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Hepatitis E in Italy: 5 years of national epidemiological, virological and environmental surveillance, 2012 to 2016

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 an...

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Detalles Bibliográficos
Autores principales: Alfonsi, Valeria, Romanò, Luisa, Ciccaglione, Anna Rita, La Rosa, Giuseppina, Bruni, Roberto, Zanetti, Alessandro, Della Libera, Simonetta, Iaconelli, Marcello, Bagnarelli, Patrizia, Capobianchi, Maria Rosaria, Garbuglia, Anna Rosa, Riccardo, Flavia, Tosti, Maria Elena
Formato: Online Artículo Texto
Lenguaje:English
Publicado: European Centre for Disease Prevention and Control (ECDC) 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6194909/
https://www.ncbi.nlm.nih.gov/pubmed/30326991
http://dx.doi.org/10.2807/1560-7917.ES.2018.23.41.1700517
Descripción
Sumario: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.