The WHO states that there are 20 million hepatitis E infections, over three million acute cases of hepatitis E, and 57 000 hepatitis E-related deaths every year. Both foodborne and environmental transmission of Hepatitis E virus (HEV) play a major role. Van der Poel (CVI) reviewed several HEV transmission routes, infection doses and differences between genotypes.
Hepatitis E virus can infect humans through the consumption of products of infected animals and bivalve molluscs. Infected animals can also spread the virus via faeces and urine; and via run-offs such excretion may contaminate surface water. In addition, consumption of contaminated water or vegetable products irrigated with contaminated water can play a role in transmission of the virus to humans and animals. Direct transmission of HEV between people is possible via blood transfusion or solid organ transplantation.
It is important to determine at what points in the potential transmission routes HEV reaches sufficiently high doses to cause infection and clinical disease. Tests on HEV are needed all along food production chains and in environmental samples. Because different genotypes have different transmission routes HEV genotyping is also of high significance.
Wim H. M. van der Poel. Food and Environmental Routes of Hepatitis E Virus Transmission. Current Opinion in Virologie, 2014, 4:1–6