title: Epidemic and sporadic hepatitis E virus transmission in West Kalimantan (Borneo), Indonesia.
abstract: A cross-sectional survey was conducted in West Kalimantan (Borneo), Indonesia to geographically profile hepatitis E virus (HEV) prevalence in the riverine areas recognized as the foci of epidemic HEV transmission in 1987. Additionally, a contiguous, although distinct, population with no identifiable historical exposure to epidemic HEV was surveyed downstream for comparative purposes. Eight hundred eighty-five sera were assayed by enzyme immunoabsorbent assay for anti-HEV IgG and anti-hepatitis A virus (HAV) IgG markers. A very high percent (90%) of both the outbreak and comparison populations was anti-HAV IgG positive by the age of nine years. In contrast, the prevalence of anti-HEV IgG in the outbreak area (50%) was significantly higher than in the comparison area (23%) (P < 0.0001). In both the outbreak and comparison areas, anti-HEV IgG prevalence increased with age ( < 0.0001), except for the group > or = 50 years of age. The prevalence (53%) of antibody to HEV in the population > or = seven years of age from the outbreak area (alive during the actual 1987 outbreak) was significantly (P < 0.0001) greater than among the children < seven years of age (born after the outbreak) (15%). However, anti-HEV IgG prevalence among the population from the comparison area did not differ significantly between the > or = seven- (23%) and < seven- (20%) year-old age groups. The percentage of anti-HEV IgG-positive individuals among males (47%) from the outbreak area was lower (P < 0.05) compared with females (55%). While overall usage of river water for drinking purposes was not universal, dependence on river water as a primary source was significantly higher (P < 0.001) in households from the outbreak area (60%) compared with the comparison area (30%). This study indicates persistence of an anti-HEV IgG response in a large percentage of the population seven years after an epidemic of HEV infections. Also, the relatively high prevalence (15%) of anti-HEV in children < seven years of age from the outbreak area reflects continuing, sporadic infections.
authors.affiliation: U.S. Naval Medical Research Unit No. 2, Jakarta, Indonesia.
authors.forename: A
authors.initials: A
authors.lastname: Corwin
authors.forename: M P
authors.initials: MP
authors.lastname: Putri
authors.forename: J
authors.initials: J
authors.lastname: Winarno
authors.forename: I
authors.initials: I
authors.lastname: Lubis
authors.forename: S
authors.initials: S
authors.lastname: Suparmanto
authors.forename: A
authors.initials: A
authors.lastname: Sumardiati
authors.forename: K
authors.initials: K
authors.lastname: Laras
authors.forename: R
authors.initials: R
authors.lastname: Tan
authors.forename: J
authors.initials: J
authors.lastname: Master
authors.forename: G
authors.initials: G
authors.lastname: Warner
authors.forename: F S
authors.initials: FS
authors.lastname: Wignall
authors.forename: R
authors.initials: R
authors.lastname: Graham
authors.forename: K C
authors.initials: KC
authors.lastname: Hyams
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004196:Disease Outbreaks; D005260:Female; D005618:Fresh Water; D006508:Hepatitis Antibodies / Q000097:blood*; D016751:Hepatitis E / Q000453:epidemiology* / Q000635:transmission*; D016752:Hepatitis E virus / Q000276:immunology*; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D007214:Indonesia / Q000453:epidemiology; D007223:Infant; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D016036:Seroepidemiologic Studies; D012737:Sex Factors; D014881:Water Supply
chemical_list: D006508:Hepatitis Antibodies; D007074:Immunoglobulin G