1887
  1. Home
  2. Eurosurveillance
  3. Volume 23, Issue 41, 11/Oct/2018
  4. Article
Surveillance and outbreak report Open Access
Like 0
Download

Abstract

Increasing numbers of hepatitis E cases are being reported in several European countries, including Italy, but the burden of hepatitis E virus (HEV) infection is largely unknown in the latter. To gain a better understanding of HEV epidemiology at national level in Italy, we piloted a strengthened and integrated human (epidemiological and virological) and environmental HEV surveillance system between 2012 and 2016. Over the 5-year period, 169 confirmed hepatitis E cases were identified, with a national annual incidence of 0.72 cases per 1,000,000. Of 65 HEV-RNA positive samples of sufficient quality for molecular analysis, 66% were genotype HEV3, 32% HEV1 and 1% HEV4. The most frequent risk factor reported by all HEV3 infected cases, was the consumption of undercooked pork and sausage. For the environmental surveillance, 679 urban sewage samples were collected from 53 wastewater treatment plants and HEV-RNA was detected in 38/679 of the samples. Among these, 25 (66%) were genotype HEV3 and the remaining were HEV1. We demonstrate that autochthonous transmission and environmental circulation of genotype HEV3 is adding to travel-related HEV transmission in Italy. We recommend the ‘One Health’ approach to integrated surveillance, and to include HEV-related messages within health information campaigns focussing on food security.

© Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.
Loading

Article metrics loading...

/content/10.2807/1560-7917.ES.2018.23.41.1700517
2018-10-11
2024-12-21
/content/10.2807/1560-7917.ES.2018.23.41.1700517
Loading
Loading full text...

Full text loading...

/deliver/fulltext/eurosurveillance/23/41/eurosurv-23-41-3.html?itemId=/content/10.2807/1560-7917.ES.2018.23.41.1700517&mimeType=html&fmt=ahah

