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Viruses 2016, 8(9), 253; doi:10.3390/v8090253

Transmission of Hepatitis E Virus in Developing Countries

1
Sher-I-Kashmir Institute of Medical Sciences, Srinagar, Kashmir 190001, India
2
Digestive Diseases Centre, Dr. Khuroo’s Medical Clinic, Srinagar, Kashmir 190010, India
3
Department of Pathology, Government Medical College, Srinagar, Kashmir 190001, India
*
Author to whom correspondence should be addressed.
Academic Editor: Jacques Izopet
Received: 21 July 2016 / Revised: 8 September 2016 / Accepted: 8 September 2016 / Published: 20 September 2016
(This article belongs to the Special Issue Recent Progress in Hepatitis E Virus Research)
View Full-Text   |   Download PDF [3709 KB, uploaded 22 September 2016]   |  

Abstract

Hepatitis E virus (HEV), an RNA virus of the Hepeviridae family, has marked heterogeneity. While all five HEV genotypes can cause human infections, genotypes HEV-1 and -2 infect humans alone, genotypes HEV-3 and -4 primarily infect pigs, boars and deer, and genotype HEV-7 primarily infects dromedaries. The global distribution of HEV has distinct epidemiological patterns based on ecology and socioeconomic factors. In resource-poor countries, disease presents as large-scale waterborne epidemics, and few epidemics have spread through person-to-person contact; however, endemic diseases within these countries can potentially spread through person-to-person contact or fecally contaminated water and foods. Vertical transmission of HEV from infected mother to fetus causes high fetal and perinatal mortality. Other means of transmission, such as zoonotic transmission, can fluctuate depending upon the region and strain of the virus. For instance, zoonotic transmission can sometimes play an insignificant role in human infections, such as in India, where human and pig HEV infections are unrelated. However, recently China and Southeast Asia have experienced a zoonotic spread of HEV-4 from pigs to humans and this has become the dominant mode of transmission of hepatitis E in eastern China. Zoonotic HEV infections in humans occur by eating undercooked pig flesh, raw liver, and sausages; through vocational contact; or via pig slurry, which leads to environmental contamination of agricultural products and seafood. Lastly, blood transfusion-associated HEV infections occur in many countries and screening of donors for HEV RNA is currently under serious consideration. To summarize, HEV genotypes 1 and 2 cause epidemic and endemic diseases in resource poor countries, primarily spreading through contaminated drinking water. HEV genotypes 3 and 4 on the other hand, cause autochthonous infections in developed, and many developing countries, by means of a unique zoonotic food-borne transmission. View Full-Text
Keywords: hepatitis E virus; hepatitis E; transmission; zoonosis hepatitis E virus; hepatitis E; transmission; zoonosis
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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

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Khuroo, M.S.; Khuroo, M.S.; Khuroo, N.S. Transmission of Hepatitis E Virus in Developing Countries. Viruses 2016, 8, 253.

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