title: Sources of hepatitis E virus genotype 3 in The Netherlands.
abstract: Non-travel-related hepatitis E virus (HEV) genotype 3 infections in persons in the Netherlands may have a zoonotic, foodborne, or water-borne origin. Possible reservoirs for HEV transmission by water, food, and animals were studied. HEV genotype 3/open reading frame 2 sequences were detected in 53% of pig farms, 4% of wild boar feces, and 17% of surface water samples. HEV sequences grouped within 4 genotype 3 clusters, of which 1 is so far unique to the Netherlands. The 2 largest clusters contained 35% and 43% of the animal and environmental sequences and 75% and 6%, respectively, of human HEV sequences obtained from a study on Dutch hepatitis E patients. This finding suggests that infection risk may be also dependent on transmission routes other than the ones currently studied. Besides the route of exposure, virus characteristics may be an important determinant for HEV disease in humans.
authors.affiliation: Laboratory for Zoonoses and Environmental Microbiology, Centre for Infectious Disease Control Netherlands, National Institute for Public Health and the Environment, Bilthoven, The Netherlands. saskia.rutjes@rivm.nl
authors.forename: Saskia A
authors.initials: SA
authors.lastname: Rutjes
authors.forename: Willemijn J
authors.initials: WJ
authors.lastname: Lodder
authors.forename: Froukje
authors.initials: F
authors.lastname: Lodder-Verschoor
authors.forename: Harold H J L
authors.initials: HH
authors.lastname: van den Berg
authors.forename: Harry
authors.initials: H
authors.lastname: Vennema
authors.forename: Erwin
authors.initials: E
authors.lastname: Duizer
authors.forename: Marion
authors.initials: M
authors.lastname: Koopmans
authors.forename: Ana Maria
authors.initials: AM
authors.lastname: de Roda Husman
mesh_terms: D000822:Animal Husbandry; D000818:Animals; D003411:Arvicolinae / Q000821:virology*; D005243:Feces / Q000821:virology; D005516:Food Microbiology; D005838:Genotype; D016751:Hepatitis E / Q000453:epidemiology / Q000635:transmission* / Q000821:virology; D016752:Hepatitis E virus / Q000145:classification / Q000235:genetics / Q000302:isolation & purification; D006801:Humans; D009426:Netherlands / Q000453:epidemiology; D045483:Rivers / Q000821:virology*; D012376:Rodent Diseases / Q000635:transmission / Q000821:virology; D034421:Sus scrofa / Q000821:virology*; D013552:Swine / Q000821:virology*; D013553:Swine Diseases / Q000453:epidemiology / Q000635:transmission / Q000821:virology; D015047:Zoonoses / Q000635:transmission* / Q000821:virology