title: Cluster of cases of acute hepatitis associated with hepatitis E virus infection acquired in the Netherlands.
abstract: Increasing evidence suggests that hepatitis E virus (HEV) infection may occur in developed countries and that swine may act as a reservoir. We report a cluster of 2 confirmed cases and 1 presumptive case of hepatitis associated with HEV. The typed strain from 1 case was related to HEV strains found in North America and Europe, and it was also related to a cluster of swine HEV strains found in The Netherlands. Our findings indicate that locally acquired HEV infections in industrialized countries may be overlooked. Routine testing for HEV infection in patients with acute hepatitis in The Netherlands should be considered before a diagnosis of autoimmune hepatitis is reached and steroid therapy is initiated.
authors.affiliation: European Programme for Intervention Epidemiology and Training, Bilthoven, The Netherlands. zux5@cdc.gov
authors.forename: Marc-Alain
authors.initials: MA
authors.lastname: Widdowson
authors.forename: Wim J M
authors.initials: WJ
authors.lastname: Jaspers
authors.forename: Wim H M
authors.initials: WH
authors.lastname: van der Poel
authors.forename: Froukje
authors.initials: F
authors.lastname: Verschoor
authors.forename: Ana Maria
authors.initials: AM
authors.lastname: de Roda Husman
authors.forename: H L J
authors.initials: HL
authors.lastname: Winter
authors.forename: Hans L
authors.initials: HL
authors.lastname: Zaaijer
authors.forename: Marion
authors.initials: M
authors.lastname: Koopmans
mesh_terms: D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D002353:Carrier State; D004197:Disease Reservoirs / Q000662:veterinary; D005260:Female; D016751:Hepatitis E / Q000453:epidemiology* / Q000662:veterinary / Q000821:virology; D016752:Hepatitis E virus / Q000302:isolation & purification*; D006801:Humans; D009426:Netherlands / Q000453:epidemiology; D013553:Swine Diseases / Q000821:virology