High circulation of Hepatitis E virus in pigs and professionals exposed to pigs in Laos

Zoonoses Public Health. 2018 Dec;65(8):1020-1026. doi: 10.1111/zph.12520. Epub 2018 Aug 27.


Epidemiological characteristics of hepatitis E Virus (HEV) differ due to the vast spatial heterogeneity in sanitation status, dietary habits and extent of exposure to animals. Although HEV infections are mostly asymptomatic, prognosis is poor for patients with compromised immune systems or pre-existing liver disease and during pregnancy. In developing countries, low hygienic standards and close human-animal interactions at farms and slaughterhouses likely favour zoonotic transmission of the virus. In this cross-sectional study from Lao People's Democratic Republic, anti-HEV IgG was detected by ELISA in 54.0% (136/252) of slaughter pigs, in 41.0% (57/139) of professionals exposed to pigs and in 18.1% of the nonrisk controls (38/210). We show that people occupationally exposed to pigs are at higher risk of infection (p < 0.001). In particular, contact to young piglets as compared to contact to the older slaughter pigs was a major risk factor (p = 0.011). Besides, consumption of bottled water significantly reduced the risk of infection (p = 0.018). In conclusion, we show that in Lao PDR, the high endemicity of HEV, the inadequate implementation of hygiene measures and the limited access to safe water jeopardize the health of professionals exposed to pigs.

Keywords: ELISA; Lao People's Democratic Republic; risk factors; seroprevalence; slaughter swine; zoonotic virus.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Abattoirs
  • Adolescent
  • Adult
  • Aged
  • Animal Husbandry
  • Animals
  • Cross-Sectional Studies
  • Farmers
  • Female
  • Hepatitis Antibodies / blood*
  • Hepatitis E / epidemiology
  • Hepatitis E / immunology
  • Hepatitis E / transmission
  • Hepatitis E / veterinary*
  • Hepatitis E virus / genetics
  • Hepatitis E virus / immunology
  • Hepatitis E virus / isolation & purification*
  • Humans
  • Male
  • Middle Aged
  • RNA, Viral / genetics
  • Seroepidemiologic Studies
  • Sus scrofa
  • Swine
  • Swine Diseases / epidemiology
  • Swine Diseases / immunology
  • Swine Diseases / transmission*
  • Swine Diseases / virology
  • Veterinarians
  • Young Adult
  • Zoonoses / epidemiology*
  • Zoonoses / immunology
  • Zoonoses / transmission
  • Zoonoses / virology


  • Hepatitis Antibodies
  • RNA, Viral