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Medical Microbiology and Immunology
Published in: Medical Microbiology and Immunology 4/2014

01-08-2014 | Original Investigation

Seroprevalence of hepatitis E virus (HEV) in humans living in high pig density areas of Germany

Authors: Andi Krumbholz, Sebastian Joel, Paul Dremsek, Anne Neubert, Reimar Johne, Ralf Dürrwald, Mario Walther, Thomas H. Müller, Detlef Kühnel, Jeannette Lange, Peter Wutzler, Andreas Sauerbrei, Rainer G. Ulrich, Roland Zell

Published in: Medical Microbiology and Immunology | Issue 4/2014

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Abstract

An increase in acute autochthonous hepatitis E virus (HEV) infections has been recorded in Germany. These are suspected to be zoonotically transmitted from wild boar, deer and domestic pig. The latter may represent a major reservoir for HEV. In this study, 537 sera from humans living in Westphalia and Lower Saxony, representing areas of high pig density in Germany, were tested for the presence of HEV-specific antibodies. Among them were 302 individuals with occupational, direct contact to pigs and 235 individuals without direct contact to pigs. Two commercial tests and one in-house assay were applied for the detection of HEV-specific immunoglobulin G (IgG) antibodies. Sera were also tested in an assay that detects all classes of HEV-specific antibodies. Depending on the test used, the seroprevalence ranged from 4.1 to 27.9 %. Exposition to pigs was found to be associated with a significantly higher seroprevalence in subjects with contact to pigs (13.2–32.8 %) compared with that in non-exposed humans (7.7–21.7 %). In particular, individuals younger than 40 years with occupational exposure exhibited a markedly higher HEV seroprevalence compared with non-exposed individuals of that age group. In general, HEV seroprevalence increased with age resulting in a similar prevalence level in the age group of ≥50 years for exposed and non-exposed individuals. Analysis of all sera by a commercial anti-HEV IgM ELISA revealed 35 positive and 25 borderline samples. However, only one positive serum could be confirmed by an IgM line assay. Selected samples from IgM and/or IgG as well as total HEV antibody-positive individuals were also tested for the presence of HEV RNA. In one of the 78 samples, the only IgM ELISA positive and IgM line assay confirmed sample, RNA of HEV genotype 3 was detected. This sequence has high similarity to HEV sequences obtained from wild boars and domestic pigs from Germany and The Netherlands. This study demonstrates that in addition to the consumption of raw or undercooked meat, direct contact to pigs has to be considered as an additional risk factor for HEV infection.
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Metadata
Title
Seroprevalence of hepatitis E virus (HEV) in humans living in high pig density areas of Germany
Authors
Andi Krumbholz
Sebastian Joel
Paul Dremsek
Anne Neubert
Reimar Johne
Ralf Dürrwald
Mario Walther
Thomas H. Müller
Detlef Kühnel
Jeannette Lange
Peter Wutzler
Andreas Sauerbrei
Rainer G. Ulrich
Roland Zell
Publication date
01-08-2014
Publisher
Springer Berlin Heidelberg
Published in
Medical Microbiology and Immunology / Issue 4/2014
Print ISSN: 0300-8584
Electronic ISSN: 1432-1831
DOI
https://doi.org/10.1007/s00430-014-0336-3

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