title: Hepatitis E virus infections in travellers: assessing the threat to the Australian blood supply.
abstract: BACKGROUND
  In many developed countries hepatitis E virus (HEV) infections have occurred predominantly in travellers to countries endemic for HEV. HEV is a potential threat to blood safety as the virus is transfusion-transmissible. To minimise this risk in Australia, individuals diagnosed with HEV are deferred. Malarialdeferrals, when donors are restricted from donating fresh blood components following travel toanareain which malaria is endemic, probably also decrease the HEV risk, by deferring donors who travel to many countries also endemic for HEV. The aim of this study is to describe overseas-acquired HEV cases in Australia, in order to determine whether infection in travellers poses a risk to Australian blood safety.
  
  
  METHODS
  Details of all notified HEV cases in Australia from 2002 to 2014 were accessed, and importation rates estimated. Countries in which HEV was acquired were compared to those for which donations are restricted following travel because of a malaria risk.
  
  
  RESULTS
  Three hundred and thirty-two cases of HEV were acquired overseas. Travel to India accounted for most of these infections, although the importation rate was highest for Nepal and Bangladesh. Countries for which donations are restricted following travel due to malaria risk accounted for 94% of overseas-acquired HEV cases.
  
  
  CONCLUSIONS
  The vast majority of overseas-acquired HEV infections were in travellers returning from South Asian countries, which are subject to donation-related travel restrictions for malaria. This minimises the risk HEV poses to the Australian blood supply.
authors.affiliation: Research and Development, Australian Red Cross Blood Service, Kelvin Grove, QLD, Australia.|School of Medicine, The University of Queensland, Herston, QLD, Australia.
authors.forename: Ashish C
authors.initials: AC
authors.lastname: Shrestha
authors.affiliation: Research and Development, Australian Red Cross Blood Service, Kelvin Grove, QLD, Australia.
authors.forename: Robert L P
authors.initials: RLP
authors.lastname: Flower
authors.affiliation: Medical Services, Australian Red Cross Blood Service, Perth, WA, Australia.
authors.forename: Clive R
authors.initials: CR
authors.lastname: Seed
authors.affiliation: Medical Services, Australian Red Cross Blood Service, Perth, WA, Australia.
authors.forename: Anthony J
authors.initials: AJ
authors.lastname: Keller
authors.affiliation: Medical Services, Australian Red Cross Blood Service, Perth, WA, Australia.
authors.forename: Veronica
authors.initials: V
authors.lastname: Hoad
authors.affiliation: Medical Services, Australian Red Cross Blood Service, Kelvin Grove, QLD, Australia.
authors.forename: Robert
authors.initials: R
authors.lastname: Harley
authors.affiliation: OzFoodNet, Office of Health Protection, Australian Government Department of Health, Canberra, Australia.
authors.forename: Robyn
authors.initials: R
authors.lastname: Leader
authors.affiliation: OzFoodNet, Office of Health Protection, Australian Government Department of Health, Canberra, Australia.
authors.forename: Ben
authors.initials: B
authors.lastname: Polkinghorne
authors.affiliation: OzFoodNet, New South Wales Department of Health, Sydney, Australia.
authors.forename: Catriona
authors.initials: C
authors.lastname: Furlong
authors.affiliation: Research and Development, Australian Red Cross Blood Service, Kelvin Grove, QLD, Australia.|School of Medicine, The University of Queensland, Herston, QLD, Australia.
authors.forename: Helen M
authors.initials: HM
authors.lastname: Faddy
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001208:Asia / Q000453:epidemiology; D001315:Australia / Q000453:epidemiology; D001782:Blood Donors / Q000600:supply & distribution; D058731:Blood Safety; D000076263:Communicable Diseases, Imported / Q000453:epidemiology*; D005260:Female; D016751:Hepatitis E / Q000453:epidemiology*; D016752:Hepatitis E virus / Q000302:isolation & purification*; D006801:Humans; D008297:Male; D008875:Middle Aged; D014195:Travel; D055815:Young Adult