aged 15 to 58 years old were studied. Eighty nine percent had jaundice and 50 to 70 percent had malaise and abdominal pain. Virus A was positive in 80 percent, virus E in 7 percent. In 14 percent of patients, all viral markers were negative. The evolution was typical in 78 percent, biphasic in 14 percent and cholestatic in 5 percent. One patient had a prolonged and one a fulminant course. Mean ALT was 1148 U/l and mean total bilirubin was 5.5 mg/dl. Seventy three percent of cases occurred during early winter and spring and 27 percent during summer and early autumm. Conclusions: The main etiology of acute viral hepatitis in Chile is virus A and most cases occur during the rainy season. Clinical features of hepatitis non A-E are similar to enteral transmission forms

Biología de los virus de hepatitis / Biology of the hepatitis viruses

El alfabeto que conforman los virus causantes de hepatitis ha crecido en forma significativa en estos últimos años. Estos virus pertenecen a familias virales muy distintas y se dividen además en virus de transmisión entérica y transmisión parenteral. Antes de 1989, se conocía el VHA, picornavirus de transmisión entérica y sin mayores secuelas, el VHB, hepatitis de transmisión parenteral, con secuelas de cirrocis y cáncer de hígado y el VHD, daltavirus que requiere una co-infección por el VHB para poder replicarse en forma efectiva y responsable de muchos casos de hepatitis fulminantes. En 1989, se descubre por técnicas de biología molecular, el VHC, hepacivirus miembro de la familia flaviviridae, de transmisión parenteral cuya infección está asociada a secuelas similares a las del VHB. En 1990 se identifica el VHE, virus de transmisión entérica. El VHF es un término reservado a un virus de transmisión entérica, cuya identificación en la India es controversial. En la búsqueda del virus reponsable de la hepatitis post-transfusional no A hasta no E, entre 1995 y 1996 se describe el denominado VHG, de transmisión parenteral, utilizando herramientas cada vez más novedosas de biología molecular, aunque este virus no parece causar hepatitis. Mas recientemente se identifica el TTV(1997) y el Sen-V(2000), de nuevo por técnicas de biología molecular ¿Será algunos de estos virus al fin el responsable de las hepatitis post-transfusionales no A hasta no G?

Infecciones tropicales en viajeros a Latinoamérica: parte I / Tropical diseases in travelers to Latin America: part I

Las infecciones permanecen como una de las más importantes causas de morbilidad entre los viajeros. Los países de América Latina son uno de los puntos de destino más importante. Las dos enfermedades de mayor frecuencia son malaria y diarrea del viajero; sin embargo, Latinoamérica es aún un importante lugar de transmisión de fiebre amarilla, dengue, leishmaniasis, hepatitis por virus A, hepatitis por virus B y enfermedades de transmisión sexual. Alrededor de 7 por ciento de los casos de malaria en el viajero en todo el mundo se adquieren en Sudamérica, y 40 a 60 por ciento de ellos son causados por Plasmodium falciparum. Se deben suministrar a los viajeros recomendaciones adecuadas de vacunación, quimioprofilaxis, y medidas de protección individual, orientados a sus lugares de destino. Un problema interesante a discutir es la enfermedad en el viajero que retorna a casa

Hepatites virais: atualizaçäo / Viral hepatitis: update

Objetivo: os autores apresentaram uma revisäo dos diferentes tipos de hepatite viral na infância. Säo discutidos, com ênfase especial, os aspectos clínicos-laboratoriais e evolutivos das formas mais freqüentes da doença. Métodos: Foram selecionados, através de Medline, os artigos mais significativos publicados nos últimos anos sobre hepatite viral na infância. As características epidemiológicas säo discutidas, sempre que possível, levando em conta dados brasileiros. Resultados: A presente revisäo analisa as hepatites causadas por agentes que têm em comum a origem viral e o hepatotropismo mas que determinam doenças com diferenças marcantes sobretudo quanto a evoluçäo e prognóstico. Em relaçäo ao vírus B, por exemplo o paciente pode apresentar desde um simples estado de portador até hepatite aguda, hepatite crônica, cirrose...

Hepatite pelo virus E / E virus hepatitis

Os autores revisam os diversos aspectos concernentes a hepatite pelo virus E. Consideram que a mesma e uma forma frequente em paises em desenvolvimento, transmitindo-se principalmento pela via fecal-oral. E causada por um virus RNA poliadenilado de cadeia simples e sentido positivo, o virus da hepatite E. Clinicamente manifesta-se de forma semelhante a uma doenca aguda icterica autolimitada, emprestando, no entanto, um mau prognostico quando acomete gestantes. Seu diagnostico e sorologico atraves da deteccao de anticorpos das classes IgG e IgM por tecnicas de enzimoimunoensaios e de Western blot. Nao ha tratamento especifico e a prevencao fundamenta-se no saneamento basico

Diagnóstico clínico e laboratorial das hepatites virais / Clinical and laboratory diagnosis of viral hepatitis

Revisäo bibliográfica sobee as hepatites virais, com ênfase nos seus testes sorológicos diagnósticos