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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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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
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author 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
author_facet 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
author_sort Alfonsi, Valeria
collection PubMed
description 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.
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spelling pubmed-61949092018-10-31 Hepatitis E in Italy: 5 years of national epidemiological, virological and environmental surveillance, 2012 to 2016 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 Euro Surveill Surveillance and Outbreak Report 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. European Centre for Disease Prevention and Control (ECDC) 2018-10-11 /pmc/articles/PMC6194909/ /pubmed/30326991 http://dx.doi.org/10.2807/1560-7917.ES.2018.23.41.1700517 Text en This article is copyright of The Authors, 2018. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution (CC BY 4.0) Licence. You may share and adapt the material, but must give appropriate credit to the source, provide a link to the licence, and indicate if changes were made.
spellingShingle Surveillance and Outbreak Report
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
Hepatitis E in Italy: 5 years of national epidemiological, virological and environmental surveillance, 2012 to 2016
title Hepatitis E in Italy: 5 years of national epidemiological, virological and environmental surveillance, 2012 to 2016
title_full Hepatitis E in Italy: 5 years of national epidemiological, virological and environmental surveillance, 2012 to 2016
title_fullStr Hepatitis E in Italy: 5 years of national epidemiological, virological and environmental surveillance, 2012 to 2016
title_full_unstemmed Hepatitis E in Italy: 5 years of national epidemiological, virological and environmental surveillance, 2012 to 2016
title_short Hepatitis E in Italy: 5 years of national epidemiological, virological and environmental surveillance, 2012 to 2016
title_sort hepatitis e in italy: 5 years of national epidemiological, virological and environmental surveillance, 2012 to 2016
topic Surveillance and Outbreak Report
url 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
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