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HEV in Belgium : An import infection or an emerging viral zoonosis?

HEV in Belgium : An import infection or an emerging viral zoonosis?. I.Micalessi, I.Thomas, B. Brochier National Center of Viral Hepatitis. Rue Juliette Wytsmanstraat 14 | 1050 Brussels | Belgium T +32 2 642 50 73| F +32 2 642 56 92 | email: Isabel.Micalessi@iph.fgov.be | www.iph.fgov.be.

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HEV in Belgium : An import infection or an emerging viral zoonosis?

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  1. HEV in Belgium:An import infection or an emerging viral zoonosis? I.Micalessi, I.Thomas, B. Brochier National Center of Viral Hepatitis Rue Juliette Wytsmanstraat 14 | 1050 Brussels | Belgium T +32 2 642 50 73| F +32 2 642 56 92 | email: Isabel.Micalessi@iph.fgov.be | www.iph.fgov.be

  2. Characteristics of HEV(1) • Symptoms: • similar to hepatitis A virus • Transmission: • mainly faecal-oral route → faecal contamination of drinking water • transmission by blood transfusion may be possible • Clinical Evolution • Acute self-limited or fulminant hepatitis • Chronic hepatitis reported in organ transplant recipients • Low mortality: 1-3% • Exception pregnant women: 15-25% HEV IgG prevalence Blood donors: 1-3% • Persons working with swine: prevalence much higher

  3. Characteristics of HEV(2) • ssRNA virus (7.2kb), non-enveloped • only member of the genus Hepevirus • in family Hepeviridae • 5 genotypes

  4. HEV: a new public health concern? Risk of transmission

  5. (weeks)

  6. Laboratory diagnosis • HEV IgG and IgM : • screening: HEV IgM and IgG ELISA (MP diagnostics) • confirmation: HEV IgG/IgM recomBlot (since 2008) (Mikrogen) • HEV RNA: • nested PCR (primers in ORF 2 region, Gyarmati et al, 2007)

  7. HEV in Belgium: preliminary results (1)

  8. HEV in Belgium: preliminaryresults (2) HEV gt 3 is present in Belgium High homology to swine isolate from the Netherlands  zoonotic transmission of HEV possible

  9. Conclusions • Sequencing in progress to determine the prevalenceof the HEV genotypes circulating in Belgium. • High homology between human and swine gt3 suggesting a viral zoonosis in Belgium  Risk factors & prevention measures • Standardised reference material (HEV RNA) and inter-laboratorium paneltesting necessary

  10. Acknowledgments • RIVM, the Netherlands J. Reimerink • IPH, Group of Virology I. Fdillate I. Thomas C. Gérard

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