Pig liver sausage as a source of hepatitis E virus transmission to humans

J Infect Dis. 2010 Sep 15;202(6):825-34. doi: 10.1086/655898.

Abstract

Background: The source and route of autochthonous hepatitis E virus (HEV) infections are not clearly established in industrialized countries despite evidence that it is a zoonosis in pigs. We investigated the role of figatellu, a traditional pig liver sausage widely eaten in France and commonly consumed raw, as a source of HEV infection.

Methods: A case-control study was conducted of 3 patients who presented autochthonous hepatitis E and 15 members of their 3 different families. Anti-HEV immunoglobulin G and immunoglobulin M antibody testing was performed with commercial assays. HEV RNA was detected in serum samples of patients and in pig liver sausages by means of real-time polymerase chain reaction and sequenced by means of in-house sequencing assays. Genetic links between HEV sequences were analyzed.

Results: Acute or recent HEV infection, defined by detection of anti-HEV immunoglobulin M antibodies and/or HEV RNA, was observed in 7 of 13 individuals who ate raw figatellu and 0 of 5 individuals who did not eat raw figatellu (P=.041). Moreover, HEV RNA of genotype 3 was recovered from 7 of 12 figatelli purchased in supermarkets, and statistically significant genetic links were found between these sequences and those recovered from patients who ate raw figatellu.

Conclusion: Our findings strongly support the hypothesis of HEV infection through ingestion of raw figatellu.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Aged
  • Animals
  • Case-Control Studies
  • Child
  • Female
  • Food Microbiology*
  • France / epidemiology
  • Hepatitis Antibodies / blood
  • Hepatitis E / diagnosis*
  • Hepatitis E / transmission*
  • Hepatitis E / virology
  • Hepatitis E virus / isolation & purification*
  • Humans
  • Immunoglobulin G / blood
  • Immunoglobulin M / blood
  • Liver
  • Male
  • Middle Aged
  • RNA, Viral / blood
  • RNA, Viral / genetics
  • Sequence Analysis, DNA
  • Swine
  • Young Adult

Substances

  • Hepatitis Antibodies
  • Immunoglobulin G
  • Immunoglobulin M
  • RNA, Viral