title: Epidemiological and molecular analyses of a non-seasonal outbreak of acute icteric hepatitis E in Bangladesh.
abstract: Acute hepatitis due to hepatitis E virus (HEV) is endemic in Bangladesh, but its epidemiological characteristics and virological features remain obscure. An outbreak of acute icteric hepatitis E occurred in Rajshahi, Bangladesh during 2010 when 200 patients with visible jaundice visited physicians within a period of 1 month (January-February). Clinical and epidemiological data were collected from these patients using questionnaires. Nucleic acids were isolated from 15 patients who were selected at random to ascertain their HEV genotypes. Near-complete nucleotide sequences of the HEV genome were detected in two patients and partial ORF2 regions in the other 13 patients. All patients tested positive for IgM antibodies to HEV but negative for other hepatitis viruses. Most patients were icteric and complained of vomiting, fever, itching, and abdominal pain. All 15 HEV sequences formed a single cluster within genotype 1a. Two of the 7,186-nt HEV sequences were 99.8% identical. This is the first study to report the clinical, epidemiological, and molecular characterization of an outbreak of acute hepatitis E in Bangladesh.
authors.affiliation: Department of Hepatology, Rajshahi Medical College, Rajshahi, Bangladesh.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Harun-Or-Rashid
authors.forename: Sheikh Mohammad Fazle
authors.initials: SM
authors.lastname: Akbar
authors.forename: Kazuaki
authors.initials: K
authors.lastname: Takahashi
authors.forename: Mamun
authors.initials: M
authors.lastname: Al-Mahtab
authors.forename: Mohammad Sakirul Islam
authors.initials: MS
authors.lastname: Khan
authors.forename: Mohammad Abdul
authors.initials: MA
authors.lastname: Alim
authors.forename: A R M Saifuddin
authors.initials: AR
authors.lastname: Ekram
authors.forename: Mohammad Mahbubur Rahman
authors.initials: MM
authors.lastname: Khan
authors.forename: Masahiro
authors.initials: M
authors.lastname: Arai
authors.forename: Shunji
authors.initials: S
authors.lastname: Mishiro
mesh_terms: D000293:Adolescent; D000328:Adult; D001459:Bangladesh / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D004196:Disease Outbreaks; D005260:Female; D005838:Genotype; D006508:Hepatitis Antibodies / Q000097:blood; D016751:Hepatitis E / Q000150:complications / Q000453:epidemiology* / Q000473:pathology / Q000821:virology; D016752:Hepatitis E virus / Q000145:classification* / Q000235:genetics* / Q000302:isolation & purification; D006801:Humans; D007075:Immunoglobulin M / Q000097:blood; D007565:Jaundice / Q000209:etiology* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D017720:Molecular Epidemiology; D008969:Molecular Sequence Data; D012367:RNA, Viral / Q000235:genetics; D017422:Sequence Analysis, DNA; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D006508:Hepatitis Antibodies; D007075:Immunoglobulin M; D012367:RNA, Viral