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Home Topics Infectious Diseases Infections A-Z Hepatitis E Surveillance

Surveillance

Hepatitis E was considered a travel-associated infection and this may have lead to under-ascertainment of this disease. Any unexplained hepatitis, regardless of travel history should be tested for hepatitis E virus (HEV).

Hepatits E surveillance covers all patients tested for HEV and cases confirmed as HEV positive by the two reference laboratories (Birmingham and Colindale).The objective is to ascertain and investigate non-travel associated cases of HEV in the UK and to identify potential risk factors.

Serologically confirmed cases of Hepatitis E can be indigenously acquired in the UK. These non-travel associated cases are likely to be older, male and infected with the genotype 3 strain (related to the pig strain). In addition, 85% of British pigs were found to be anti-HEV antibody positive. However, no direct evidence of transmission from pig to human has been demonstrated. See Related Publications

The number of cases of HEV infection diagnosed by the reference laboratories increased significantly between 2003 and 2005. This was followed by a marked decrease between 2007 and 2009. However, since 2010 numbers of cases have increased substantially (Table). Non-travel cases now account for the majority (467 or 69%) of cases in 2013 compared to an average of 45% of cases in previous years. More than half of the non-travel cases are both male and over 50 years of age. Following the increase in the number of hepatitis E cases seen in England and Wales a case-control study, undertaken to investigate routes of acquisition in cases of possible indigenous origin, implicated processed pork products.

Year

 

2003

2004

2005

2006

2007

2008

2009

2010 2011 2012 *2013

Number of confirmed cases

124 149 329 289 162 176 175 274 456 579

676

                                                                                                                          *provisional data

Click here for the current operational guidelines  for Health Protection Teams to respond appropriately to laboratory reports and/or clinical notifications of hepatitis E virus (HEV) infection.

A structured questionnaire (see surveillance form below) has been developed as part of HEV surveillance. If an outbreak, cluster or interesting case is identified this can be used to gather further information. All completed surveillance forms should be faxed to the EIZ team at Colindale (secure fax: 0208905 9929) or scanned and emailed to zoonoses@phe.gov.uk.

For further information on surveillance for human Hepatitis E in the UK please contact us.


 

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