title: Hepatitis E virus: do locally acquired infections in Australia necessitate laboratory testing in acute hepatitis patients with no overseas travel history?
abstract: Hepatitis E virus (HEV) is emerging as a global public health threat. Water-borne HEV outbreaks are common in developing countries and are associated with genotypes 1 and 2. In industrialised countries, sporadic cases of zoonotic transmission associated with genotypes 3 and 4 are increasingly being reported. Transfusion- and transplantation-transmitted HEV have been documented, although ingestion of contaminated food is thought to be the major transmission route. Severe disease is possible and chronic hepatitis infection occurs in solid-organ-transplant recipients and in patients with immunosuppressive disorders. In Australia, HEV cases are mainly travellers returning from disease endemic countries. Indeed, there are few reported cases of locally acquired HEV. Pigs in Australia have been shown to be infected with HEV, which indicates the possibility of zoonotic transmission. The extent of locally acquired infection is not known, however it may be greater than expected and may necessitate laboratory testing in patients reporting no overseas travel.
authors.affiliation: 1Research and Development, Australian Red Cross Blood Service, Kelvin Grove, Qld 2School of Medicine, The University of Queensland, St Lucia, Qld 3Medical Services, Australian Red Cross Blood Service, Osborne Park, WA, Australia.
authors.forename: Ashish C
authors.initials: AC
authors.lastname: Shrestha
authors.forename: Helen M
authors.initials: HM
authors.lastname: Faddy
authors.forename: Robert L P
authors.initials: RL
authors.lastname: Flower
authors.forename: Clive R
authors.initials: CR
authors.lastname: Seed
authors.forename: Anthony J
authors.initials: AJ
authors.lastname: Keller
mesh_terms: D000818:Animals; D001315:Australia; D016751:Hepatitis E / Q000175:diagnosis*; D016752:Hepatitis E virus / Q000302:isolation & purification*; D006801:Humans; D013552:Swine; D015047:Zoonoses / Q000175:diagnosis*