References

  1. Pérez-Gracia MT, Mateos Lindemann ML, Caridad Montalvo Villalba M. Hepatitis E: current status. Rev Med Virol. 2013;23(6):384-98.  https://doi.org/10.1002/rmv.1759  PMID: 24038432 
  2. World Health Organization (WHO). Hepatitis E. Fact sheet. Geneva: WHO; 2018. Available from: http://www.who.int/news-room/fact-sheets/detail/hepatitis-e
  3. Adlhoch C, Avellon A, Baylis SA, Ciccaglione AR, Couturier E, de Sousa R, et al. Hepatitis E virus: Assessment of the epidemiological situation in humans in Europe, 2014/15. J Clin Virol. 2016;82:9-16.  https://doi.org/10.1016/j.jcv.2016.06.010  PMID: 27393938 
  4. Aspinall EJ, Couturier E, Faber M, Said B, Ijaz S, Tavoschi L, et al. On Behalf Of The Country Experts. Hepatitis E virus infection in Europe: surveillance and descriptive epidemiology of confirmed cases, 2005 to 2015. Euro Surveill. 2017;22(26):30561.  https://doi.org/10.2807/1560-7917.ES.2017.22.26.30561  PMID: 28681720 
  5. Tosti ME, Longhi S, de Waure C, Mele A, Franco E, Ricciardi W, et al. Assessment of timeliness, representativeness and quality of data reported to Italy’s national integrated surveillance system for acute viral hepatitis (SEIEVA). Public Health. 2015;129(5):561-8.  https://doi.org/10.1016/j.puhe.2015.02.015  PMID: 25795017 
  6. La Rosa G, Della Libera S, Iaconelli M, Ciccaglione AR, Bruni R, Taffon S, et al. Surveillance of hepatitis A virus in urban sewages and comparison with cases notified in the course of an outbreak, Italy 2013. BMC Infect Dis. 2014;14(1):419.  https://doi.org/10.1186/1471-2334-14-419  PMID: 25074676 
  7. World Health Organization (WHO). Technical considerations and case definitions to improve surveillance for viral hepatitis. Geneva: WHO; 2016. Available from: http://apps.who.int/iris/bitstream/10665/204501/1/9789241549547_eng.pdf.
  8. La Rosa G, Fratini M, Muscillo M, Iaconelli M, Taffon S, Equestre M, et al. Molecular characterisation of human hepatitis E virus from Italy: comparative analysis of five reverse transcription-PCR assays. Virol J. 2014 22;11:72.
  9. Giordani MT, Fabris P, Brunetti E, Goblirsch S, Romanò L. Hepatitis E and lymphocytic leukemia in Man, Italy. Emerg Infect Dis. 2013;19(12):2054-6.  https://doi.org/10.3201/eid1912.130521  PMID: 24274068 
  10. Fraticelli P, Bagnarelli P, Tarantino G, Martino GP, Benfaremo D, Nobili L, et al. Chronic hepatitis E in a patient treated with rituximab and mycophenolate mofetil for Sjögren’s syndrome. Rheumatology (Oxford). 2016;55(12):2275-7.  https://doi.org/10.1093/rheumatology/kew282  PMID: 27498353 
  11. Nicand É, Bigaillon C, Tessé S. Hépatite E en France: Données de surveillance des cas humains, 2006-2008. Bull Epidemiol Hebd (Paris). 2009;31-32:337-42.
  12. Ijaz S, Said B, Boxall E, Smit E, Morgan D, Tedder RS. Indigenous hepatitis E in England and wales from 2003 to 2012: evidence of an emerging novel phylotype of viruses. J Infect Dis. 2014;209(8):1212-8.  https://doi.org/10.1093/infdis/jit652  PMID: 24273173 
  13. Robert Koch Institut. Hepatitis-E-Virus-Infektion aus virologischer Sicht. Epidemiol Bull. 2015;15:119-27.
  14. Fraga M, Doerig C, Moulin H, Bihl F, Brunner F, Müllhaupt B, et al. Hepatitis E virus as a cause of acute hepatitis acquired in Switzerland. Liver Int. 2018;38(4):619-26.  https://doi.org/10.1111/liv.13557  PMID: 28834649 
  15. Stroffolini T, Rapicetta M, Chionne P, Esvan R, Madonna E, Lombardo F, et al. Evidence for the presence of autochthonous (locally acquired) cases of acute hepatitis E virus infections in Italy since the 80s. Eur J Intern Med. 2015;26(5):348-50.  https://doi.org/10.1016/j.ejim.2015.03.012  PMID: 25887055 
  16. Puttini C, Riccio ML, Redi D, Tordini G, Cenerini M, Romanello F, et al. Seroprevalence of hepatitis E virus (HEV) infection in blood donors and renal transplant recipients: a retrospective study from central Italy. Infez Med. 2015;23(3):253-6. PMID: 26397295 
  17. Lanini S, Garbuglia AR, Lapa D, Puro V, Navarra A, Pergola C, et al. Epidemiology of HEV in the Mediterranean basin: 10-year prevalence in Italy. BMJ Open. 2015;5(7):e007110.  https://doi.org/10.1136/bmjopen-2014-007110  PMID: 26173715 
  18. Lucarelli C, Spada E, Taliani G, Chionne P, Madonna E, Marcantonio C, et al. High prevalence of anti-hepatitis E virus antibodies among blood donors in central Italy, February to March 2014. Euro Surveill. 2016;21(30):30299.  https://doi.org/10.2807/1560-7917.ES.2016.21.30.30299  PMID: 27494608 
  19. Mansuy JM, Gallian P, Dimeglio C, Saune K, Arnaud C, Pelletier B, et al. A nationwide survey of hepatitis E viral infection in French blood donors. Hepatology. 2016;63(4):1145-54.  https://doi.org/10.1002/hep.28436  PMID: 27008201 
  20. Hartl J, Otto B, Madden RG, Webb G, Woolson KL, Kriston L, et al. Hepatitis E Seroprevalence in Europe: A Meta-Analysis. Viruses. 2016;8(8):E211.  https://doi.org/10.3390/v8080211  PMID: 27509518 
  21. Del Manso M, De Crescenzo M, Bella A, D’Ancona P, Giannitelli S, Lana S, et al. [Food-borne illnesses: a survey of regional reference laboratories in Italy.]. Ig Sanita Pubbl. 2009;65(6):573-82. PMID: 20376158 
