Locally acquired hepatitis E virus infection, El Paso, Texas

Area of Science:

• Hepatology
• Virology
• Epidemiology

Background:

• Hepatitis E virus (HEV) is an enterically transmitted RNA virus responsible for epidemic and sporadic acute hepatitis.
• While HEV antibodies are prevalent in the US population (up to 36%), reported cases of acute hepatitis E without international travel history are rare.

Observation:

• This report details a case of acute hepatitis E in El Paso, Texas, with no travel history.
• The identified HEV strain showed 98% genetic similarity to a previously isolated HEV strain found in US swine.

Findings:

• Despite thorough investigation, no definitive source of HEV infection was identified for this patient.
• Active surveillance did not reveal additional cases in the region.

Implications:

• This case suggests a potential for locally-acquired hepatitis E in the United States, possibly linked to zoonotic transmission from swine.
• Further research is needed to understand the epidemiology and transmission routes of HEV within the US population.
• Enhanced surveillance may be necessary to detect and manage non-travel-associated hepatitis E cases.