title: A national survey of acute hepatitis E in France.
abstract: BACKGROUND
  Few data are available on the incidence, risk factors and contamination pathways involved in acute indigenous hepatitis E in developed countries.
  
  
  OBJECTIVE
  To draw up an overall picture of hepatitis E cases, to confirm whether or not the majority of the cases were indigenous and to attempt to identify the risk factors and contamination pathways involved in hepatitis E.
  
  
  METHODS
  This study was performed in the framework of a national network (ANGH) including 96 participating centres. The 19 centres with at least one case of acute HEV reported a total number of 53 cases.
  
  
  RESULTS
  A decreasing South-to-North geographic gradient was observed. A nonspecific clinical profile was observed in many cases. Acute hepatitis E was of indigenous origin in 90% of the patients. The most relevant and/or frequent possible risk factors among the 47 indigenous metropolitan cases were water consumption from a personal water supply, uncooked shellfish consumption and the recent acquisition of a pet pig.
  
  
  CONCLUSIONS
  This national survey confirmed that acute indigenous hepatitis E is an emerging disease in developed countries such as France, and suggests that various risk factors are responsible for acute indigenous hepatitis E contamination in non-endemic countries.
authors.affiliation: Hôpital de Jour, Hôpital d'Hyères, BP 82, 83407 Hyères Cedex, France. crenou@ch-hyeres.fr
authors.forename: C
authors.initials: C
authors.lastname: Renou
authors.forename: X
authors.initials: X
authors.lastname: Moreau
authors.forename: A
authors.initials: A
authors.lastname: Pariente
authors.forename: J-F
authors.initials: JF
authors.lastname: Cadranel
authors.forename: E
authors.initials: E
authors.lastname: Maringe
authors.forename: T
authors.initials: T
authors.lastname: Morin
authors.forename: X
authors.initials: X
authors.lastname: Causse
authors.forename: J-L
authors.initials: JL
authors.lastname: Payen
authors.forename: J
authors.initials: J
authors.lastname: Izopet
authors.forename: E
authors.initials: E
authors.lastname: Nicand
authors.forename: M
authors.initials: M
authors.lastname: Bourlière
authors.forename: G
authors.initials: G
authors.lastname: Penaranda
authors.forename: J
authors.initials: J
authors.lastname: Hardwigsen
authors.forename: R
authors.initials: R
authors.lastname: Gerolami
authors.forename: J-M
authors.initials: JM
authors.lastname: Péron
authors.forename: N
authors.initials: N
authors.lastname: Pavio
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D004812:Epidemiologic Methods; D005260:Female; D005602:France / Q000453:epidemiology; D016751:Hepatitis E / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D014195:Travel