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Hepatitis E seroconversion in United States travelers abroad
W W Ooi1, J M Gawoski, P O Yarbough
1Department of Laboratory Medicine, Lahey Clinic Medical Center, Burlington, Massachusetts 01805, USA.
The American Journal of Tropical Medicine and Hygiene
|December 10, 1999
Summary
Hepatitis E virus (HEV) exposure is a risk for US travelers, often resulting in subclinical infections. Antibody testing revealed four seroconversions, indicating infection acquired during travel without overt symptoms.
Area of Science:
- * Virology
- * Epidemiology
- * Immunology
Background:
- * Hepatitis E virus (HEV) infection is increasingly recognized in travelers returning from endemic areas.
- * Sporadic symptomatic cases have been reported in United States travelers to developing countries.
- * Understanding HEV exposure risk in travelers is crucial for public health.
Purpose of the Study:
- * To evaluate the risk of Hepatitis E virus exposure in United States travelers.
- * To identify seroconversions indicative of HEV infection acquired during travel.
- * To determine if HEV infections in travelers are typically symptomatic or subclinical.
Main Methods:
- * 356 US travelers attending Travel Clinics were tested for HEV antibodies (IgG and IgM) before and after travel.
- * HEV ELISA diagnostic kits utilizing recombinant antigens from open reading frames 2 and 3 were employed.
- * Longitudinal sample analysis included specimens obtained before travel, 6 weeks post-travel, and 6 months post-travel.
Main Results:
- * Nine patients were initially IgG seropositive before travel.
- * Four individuals demonstrated HEV IgG seroconversion, confirmed at least 6 months after return.
- * HEV seroconversion occurred in travelers visiting diverse destinations including Thailand, China, Russia, and Peru.
- * Samples taken 6 weeks post-travel were negative for HEV in seroconverting patients, suggesting a delayed antibody response or subclinical infection.
- * None of the seropositive or seroconverting individuals reported hepatitis symptoms.
Conclusions:
- * Travel to various international destinations poses a risk of Hepatitis E virus exposure for US travelers.
- * HEV infection acquired during travel is frequently subclinical, without overt hepatitis symptoms.
- * Longitudinal antibody testing is essential to detect HEV seroconversions in travelers.