title: Emergence of autochthonous infections with hepatitis E virus of genotype 4 in Europe.
abstract: In Europe, autochthonous hepatitis E is caused by genotype 3 hepatitis E virus (HEV) in almost all cases. A total of 15 infections with genotype 4 HEV were diagnosed in France from May 2009 to April 2012, and all but one of the HEV-4 strains implicated in these infections were genetically related and highly similar to HEV-4 sequences isolated from swine in Belgium. In addition, 5 autochthonous HEV-4 infections have been described in the region of Lazio, Italy, during March and April 2011, and these HEV sequences were 100% identical to one another but showed relatively low similarity (74-85%) to HEV-4 RNA samples collected in France. We report 6 additional HEV-4 infections that were diagnosed from May to July 2012 which represented 50% of the HEV infections diagnosed during this period in our clinical microbiology laboratory. Five of these HEV-4 strains were associated with autochthonous infections and were clustered together and with the majority of HEV-4 previously described in France, whereas the sixth strain was genetically divergent. Taken together with reports from other teams, these observations indicate that autochthonous infections with HEV-4 are emerging in Europe and have been transmitted by at least two distinct sources.
authors.affiliation: IHU Méditerranée Infection, Pôle des Maladies Infectieuses et Tropicales Clinique et Biologique, Fédération de Bactériologie-Hygiène-Virologie, Centre Hospitalo-Universitaire Timone, Assistance Publique - Hôpitaux Marseille (AP-HM), Marseille, France.
authors.forename: Yanis
authors.initials: Y
authors.lastname: Bouamra
authors.forename: René
authors.initials: R
authors.lastname: Gérolami
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Arzouni
authors.forename: Jean-Charles
authors.initials: JC
authors.lastname: Grimaud
authors.forename: Pierre
authors.initials: P
authors.lastname: Lafforgue
authors.forename: Marjorie
authors.initials: M
authors.lastname: Nelli
authors.forename: Natacha
authors.initials: N
authors.lastname: Tivoli
authors.forename: Audrey
authors.initials: A
authors.lastname: Ferretti
authors.forename: Anne
authors.initials: A
authors.lastname: Motte
authors.forename: Philippe
authors.initials: P
authors.lastname: Colson
mesh_terms: D016000:Cluster Analysis; D021821:Communicable Diseases, Emerging / Q000453:epidemiology* / Q000821:virology*; D005602:France / Q000453:epidemiology; D005838:Genotype; D016751:Hepatitis E / Q000453:epidemiology* / Q000821:virology*; D016752:Hepatitis E virus / Q000145:classification* / Q000235:genetics* / Q000302:isolation & purification; D006801:Humans; D007558:Italy / Q000453:epidemiology; D010802:Phylogeny; D012367:RNA, Viral / Q000235:genetics
chemical_list: D012367:RNA, Viral