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Hepatitis E Outbreak in the Central Part of Italy Sustained by Multiple HEV Genotype 3 Strains, June–December 2019

In European countries, autochthonous acute hepatitis E cases are caused by Hepatitis E Virus (HEV) genotype 3 and are usually observed as sporadic cases. In mid/late September 2019, a hepatitis E outbreak caused by HEV genotype 3 was recognized by detection of identical/highly similar HEV sequences...

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Autores principales: Garbuglia, Anna Rosa, Bruni, Roberto, Villano, Umbertina, Vairo, Francesco, Lapa, Daniele, Madonna, Elisabetta, Picchi, Giovanna, Binda, Barbara, Mariani, Rinalda, De Paulis, Francesca, D’Amato, Stefania, Grimaldi, Alessandro, Scognamiglio, Paola, Capobianchi, Maria Rosaria, Ciccaglione, Anna Rita
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8235070/
https://www.ncbi.nlm.nih.gov/pubmed/34204376
http://dx.doi.org/10.3390/v13061159
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author Garbuglia, Anna Rosa
Bruni, Roberto
Villano, Umbertina
Vairo, Francesco
Lapa, Daniele
Madonna, Elisabetta
Picchi, Giovanna
Binda, Barbara
Mariani, Rinalda
De Paulis, Francesca
D’Amato, Stefania
Grimaldi, Alessandro
Scognamiglio, Paola
Capobianchi, Maria Rosaria
Ciccaglione, Anna Rita
author_facet Garbuglia, Anna Rosa
Bruni, Roberto
Villano, Umbertina
Vairo, Francesco
Lapa, Daniele
Madonna, Elisabetta
Picchi, Giovanna
Binda, Barbara
Mariani, Rinalda
De Paulis, Francesca
D’Amato, Stefania
Grimaldi, Alessandro
Scognamiglio, Paola
Capobianchi, Maria Rosaria
Ciccaglione, Anna Rita
author_sort Garbuglia, Anna Rosa
collection PubMed
description In European countries, autochthonous acute hepatitis E cases are caused by Hepatitis E Virus (HEV) genotype 3 and are usually observed as sporadic cases. In mid/late September 2019, a hepatitis E outbreak caused by HEV genotype 3 was recognized by detection of identical/highly similar HEV sequences in some hepatitis E cases from two Italian regions, Abruzzo and Lazio, with most cases from this latter region showing a link with Abruzzo. Overall, 47 cases of HEV infection were finally observed with onsets from 8 June 2019 to 6 December 2019; they represent a marked increase as compared with just a few cases in the same period of time in the past years and in the same areas. HEV sequencing was successful in 35 cases. The phylogenetic analysis of the viral sequences showed 30 of them grouped in three distinct molecular clusters, termed A, B, and C: strains in cluster A and B were of subtype 3e and strains in cluster C were of subtype 3f. No strains detected in Abruzzo in the past years clustered with the strains involved in the present outbreak. The outbreak curve showed partially overlapped temporal distribution of the three clusters. Analysis of collected epidemiological data identified pork products as the most likely source of the outbreak. Overall, the findings suggest that the outbreak might have been caused by newly and almost simultaneously introduced strains not previously circulating in this area, which are possibly harbored by pork products or live animals imported from outside Abruzzo. This possibility deserves further studies in this area in order to monitor the circulation of HEV in human cases as well as in pigs and wild boars.
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spelling pubmed-82350702021-06-27 Hepatitis E Outbreak in the Central Part of Italy Sustained by Multiple HEV Genotype 3 Strains, June–December 2019 Garbuglia, Anna Rosa Bruni, Roberto Villano, Umbertina Vairo, Francesco Lapa, Daniele Madonna, Elisabetta Picchi, Giovanna Binda, Barbara Mariani, Rinalda De Paulis, Francesca D’Amato, Stefania Grimaldi, Alessandro Scognamiglio, Paola Capobianchi, Maria Rosaria Ciccaglione, Anna Rita Viruses Article In European countries, autochthonous acute hepatitis E cases are caused by Hepatitis E Virus (HEV) genotype 3 and are usually observed as sporadic cases. In mid/late September 2019, a hepatitis E outbreak caused by HEV genotype 3 was recognized by detection of identical/highly similar HEV sequences in some hepatitis E cases from two Italian regions, Abruzzo and Lazio, with most cases from this latter region showing a link with Abruzzo. Overall, 47 cases of HEV infection were finally observed with onsets from 8 June 2019 to 6 December 2019; they represent a marked increase as compared with just a few cases in the same period of time in the past years and in the same areas. HEV sequencing was successful in 35 cases. The phylogenetic analysis of the viral sequences showed 30 of them grouped in three distinct molecular clusters, termed A, B, and C: strains in cluster A and B were of subtype 3e and strains in cluster C were of subtype 3f. No strains detected in Abruzzo in the past years clustered with the strains involved in the present outbreak. The outbreak curve showed partially overlapped temporal distribution of the three clusters. Analysis of collected epidemiological data identified pork products as the most likely source of the outbreak. Overall, the findings suggest that the outbreak might have been caused by newly and almost simultaneously introduced strains not previously circulating in this area, which are possibly harbored by pork products or live animals imported from outside Abruzzo. This possibility deserves further studies in this area in order to monitor the circulation of HEV in human cases as well as in pigs and wild boars. MDPI 2021-06-17 /pmc/articles/PMC8235070/ /pubmed/34204376 http://dx.doi.org/10.3390/v13061159 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Garbuglia, Anna Rosa
Bruni, Roberto
Villano, Umbertina
Vairo, Francesco
Lapa, Daniele
Madonna, Elisabetta
Picchi, Giovanna
Binda, Barbara
Mariani, Rinalda
De Paulis, Francesca
D’Amato, Stefania
Grimaldi, Alessandro
Scognamiglio, Paola
Capobianchi, Maria Rosaria
Ciccaglione, Anna Rita
Hepatitis E Outbreak in the Central Part of Italy Sustained by Multiple HEV Genotype 3 Strains, June–December 2019
title Hepatitis E Outbreak in the Central Part of Italy Sustained by Multiple HEV Genotype 3 Strains, June–December 2019
title_full Hepatitis E Outbreak in the Central Part of Italy Sustained by Multiple HEV Genotype 3 Strains, June–December 2019
title_fullStr Hepatitis E Outbreak in the Central Part of Italy Sustained by Multiple HEV Genotype 3 Strains, June–December 2019
title_full_unstemmed Hepatitis E Outbreak in the Central Part of Italy Sustained by Multiple HEV Genotype 3 Strains, June–December 2019
title_short Hepatitis E Outbreak in the Central Part of Italy Sustained by Multiple HEV Genotype 3 Strains, June–December 2019
title_sort hepatitis e outbreak in the central part of italy sustained by multiple hev genotype 3 strains, june–december 2019
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8235070/
https://www.ncbi.nlm.nih.gov/pubmed/34204376
http://dx.doi.org/10.3390/v13061159
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