  22. Wu WC, Su CW, Yang JY, Lin SF, Chen JY, Wu JC. Application of serologic assays for diagnosing acute hepatitis E in national surveillance of a nonendemic area. J Med Virol. 2014;86(4):720-8.  https://doi.org/10.1002/jmv.23785  PMID: 24395716 
  23. Dalton HR, Kamar N, Izopet J. Hepatitis E in developed countries: current status and future perspectives. Future Microbiol. 2014;9(12):1361-72.  https://doi.org/10.2217/fmb.14.89  PMID: 25517900 
  24. ISMEA mercati. Carne suina e salumi - I numeri del settore (ISMEA agri-food markets. Pork meat and cold cuts - The numbers of the sector). 2015. Available from: http://www.ismeamercati.it/flex/cm/pages/ServeBLOB.php/L/IT/IDPagina/4353#MenuV
  25. Caruso C, Peletto S, Rosamilia A, Modesto P, Chiavacci L, Sona B, et al. Hepatitis E Virus: A Cross-Sectional Serological and Virological Study in Pigs and Humans at Zoonotic Risk within a High-Density Pig Farming Area. Transbound Emerg Dis. 2017;64(5):1443-53.  https://doi.org/10.1111/tbed.12533  PMID: 27380833 
  26. Montesano C, Giovanetti M, Ciotti M, Cella E, Lo Presti A, Grifoni A, et al. Hepatitis E Virus Circulation in Italy: Phylogenetic and Evolutionary Analysis. Hepat Mon. 2016;16(3):e31951.  https://doi.org/10.5812/hepatmon.31951  PMID: 27226798 
  27. O’Riordan J, Boland F, Williams P, Donnellan J, Hogema BM, Ijaz S, et al. Hepatitis E virus infection in the Irish blood donor population. Transfusion. 2016;56(11):2868-76.  https://doi.org/10.1111/trf.13757  PMID: 27522065 
  28. Hewitt PE, Ijaz S, Brailsford SR, Brett R, Dicks S, Haywood B, et al. Hepatitis E virus in blood components: a prevalence and transmission study in southeast England. Lancet. 2014;384(9956):1766-73.  https://doi.org/10.1016/S0140-6736(14)61034-5  PMID: 25078306 
  29. Goel A, Aggarwal R. Advances in hepatitis E - II: Epidemiology, clinical manifestations, treatment and prevention. Expert Rev Gastroenterol Hepatol. 2016;10(9):1065-74.  https://doi.org/10.1080/17474124.2016.1185365  PMID: 27148907 
  30. Iaconelli M, Purpari G, Della Libera S, Petricca S, Guercio A, Ciccaglione AR, et al. Hepatitis A and E Viruses in Wastewaters, in River Waters, and in Bivalve Molluscs in Italy. Food Environ Virol. 2015;7(4):316-24.  https://doi.org/10.1007/s12560-015-9207-3  PMID: 26115693 
  31. La Rosa G, Proroga YTR, De Medici D, Capuano F, Iaconelli M, Della Libera S, et al. First Detection of Hepatitis E Virus in Shellfish and in Seawater from Production Areas in Southern Italy. Food Environ Virol. 2018;10(1):127-31.  https://doi.org/10.1007/s12560-017-9319-z  PMID: 28956272 
Hepatitis E in Italy: 5 years of national epidemiological, virological and environmental surveillance, 2012 to 2016
<p class="citation"> <span>Citation style for this article:</span> <span class="meta-value authors"> <a href="/search?value1=Valeria+Alfonsi&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Alfonsi Valeria</a>, <a href="/search?value1=Luisa+Roman%C3%B2&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Romanò Luisa</a>, <a href="/search?value1=Anna+Rita+Ciccaglione&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Ciccaglione Anna Rita</a>, <a href="/search?value1=Giuseppina+La+Rosa&option1=author&noRedirect=true" class="nonDisambigAuthorLink">La Rosa Giuseppina</a>, <a href="/search?value1=Roberto+Bruni&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Bruni Roberto</a>, <a href="/search?value1=Alessandro+Zanetti&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Zanetti Alessandro</a>, <a href="/search?value1=Simonetta+Della+Libera&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Della Libera Simonetta</a>, <a href="/search?value1=Marcello+Iaconelli&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Iaconelli Marcello</a>, <a href="/search?value1=Patrizia+Bagnarelli&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Bagnarelli Patrizia</a>, <a href="/search?value1=Maria+Rosaria+Capobianchi&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Capobianchi Maria Rosaria</a>, <a href="/search?value1=Anna+Rosa+Garbuglia&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Garbuglia Anna Rosa</a>, <a href="/search?value1=Flavia+Riccardo&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Riccardo Flavia</a>, <a href="/search?value1=Maria+Elena+Tosti&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Tosti Maria Elena</a>, <a href="/search?value1=Collaborating+Group&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Collaborating Group</a></span>. Hepatitis E in Italy: 5 years of national epidemiological, virological and environmental surveillance, 2012 to 2016. <a href="/content/ecdc">Euro Surveill.</a> 2018;23(41):pii=1700517. <a href="https://doi.org/10.2807/1560-7917.ES.2018.23.41.1700517" title="doi link" target="_blank">https://doi.org/10.2807/1560-7917.ES.2018.23.41.1700517</a> <span class="ES_Article_citation"> <span class="generated">Received</span>: 27 Jul 2017;&nbsp;&nbsp; <span class="generated">Accepted</span>: 24 Mar 2018 </span> </p>
/content/10.2807/1560-7917.ES.2018.23.41.1700517
/content/10.2807/1560-7917.ES.2018.23.41.1700517
Loading

Data & Media loading...

Submit comment
Close
Comment moderation successfully completed
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error