Coastal clustering of HEV; Cornwall, UK

BACKGROUND AND AIMSAutochthonous hepatitis E virus (HEV) infection is a porcine zoonosis and increasingly recognized in developed countries. In most cases the route of infection is uncertain. A previous study showed that HEV was associated geographically with pig farms and coastal areas. AIMThe aim...

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Published in:	European journal of gastroenterology & hepatology Vol. 28; no. 3; pp. 323 - 327
Main Authors:	Hunter, Jeremy G, Madden, Richie G, Stone, Ashleigh M, Osborne, Nick, Wheeler, Ben, Vine, Louisa, Dickson, Amanda, Barlow, Maggie, Lewis, James, Bendall, Richard P, Lin, Nan X, Henley, William E, Gaze, William H, Dalton, Harry R
Format:	Journal Article
Language:	English
Published:	England Copyright Wolters Kluwer Health, Inc. All rights reserved 01-03-2016
Subjects:	Animal Husbandry Animals Case-Control Studies Cluster Analysis England - epidemiology Environmental Exposure Hepatitis E - diagnosis Hepatitis E - epidemiology Hepatitis E - transmission Hepatitis E virus - isolation & purification Humans Incidence Logistic Models Odds Ratio Rain Residence Characteristics Risk Assessment Risk Factors Socioeconomic Factors Swine Time Factors
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Summary:	BACKGROUND AND AIMSAutochthonous hepatitis E virus (HEV) infection is a porcine zoonosis and increasingly recognized in developed countries. In most cases the route of infection is uncertain. A previous study showed that HEV was associated geographically with pig farms and coastal areas. AIMThe aim of the present research was to study the geographical, environmental and social factors in autochthonous HEV infection. METHODSCases of HEV genotype 3 infection and controls were identified from 2047 consecutive patients attending a rapid-access hepatology clinic. For each case/control the following were recordeddistance from home to nearest pig farm, distance from home to coast, rainfall levels during the 8 weeks before presentation, and socioeconomic status. RESULTSA total of 36 acute hepatitis E cases, 170 age/sex-matched controls and 53 hepatitis controls were identified. The geographical spread of hepatitis E cases was not even when compared with both control groups. Cases were more likely to live within 2000 m of the coast (odds ratio=2.32, 95% confidence interval=1.08–5.19, P=0.03). There was no regional difference in the incidence of cases and controls between west and central Cornwall. There was no difference between cases and controls in terms of distance from the nearest pig farm, socioeconomic status or rainfall during the 8 weeks before disease presentation. CONCLUSIONCases of HEV infection in Cornwall are associated with coastal residence. The reason for this observation is uncertain, but might be related to recreational exposure to beach areas exposed to HEV-contaminated ‘run-off’ from pig farms. This hypothesis merits further study.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0954-691X 1473-5687
DOI:	10.1097/MEG.0000000000000518