The first case of hepatitis E subgenotype 4c causing acute hepatitis E in Nagano Prefecture

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  • Yamagishi Masato
    Department of General Internal Medicine, Zisenkai Aizawa Hospital
  • Terakawa Ion
    Department of General Internal Medicine, Zisenkai Aizawa Hospital
  • Yamamoto Tomokiyo
    Department of General Internal Medicine, Zisenkai Aizawa Hospital
  • Suzuki Naomi
    Suzuki Naika Clinic
  • Kiyosawa Kendo
    Department of Gastroenterology and Hepatology, Zisenkai Aizawa Hospital
  • Usuda Seiichi
    Department of Gastroenterology and Hepatology, Zisenkai Aizawa Hospital
  • Okamoto Hiroaki
    Division of Virology, Department of Infection and Immunity, Jichi Medical University School of Medicine

Bibliographic Information

Other Title
  • 長野県で初分離された感染源不明のHEV subgenotype 4c株による急性E型肝炎の1例
  • 症例報告 長野県で初分離された感染源不明のHEV subgenotype 4c株による急性E型肝炎の1例
  • ショウレイ ホウコク ナガノケン デ ハツ ブンリ サレタ カンセン ゲン フメイ ノ HEV subgenotype 4cカブ ニ ヨル キュウセイ Eガタ カンエン ノ 1レイ

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Abstract

<p>A 62-year-old male forestry worker was referred to our hospital with general malaise and anorexia, as well as a high level of liver enzymes (AST 1559 U/L, ALT 2464 U/L). He was diagnosed with acute hepatitis E (HEV) after testing positive for IgA/IgM HEV antibodies and HEV RNA. He had not ingested untreated water and had not eaten raw meat or the visceral organs of pigs, boars, or deer in the past year. He had not been in contact with these types of animals or any hepatitis patients in the past year. He had no history of blood transfusion. Hepatitis E subgenotype 4c (HEV-4c) was recovered from the patient's serum in the early phase of the illness. Hepatitis E caused by HEV- 4c has been reported in Hokkaido and the Tohoku region, but this was the first report of the disease in Nagano Prefecture. The patient had not travelled to these areas in the past year; therefore, the route by which the virus had been transmitted in this case remains unknown. According to a nationwide survey of their dietary histories, the rate of pork and visceral organ consumption in hepatitis E patients is close to 50%, suggesting that commercially available pork and visceral organs may be the main source of HEV transmission. This particular patient often consumed pork products, which may, therefore, likely be the source of HEV infection. Accordingly, the prevention of HEV infection in domestic pigs is important. It is also important to maintain awareness of how to safely cook and consume pork products. This case made us reflect on methods for preventing HEV infection.</p>

Journal

  • Kanzo

    Kanzo 61 (4), 197-203, 2020-04-01

    The Japan Society of Hepatology

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