title: Hepatitis E Virus: A Cross-Sectional Serological and Virological Study in Pigs and Humans at Zoonotic Risk within a High-Density Pig Farming Area.
abstract: An increase in autochthonous hepatitis E virus (HEV) infections has been recorded in Italy suspected to be zoonotically transmitted from pigs; this study was carried out to determinate the seroprevalence and risk factors associated with hepatitis HEV exposition, both in swine and humans working in pig farms, located within a high-density pig farming area in Piedmont region, north-western Italy. The presence of viral RNA in human and swine samples was also evaluated, and phylogenetic analysis was performed on HEV-positive samples. Forty-two swine farms were sampled; 142 workers were enrolled in the study and classified into two groups: (i) 69 workers with occupational contact with swine (including veterinarians and farmers) recruited in the 42 sampled farms; (ii) 73 without occupational contact with swine. Forty-one of 42 (97%) swine farms resulted positive to enzyme-linked immunosorbent assay test for HEV antibodies (Abs). Overall seroprevalence in swine was 50% (441/879), with seropositivity rate higher in sows (333/469, 71%). HEV RNA in stool samples was detected in animals from 13 of 42 tested farms (31%), and a higher positivity resulted in weaners (40/246, 16.3%). Phylogenetic analysis classified all HEV isolates within genotype 3 (subtypes 3f, 3e, 3c). All humans were negative for HEV viral genome in blood. Five of 142 sera were positive for IgG anti-HEV with an overall prevalence of 3.52% with no statistically significant differences in prevalence rates between workers at zoonotic risk and the control group (5.7% versus 1.3%). In contrast, a significant difference (OR 10.1) was observed within the subgroup including subjects exposed for short periods (veterinarians) compared with those who worked for long periods (farmers) suggesting a correlation between the time of exposure and the likelihood of HEV infection. Reporting HEV infection is not mandatory in Italy, but a constant epidemiological surveillance should be ensured to clarify the epidemiology of this disease.
authors.affiliation: Istituto Zooprofilattico Sperimentale del Piemonte, Liguria e Valled' Aosta, Turin, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Caruso
authors.affiliation: Istituto Zooprofilattico Sperimentale del Piemonte, Liguria e Valled' Aosta, Turin, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Peletto
authors.affiliation: Università di Parma, Parma, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Rosamilia
authors.affiliation: Istituto Zooprofilattico Sperimentale del Piemonte, Liguria e Valled' Aosta, Turin, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Modesto
authors.affiliation: Istituto Zooprofilattico Sperimentale del Piemonte, Liguria e Valled' Aosta, Turin, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Chiavacci
authors.affiliation: Azienda Sanitaria Locale CN1, Cuneo, Italy.
authors.forename: B
authors.initials: B
authors.lastname: Sona
authors.affiliation: Istituto Zooprofilattico Sperimentale del Piemonte, Liguria e Valled' Aosta, Turin, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Balsamelli
authors.affiliation: Ospedale Amedeo di Savoia, Università di Torino, Turin, Italy.
authors.forename: V
authors.initials: V
authors.lastname: Ghisetti
authors.affiliation: Istituto Zooprofilattico Sperimentale del Piemonte, Liguria e Valled' Aosta, Turin, Italy.
authors.forename: P L
authors.initials: PL
authors.lastname: Acutis
authors.affiliation: Istituto Zooprofilattico Sperimentale della Lombardia ed Emilia Romagna, Brescia, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Pezzoni
authors.affiliation: Istituto Zooprofilattico Sperimentale della Lombardia ed Emilia Romagna, Brescia, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Brocchi
authors.affiliation: Istituto Zooprofilattico Sperimentale del Piemonte, Liguria e Valled' Aosta, Turin, Italy.
authors.forename: N
authors.initials: N
authors.lastname: Vitale
authors.affiliation: Istituto Zooprofilattico Sperimentale del Piemonte, Liguria e Valled' Aosta, Turin, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Masoero
mesh_terms: D000328:Adult; D000822:Animal Husbandry; D000818:Animals; D003430:Cross-Sectional Studies; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D016751:Hepatitis E / Q000453:epidemiology* / Q000662:veterinary* / Q000821:virology; D016752:Hepatitis E virus / Q000302:isolation & purification; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000453:epidemiology* / Q000821:virology; D010802:Phylogeny; D015995:Prevalence; D012307:Risk Factors; D016036:Seroepidemiologic Studies; D034421:Sus scrofa; D013552:Swine; D013553:Swine Diseases / Q000453:epidemiology* / Q000821:virology
keywords: cross-sectional study; hepatitis E virus; humans; phylogenetic analysis; pigs; risk factor; zoonosis