Abstract
After an acute hepatitis E (HEV) outbreak in Southern Switzerland, in January 2017 the local public health authorities started an active program of food chain control and public education. In this retrospective study, we analysed all laboratory-confirmed acute cases of HEV infection diagnosed between 2014 and 2020. In the period before the public health intervention, the number of cases increased steadily from 2014 (4 of 40 tests, 10%) reaching a peak in the last quarter of 2016 (42 of 285 tests, 14.7 %). Afterwards, the number of positive cases decreased steadily, reaching its lowest value (0.3%) in the second quarter of 2019. There was a statistically significant difference between the frequency of positive cases and period of testing, i.e., before and after the introduction of the public health interventions. Our study shows that active public health measures to control sausages containing raw pork liver can reduce the prevalence of HEV infection.
Highlights
Hepatitis E (HEV) is the most prevalent cause of acute hepatitis in the world [1]
In Switzerland, the estimated overall seroprevalence in pigs is approximately 60% [3,4]; in humans it is 20%, but higher values have been reported from Southern Switzerland (>30%), where the prevalence may reach almost 60% in some districts [5]
Numerous studies have shown that meat products from domestic pigs and wild boars, especially pork sausages containing raw liver, are contaminated with HEV [2,6,7,8,9,10]
Summary
Hepatitis E (HEV) is the most prevalent cause of acute hepatitis in the world [1]. In developed countries, HEV infection occurs mainly through zoonotic transmission or, more rarely, contaminated blood products [1]. Numerous studies have shown that meat products from domestic pigs and wild boars, especially pork sausages containing raw liver, are contaminated with HEV [2,6,7,8,9,10]. The percentage of HEV-contaminated food products of porcine origin can vary from less than 1% to more than 50%, depending on the country and the local products. The percentage of HEV-contaminated food products of porcine origin can vary 2froofm less than 1% to more than 50%, depending on the country and the local products. Press release with recommendations by the local authorities to: (a) all meat producers: detailed description of the mandatory changes in the production of sausages containing raw pork liver (b) all medical doctors active in Southern Switzerland: explanation of the modality of HEV infection and its possible hepatic and extra-hepatic clinical manifestations.
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