Travel-related hepatitis E: a two-decade GeoSentinel analysis

Area of Science:

• Global Health
• Infectious Diseases
• Travel Medicine

Background:

• Hepatitis E virus (HEV) is a significant global pathogen, endemic in many developing nations.
• While national data on travel-related HEV exist, comprehensive global epidemiological data are lacking.
• The availability of HEV diagnostic testing worldwide remains largely unexplored.

Purpose of the Study:

• To investigate the epidemiology of HEV infections in international travelers.
• To assess the global availability and accessibility of HEV diagnostic testing within the GeoSentinel surveillance network.

Main Methods:

• A multicenter, retrospective, cross-sectional study of HEV infections reported in the GeoSentinel Network (1999-2018).
• A survey of GeoSentinel sites to evaluate HEV diagnostic procedures (serology and molecular tests) availability and accessibility during the study period.

Main Results:

• 165 travel-related HEV infections were identified, predominantly since 2010 and among tourists.
• South Asia was the primary region of exposure (62%), with 27 countries reporting cases.
• Access to HEV serology was available locally in 73% of responding sites, while 55% had access to molecular diagnostics.

Conclusions:

• Suboptimal access to HEV diagnostic testing may impede timely diagnosis and management of infections.
• Pre-travel consultations emphasizing food and water precautions are crucial for travelers to high-prevalence areas like South Asia.
• Enhancing HEV diagnostic capacity is essential for effective prevention and accurate diagnosis of travel-related HEV infections.