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Home Topics Infectious Diseases Infections A-Z Hepatitis E Surveillance

Surveillance

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.

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).

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, a recent study found that more than 90% of British pigs were 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 has increased significantly since 2010 (Table). Non-travel cases now account for the majority (477 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 Number of confirmed cases
2003 124
2004 149
2005 329
2006 289
2007 162
2008 176
2009 175
2010 274
2011 456
2012 579
2013 691
2014 200*

      *provisional data for first quarter (Jan-March)

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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