Non-travel-associated hepatitis E in England and Wales: demographic, clinical, and molecular epidemiological characteristics.
Between 1996 and 2003, 186 cases of hepatitis E were serologically diagnosed. Of these, 17 (9%) were not associated with recent travel abroad. Patients were >55 years old (range, 56-82 years old) and tended to be male (76%). Two patients presented with fulminant hepatitis. A total of 129 (69%) cases were associated with recent travel to countries where hepatitis E virus (HEV) is hyperendemic. Compared with patients with travel-associated disease, patients with non-travel-associated disease were more likely to be older, living in coastal or estuarine areas, not of South Asian ethnicity, and infected by genotype 3 strains of HEV. The genotype 3 subgenomic nucleotide sequences were unique and closely related to those from British pigs. Patients infected by HEV indigenous to England and Wales tended to belong to a distinct demographic group, there were multiple sources of infection, and pigs might have been a viral reservoir.
Ijaz
Samreen
S
Virus Reference Division, Centre for Infections, Health Protection Agency, University College London, London, United Kingdom.
Arnold
Eve
E
Banks
Malcolm
M
Bendall
Richard P
RP
Cramp
Matthew E
ME
Cunningham
Richard
R
Dalton
Harry R
HR
Harrison
Tim J
TJ
Hill
Simon F
SF
Macfarlane
Lorna
L
Meigh
Rolf E
RE
Shafi
Shuja
S
Sheppard
Martin J
MJ
Smithson
Jacquie
J
Wilson
Melanie P
MP
Teo
Chong-Gee
CG
D000368:Aged; D000369:Aged, 80 and over; D003710:Demography; D004739:England / Q000453:epidemiology; D005260:Female; D006508:Hepatitis Antibodies / Q000097:blood; D016751:Hepatitis E / Q000453:epidemiology* / Q000503:physiopathology* / Q000821:virology; D016752:Hepatitis E virus / Q000145:classification / Q000235:genetics* / Q000276:immunology; D006801:Humans; D008297:Male; D008875:Middle Aged; D017720:Molecular Epidemiology; D014195:Travel; D014852:Wales / Q000453:epidemiology
D006508:Hepatitis Antibodies