title: Hepatitis E Virus Genotype 3 in Sewage and Genotype 1 in Acute Hepatitis Cases, Israel.
abstract: Hepatitis E virus (HEV) is an emerging infectious agent in developed countries. HEV genotypes 1 (G1) and 3 (G3) have been identified in environmental and clinical samples in Europe. In Israel, the overall prevalence of anti-HEV IgG antibodies was found to be 10.6%; however, reports of HEV infection are scarce. In this study, the presence of HEV in Israel was investigated using 169 sewage samples from 32 treatment facilities and 49 samples from acute hepatitis patients, all collected between 2013 and 2015. Fourteen sewage samples, from Haifa (11/18 samples), Tel Aviv (2/29 samples), and Beer Sheva (1/17 samples), regions with good sanitary conditions and middle-high socioeconomic populations, were HEV positive. Among the patient samples, 6.1% (3/49) were HEV positive, all returning travelers from India. Genotype analysis revealed G1 HEV in patients and G3 HEV sequences in sewage. Evidence that HEV could be establishing itself in our region may justify more active surveillance to monitor its spread.
authors.affiliation: Central Virology Laboratory, Ministry of Health, Tel-Hashomer, Ramat-Gan, Israel.
authors.forename: Daniela
authors.initials: D
authors.lastname: Ram
authors.affiliation: Central Virology Laboratory, Ministry of Health, Tel-Hashomer, Ramat-Gan, Israel.
authors.forename: Yossi
authors.initials: Y
authors.lastname: Manor
authors.affiliation: Central Virology Laboratory, Ministry of Health, Tel-Hashomer, Ramat-Gan, Israel.
authors.forename: Yael
authors.initials: Y
authors.lastname: Gozlan
authors.affiliation: Center for Geographic Medicine and Tropical Diseases, Chaim Sheba Medical Center, Tel-Hashomer, Ramat-Gan, Israel. Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Eli
authors.initials: E
authors.lastname: Schwartz
authors.affiliation: Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. Liver Diseases Center, Chaim Sheba Medical Center, Tel-Hashomer, Ramat-Gan, Israel.
authors.forename: Ziv
authors.initials: Z
authors.lastname: Ben-Ari
authors.affiliation: School of Public Health, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Ella
authors.initials: E
authors.lastname: Mendelson
authors.affiliation: Central Virology Laboratory, Ministry of Health, Tel-Hashomer, Ramat-Gan, Israel. orna.mor@sheba.health.gov.il.
authors.forename: Orna
authors.initials: O
authors.lastname: Mor
mesh_terms: D000208:Acute Disease; D060005:Genotyping Techniques; D006508:Hepatitis Antibodies / Q000097:blood; D016751:Hepatitis E / Q000175:diagnosis / Q000453:epidemiology*; D016752:Hepatitis E virus / Q000235:genetics* / Q000302:isolation & purification*; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D007194:India; D007557:Israel / Q000453:epidemiology; D015995:Prevalence; D012367:RNA, Viral / Q000302:isolation & purification; D012722:Sewage / Q000821:virology*; D012959:Socioeconomic Factors; D014195:Travel
chemical_list: D006508:Hepatitis Antibodies; D007074:Immunoglobulin G; D012367:RNA, Viral; D012722:Sewage