Guest guest Posted July 22, 2002 Report Share Posted July 22, 2002 Sun, 21 Jul 2002 21:50:47 -0400 (EDT) promed-ahead-edr " ProMED-mail " <promed PRO/AH/EDR> Hepatitis E virus, new genotypes - Japan HEPATITIS E VIRUS, NEW GENOTYPES - JAPAN **************************************** A ProMED-mail post <http://www.promedmail.org> ProMED-mail is a program of the International Society for Infectious Diseases <http://www.isid.org> Sun 21 Jul 2002 Pablo Nart <p.nart Source: Yomiuri Shimbun, Sun 21 Jul 2002 [edited] <http://www.yomiuri.co.jp/newse/20020721wo31.htm> Hepatitis E Virus Infection Linked to 3 Deaths in Tokyo ---------------------- Hepatitis E, once considered a disease of developing countries with poor sanitary conditions, has claimed the lives of 3 Japanese since the 1990s, research undertaken by Toshiba Hospital in Tokyo has found. Of the main viral forms of [hepatitis], which inflames the liver, only hepatitis E virus infection can be spread by animals. The Health, Labor and Welfare Ministry began researching the number of cases of hepatitis E virus infection and studying the route of infection, after Europe and the United States reported increased [incidence] of the disease in recent years. The 3 patients who died were diagnosed with hepatitis E virus infection during autopsies. Among them was a Hokkaido woman who was diagnosed with acute hepatitis 6 days after being admitted to a hospital last year and later underwent a partial liver transplant from a living donor. However, she died 3 months after the operation. A research team led by Shunji Mishiro, director of Toshiba Hospital's research department, detected hepatitis E virus (HEV) when testing her blood after her death. Another research group also found HEV in the serums of 2 elderly men of the Tohoku Region who died of acute hepatitis in the 1990s. The cases, the first fatalities confirmed to be caused by hepatitis E virus in the nation, were reported to a meeting of experts last month. Mishiro and his team also detected HEV in the blood of 7 patients in Tokyo, Saitama Prefecture and Hokkaido who had been diagnosed with acute hepatitis between 1996 and 2002. As none of the 7 had been to places abroad where the disease is prevalent, experts said it is likely the virus has taken root in the country. Cases of people returning from abroad with the illness also have been confirmed. Examinations found 3 [genotypes] of HEV among the 7 people who contracted the virus in Japan, all of which were different from the types of the virus found overseas. Mishiro determined that HEV came to the country through 3 routes. HEV, as with hepatitis A virus (HAV), is contained in patients' stools, and can be caught through consuming food or water contaminated by feces from an infected person. According to studies in areas where the virus is rampant, hepatitis virus infection E can become more serious than hepatitis A. The virus is fatal in 1-2 percent of cases; a death rate 10 times that of hepatitis A. About 20 percent of pregnant women who contract acute hepatitis E die. In Japan, HEV has not been considered a serious risk because it has been associated with countries with underdeveloped water supplies. In light of this and the fact that HEV testing is not widely available, it is possible that other people infected with the virus have gone undiagnosed. HEV can [survive] and grow in the body of animals without causing serious problems to its host. Therefore, pigs, goats, and rats are thought to carry the virus in some foreign countries. As the virus can spread if left unchecked, the ministry is trying to determine as soon as possible the number of hepatitis E cases among patients infected with unspecified forms of acute hepatitis. -- ProMED-mail <promed [As stated above, Hepatitis E virus (HEV) infection has been associated with developing regions and attributed to oral-fecal transmission due to inadequate sanitation. Several recent findings, however, have led to a new understanding of this virus. A number of novel isolates have been identified in patients with acute hepatitis from regions other than Japan not considered endemic for HEV (Austria, the Netherlands, New Zealand, Spain, and the United States). These individuals reported no recent travel to HEV-endemic areas. In addition, a number of HEV-like sequences have also been isolated from swine worldwide, suggesting the potential of an animal reservoir. The August issue of the Journal of General Virology (83(Pt 8):1931-1940, 2002) contains a paper by Takahashi et al. describing the identification of 2 distinct genotypes of hepatitis E virus in a Japanese patient with acute hepatitis who had not travelled abroad. The paper should be consulted for an up-to-date assessment of the situation. The authors conclude among other things that one of the 2 strains had higher sequence identity to human and swine HEV isolates from the United States (US1, US2 and swUS1) than to those reported thus far from Japan (JRA1 and swJ570). The 2 co-infecting strains identified from the single patient shared only 80.1 percent nucleotide identity. These results indicate that multiple genotypes of HEV co-circulate in Japan, and that genotype IV comprises a remarkably heterogeneous group of HEVs. It seems clear that at least 4 distinct genotypes of hepatitis E virus are prevalent in Japan and that this should be taken into account in the treatment of acute hepatitis. - Mod.CP] [see also: 2001 ---- Hepatitis E, epidemiology - Spain 20011005.2411 Hepatitis E virus, rat-borne? - USA 20011123.2871 2000 ---- Hepatitis E virus, full-length clone 20000223.0247 1999 ---- Hepatitis E: emerging zoonosis? 19990121.0099 1997 ---- Hepatitis E, new strain - USA 19971117.2317 1996 ---- Hepatitis E, new strain - USA (05) 19971202.2405] .............mpp/cp/pg/dk Health - Feel better, live better http://health. Quote Link to comment Share on other sites More sharing options...
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