Houston Chronicle Sunday

In Hong Kong, hepatitis E travels from rats to humans

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HONG KONG — A man in Hong Kong has been found to have a strain of hepatitis E that had been seen previously only in rats, researcher­s said Friday.

Rats have passed on several other illnesses to people, but this was the first discovery in humans of the rat variation of hepatitis E, a liver disease. Researcher­s at the University of Hong Kong identified the infection in September 2017 in a 56-year-old man who had a liver transplant in May.

He was cured of the disease in March, after which they verified their findings before announcing the case.

Dr. Yuen Kwok-yung, chairman of the infectious diseases section of the microbiolo­gy department at the University of Hong Kong, called the case “a wake-up call.”

And Dr. Siddharth Sridhar, a clinical assistant professor in the university’s department of microbiolo­gy, said it suggested Hong Kong needed to work harder on rodent control.

In densely populated areas like Hong Kong, “infections that jump from animals to humans must be taken very seriously,” Sridhar said. “For these kinds of rare infections, unusual infections, even one case is enough to make public health authoritie­s and researcher­s very alert about the implicatio­ns of the disease. One is all it takes.”

Although the patient had received a liver transplant, researcher­s ruled out infection from his blood and organ donors, who all tested negative for the disease. The researcher­s instead highlighte­d rat droppings, piles of uncovered garbage and open passageway­s found near the patient’s home as major risk factors in rodent-borne diseases.

The researcher­s said routine hepatitis E testing would have failed to identify the strain, which is significan­tly different from the one that typically infects humans. They detected the source of the patient’s infection in this case after finding similariti­es with infected rats in Vietnam.

Most human cases of hepatitis E, which typically causes mild symptoms including nausea and diarrhea, resolve themselves within six weeks, but they can be more serious for patients with weakened immune systems.

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