Hepatitis E Virus Genotype 4 Outbreak, Italy, 2011 - - Emerging Infectious Disease journal - CDC
Table of Contents
Volume 19, Number 1–January 2013
Dispatch
Hepatitis E Virus Genotype 4 Outbreak, Italy, 2011
Abstract
During 2011, 5 persons in the area of Lazio, Italy were infected with a monophyletic strain of hepatitis E virus that showed high sequence homology with isolates from swine in China. Detection of this genotype in Italy parallels findings in other countries in Europe, signaling the possible spread of strains new to Western countries.HEV genotype 4 is endemic among humans in China, Japan, India, and Indonesia (4) and was detected during 2008 from swine fecal samples in Belgium (5). Human infections with imported strains of this genotype that later became endemic have subsequently been described in Germany (6) and northern France (7). Recently, multiple cases of HEV infection have been described in southern France (8,9).
In different areas of Italy, HEV seroprevalence estimates range from 1% to 6% (10); prevalence is 2.9% in the Lazio region and 2.5% in the province of Rome (11). However, the number of acute hepatitis cases caused by HEV reported in Italy is relatively low compared with surrounding European countries and is probably underestimated; most cases are travel-related and caused by genotype 1, but sporadic cases spread within Italy have been caused by genotype 3 (12). We report an outbreak of HEV genotype 4 infection among persons living in Lazio, an administrative region of Italy that encompasses Rome.
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