11/14/2023 0 Comments Hep b transmission fecesConsumption of shellfish was a risk factor in a recently described outbreak that occurred among cruise ship passengers ( 5). In developed countries, sporadic cases of HEV genotype 3 have occurred following consumption of uncooked/undercooked pork or deer meat. In developing countries, where HEV genotypes 1 and 2 predominate, the most common source of HEV infection is contaminated drinking water. HEV is usually spread by the fecal-oral route. Recently, a new genotype (genotype 7) was identified in a liver-transplant recipient from UAE with chronic hepatitis E virus infection who frequently consumed camel meat and milk ( 4). Cases of hepatitis E typically present in one of two ways: either as large outbreaks and sporadic cases in areas where HEV is endemic (genotype 1 in Asia and Africa, genotype 2 in Mexico and west Africa, and genotype 4 in Taiwan and China) or as isolated cases in developed countries like the United States (genotype 3). Four genotypes of HEV cause illness in humans, each displaying different epidemiologic and clinical characteristics in developing and developed countries. This can be attributed largely to the viral genotypes circulating in different parts of the world. HEV is unique, in that it has a different clinical and epidemiologic profile depending on where the infection is acquired. What are the different genotypes of hepatitis E and where can they be found? People living in crowded camps or temporary housing, including refugees and people who are internally displaced, are at particularly high risk. Hepatitis E epidemics involving large numbers of people have been reported in Asia, the Middle East, Africa, and Central America ( 3). Hepatitis E is most common in developing countries with inadequate water supply and poor environmental sanitation. Sporadic cases of hepatitis E in developed countries, including the United States, are primarily caused by HEV genotype 3 and largely affect older men (those >40 years of age). Sporadic, non-travel-related cases of hepatitis E have been identified in the United States ( 2) no clear exposure was identified for these domestically acquired cases. Hepatitis E is not commonly acquired in the United States most cases of symptomatic hepatitis E in the United States occur among people who have traveled to a developing country where hepatitis E is endemic. How common is hepatitis E in the United States? However, acute infection can become chronic in rare cases, primarily in people who have received solid-organ transplants ( 1). In the vast majority of people, HEV infection results in a self-limited, acute illness. Although rare in developed countries, hepatitis E is widespread in the developing world. Hepatitis E is a liver disease caused by the hepatitis E virus (HEV).
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