Seroepidemiology of a second epidemic of hepatitis E in a population that had recorded first epidemic 30 years before and has been under surveillance since then.

摘要

PURPOSE: Large-scale waterborne epidemics of hepatitis E occur in developing countries. It is not known why these epidemics occur repeatedly and selectively in adult population? METHODS: We studied seroepidemiology of an outbreak of hepatitis E in one of 15 villages that had recorded first epidemic of hepatitis E 30 years back. Another village not affected by the second epidemic was taken as a control. Overall, 1,216 sera were collected (638 from the epidemic village and 578 from the control village) for serological markers of both hepatitis A virus (HAV) and hepatitis E virus (HEV). RESULTS: The seroprevalence of anti-HEV in this population following the first epidemic in 1978 was 29.4%. Antibodies were detected in only 47% of the 45 patients affected by icteric HEV infection 14 years after the first epidemic. At 30-year follow-up, the seroprevalence of anti-HEV was only 4.5% (26/578). In the village affected by second epidemic, 138 (21.6%) subjects had serological evidence of recent HEV infection. The attack rate was 23.6% (78/330) in children (