title: Indigenous hepatitis E virus infection of a plasma donor in Germany.
abstract: BACKGROUND
  Although Europe is supposed to be non-endemic for hepatitis E virus (HEV), locally acquired human cases are registered, and a relatively high prevalence for anti-HEV was found in blood donors in some European countries. Transfusion-transmitted infections by contaminated blood products were reported in Japan and sporadically in Europe.
  
  
  METHODS
  Several samples from a plasma donor were screened with a highly sensitive quantitative HEV real-time polymerase chain reaction and the full-length genome was generated. Serology was performed with two different commercially available ELISA kits.
  
  
  RESULTS
  The full-length genome sequence of human HEV was identified using samples from a plasma donor with acute self-limiting hepatitis. Plasma donated 2 weeks before onset of elevated liver enzyme levels was already positive for HEV RNA (10(4) copies/ml). High viraemia (10(6) copies/ml) correlated with the detection of anti-HEV IgM in the first blood sample with increased alanine transaminase levels. Phylogenetic analyses grouped the isolate within genotype 3, subtype 3f.
  
  
  CONCLUSIONS
  The sequence analyses and the epidemiological data revealed that the plasma donor was most probably infected with a swine HEV. This case supports the ongoing discussion of an obligatory HEV nucleic acid testing of blood products for special recipient risk groups.
authors: Center for Biological Safety, Robert Koch-Institut, Berlin, Germany.
authors: C
authors: C
authors: Adlhoch
authors: M
authors: M
authors: Kaiser
authors: G
authors: G
authors: Pauli
authors: J
authors: J
authors: Koch
authors: H
authors: H
authors: Meisel
mesh_terms: D000818:Animals; D001782:Blood Donors; D017848:Blood-Borne Pathogens; D005260:Female; D016679:Genome, Viral / Q000235:genetics*; D005858:Germany / Q000453:epidemiology; D006508:Hepatitis Antibodies / Q000097:blood; D016751:Hepatitis E / Q000097:blood / Q000453:epidemiology / Q000235:genetics / Q000635:transmission; D016752:Hepatitis E virus / Q000235:genetics*; D006801:Humans; D008297:Male; D010802:Phylogeny; D010949:Plasma / Q000821:virology; D012367:RNA, Viral / Q000097:blood / Q000235:genetics; D013552:Swine; D013553:Swine Diseases / Q000097:blood / Q000453:epidemiology / Q000235:genetics / Q000635:transmission / Q000821:virology
chemical_list: D006508:Hepatitis Antibodies; D012367:RNA, Viral