Epidemiology of hepatitis E in South-East Europe in the "One Health" concept

Mrzljak, Anna and Dinjar-Kujundžić, Petra and Jemeršić, Lorena and Prpić, Jelena and Barbić, Ljubo and Savić, Vladimir and Stevanović, Vladimir and Vilibić-Čavlek, Tatjana (2019) Epidemiology of hepatitis E in South-East Europe in the "One Health" concept. World Journal of Gastroenterology, 25 (25). pp. 3168-3182. ISSN 1007-9327

[img] PDF - Published Version
Download (1MB)


The significance of hepatitis E virus (HEV) as an important public health problem is rising. Until a decade ago, cases of HEV infection in Europe were mainly confined to returning travelers, but nowadays, hepatitis E represents an emerging zoonotic infection in many European countries. The aim of this manuscript is to perform a systematic review of the published literature on hepatitis E distribution in humans, animals and environmental samples ("One Health" concept) in the South-Eastern European countries. Comparison of the available data showed that the anti-HEV seroprevalence in the South-Eastern Europe varies greatly, depending on the population studied, geographical area and methods used. The IgG seroprevalence rates in different population groups were found to be 1.1%-24.5% in Croatia, up to 20.9% in Bulgaria, 5.9-%17.1% in Romania, 15% in Serbia, up to 9.7% in Greece and 2%-9.7% in Albania. Among possible risk factors, older age was the most significant predictor for HEV seropositivity in most studies. Higher seroprevalence rates were found in animals. HEV IgG antibodies in domestic pigs were detected in 20%-54.5%, 29.2%-50%, 38.94%-50% and 31.1%-91.7% in Serbia, Bulgaria, Romania and Croatia, respectively. In wild boars seroprevalence rates were up to 10.3%, 30.3% and 31.1% in Romania, Slovenia and Croatia, respectively. A high HEV RNA prevalence in wild boars in some countries (Croatia and Romania) indicated that wild boars may have a key role in the HEV epidemiology. There are very few data on HEV prevalence in environmental samples. HEV RNA was detected in 3.3% and 16.7% surface waters in Slovenia and Serbia, respectively. There is no evidence of HEV RNA in sewage systems in this region. The available data on genetic characterization show that human, animal and environmental HEV strains mainly belong to the genotype 3.

Item Type: Article
MeSH: Animals ; Communicable Diseases, Emerging / epidemiology ; Communicable Diseases, Emerging / veterinary ; Communicable Diseases, Emerging / virology ; Environmental Microbiology ; Europe, Eastern / epidemiology ; Hepatitis Antibodies / blood ; Hepatitis Antibodies / immunology ; Hepatitis Antibodies / isolation & purification ; Hepatitis E / epidemiology ; Hepatitis E / veterinary ; Hepatitis E / virology ; Hepatitis E virus / genetics ; Hepatitis E virus / immunology ; Hepatitis E virus / isolation & purification ; Humans ; Prevalence ; Seroepidemiologic Studies ; Sus scrofa / blood ; Sus scrofa / virology ; Zoonoses / epidemiology ; Zoonoses / virology
Departments: Katedra za internu medicinu
Katedra za medicinsku mikrobiologiju i parazitologiju
Depositing User: Kristina Berketa
Status: Published
Dinjar-Kujundžić, PetraUNSPECIFIED
Jemeršić, LorenaUNSPECIFIED
Savić, VladimirUNSPECIFIED
Stevanović, VladimirUNSPECIFIED
Vilibić-Čavlek, TatjanaUNSPECIFIED
Date: 7 July 2019
Date Deposited: 27 Jan 2020 12:50
Last Modified: 27 Jan 2020 12:50
Subjects: /
Related URLs:
URI: http://medlib.mef.hr/id/eprint/3556

Actions (login required)

View Item View Item


Downloads per month over past year