A scoping review of the evidence for public health risks of three emerging potentially zoonotic viruses: hepatitis E virus, norovirus, and rotavirus

Prev Vet Med. 2015 Apr 1;119(1-2):61-79. doi: 10.1016/j.prevetmed.2015.01.015. Epub 2015 Jan 24.


Emerging zoonoses are defined as those newly recognized, or increasing in incidence or geographic range. Hepatitis E virus (HEV), norovirus (NoV), and rotavirus (RV), while well known to be transmitted person-person, have also been hypothesized to be emerging zoonoses. Our objective was to investigate their potential public health risks from animal reservoirs. Given the diversity of evidence sources, a scoping review incorporating a mixed methods synthesis approach was used. A broad search was conducted in five electronic databases. Each citation was appraised independently by two reviewers using screening tools designed and tested a priori. Level 1 relevance screening excluded irrelevant citations; level 2 confirmed relevance and categorized. At level 3 screening, data were extracted to support a risk profile. A stakeholder group provided input on study tools and knowledge translation and transfer. Level 1 screening captured 2471 citations, with 1270 advancing to level 2 screening, and 1094 to level 3. We defined criteria for case attribution to zoonosis for each virus. Using these criteria, we identified a small number of zoonotic cases (HEV n=3, NoV=0, RV=40 (zoonoses=3; human-animal re-assortants=37)) categorized as 'likely'. The available evidence suggests the following potential HEV human exposure sources: swine, other domestic animals, wildlife, surface waters, and asymptomatic human shedders. Possible at-risk groups include the immunocompromised and the elderly. Reports of NoV intergenogroup recombinants suggest potential for human-animal recombination. Greatest public health impact for RV zoonoses may be the potential effect of human-animal reassortants on vaccination efficacy.

Keywords: Hepatitis E virus; Knowledge synthesis; Norovirus; Rotavirus; Scoping review; Zoonosis.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Animals
  • Caliciviridae Infections / epidemiology*
  • Caliciviridae Infections / veterinary
  • Caliciviridae Infections / virology
  • Disease Reservoirs
  • Gastroenteritis / epidemiology*
  • Gastroenteritis / veterinary
  • Gastroenteritis / virology
  • Hepatitis E / epidemiology*
  • Hepatitis E / veterinary
  • Hepatitis E / virology
  • Hepatitis E virus / physiology
  • Humans
  • Norovirus / physiology
  • Public Health*
  • Risk Factors
  • Rotavirus / physiology
  • Rotavirus Infections / epidemiology*
  • Rotavirus Infections / veterinary
  • Rotavirus Infections / virology
  • Zoonoses / epidemiology
  • Zoonoses / virology