[A man who contracted hepatitis E in the Netherlands]

Area of Science:

• Hepatology
• Infectious Diseases
• Virology

Background:

• Hepatitis E virus (HEV) infection is typically associated with travel to endemic tropical or subtropical regions.
• Transmission occurs via the fecal-oral route, often through contaminated water or food.
• HEV infection is rare in the Netherlands, but autochthonous cases have been reported since 2000.

Observation:

• A 55-year-old man presented with jaundice and cholestatic liver function impairment after returning from Surinam.
• Serological tests revealed IgG and IgM antibodies to HEV, and serum PCR confirmed the infection.
• Despite the travel history, the incubation period suggested the infection was acquired locally in the Netherlands.

Findings:

• The patient experienced spontaneous recovery from the HEV infection.
• The case highlights the possibility of HEV acquisition within the Netherlands, potentially through zoonotic transmission.
• Diagnosis was confirmed through serological detection of HEV-specific IgM and IgG antibodies and PCR.

Implications:

• HEV infection should be considered in patients with acute hepatitis of unknown origin, even without a travel history to endemic areas.
• Increased awareness of non-travel-associated HEV cases is crucial for timely diagnosis and management.
• Further investigation into potential zoonotic transmission routes in non-endemic regions is warranted.