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Laboratory-based surveillance for hepatitis E virus infection, United States, 2005-2012.
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MedLine Citation:
PMID:  23347695     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
To investigate characteristics of hepatitis E cases in the United States, we tested samples from persons seronegative for acute hepatitis A and B whose clinical specimens were referred to the Centers for Disease Control and Prevention during June 2005-March 2012 for hepatitis E virus (HEV) testing. We found that 26 (17%) of 154 persons tested had hepatitis E. Of these, 15 had not recently traveled abroad (nontravelers), and 11 had (travelers). Compared with travelers, nontravelers were older (median 61 vs. 32 years of age) and more likely to be anicteric (53% vs. 8%); the nontraveler group also had fewer persons of South Asian ethnicity (7% vs. 73%) and more solid-organ transplant recipients (47% vs. 0). HEV genotype 3 was characterized from 8 nontravelers and genotypes 1 or 4 from 4 travelers. Clinicians should consider HEV infection in the differential diagnosis of hepatitis, regardless of patient travel history.
Authors:
Jan Drobeniuc; Tracy Greene-Montfort; Ngoc-Thao Le; Tonya R Mixson-Hayden; Lilia Ganova-Raeva; Chen Dong; Ryan T Novak; Umid M Sharapov; Rania A Tohme; Eyasu Teshale; Saleem Kamili; Chong-Gee Teo
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Emerging infectious diseases     Volume:  19     ISSN:  1080-6059     ISO Abbreviation:  Emerging Infect. Dis.     Publication Date:  2013 Feb 
Date Detail:
Created Date:  2013-01-25     Completed Date:  2013-07-01     Revised Date:  2013-07-11    
Medline Journal Info:
Nlm Unique ID:  9508155     Medline TA:  Emerg Infect Dis     Country:  United States    
Other Details:
Languages:  eng     Pagination:  218-22; quiz 353     Citation Subset:  IM    
Affiliation:
Centers for Disease Control and Prevention, Atlanta, GA 30333, USA. jqd6@cdc.gov
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Antibodies, Viral / blood
Epidemiological Monitoring
Female
Genes, Viral
Hepatitis E / blood,  diagnosis*,  epidemiology,  immunology
Hepatitis E virus / genetics*,  immunology
Humans
Male
Middle Aged
Phylogeny
Prevalence
RNA, Viral / blood
Sequence Analysis, DNA
Travel
United States / epidemiology
Young Adult
Chemical
Reg. No./Substance:
0/Antibodies, Viral; 0/RNA, Viral
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Full Text
Journal Information
Journal ID (nlm-ta): Emerg Infect Dis
Journal ID (iso-abbrev): Emerging Infect. Dis
Journal ID (publisher-id): EID
ISSN: 1080-6040
ISSN: 1080-6059
Publisher: Centers for Disease Control and Prevention
Article Information
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Print publication date: Month: 2 Year: 2013
Volume: 19 Issue: 2
First Page: 218 Last Page: 222
PubMed Id: 23347695
ID: 3563276
Publisher Id: 12-0961
DOI: 10.3201/eid1902.120961

Laboratory-based Surveillance for Hepatitis E Virus Infection, United States, 2005–2012 Alternate Title:Hepatitis E Virus Infection, United States, 2005–2012
Jan Drobeniuc
Tracy Greene-Montfort
Ngoc-Thao Le
Tonya R. Mixson-Hayden
Lilia Ganova-Raeva
Chen Dong
Ryan T. Novak
Umid M. Sharapov
Rania A. Tohme
Eyasu Teshale
Saleem Kamili
Chong-Gee Teo
Author affiliation: Centers for Disease Control and Prevention, Atlanta, GA, USA
Correspondence: Address for correspondence: Jan Drobeniuc, Centers for Disease Control and Prevention, 1600 Clifton Rd NE, Mailstop A33, Atlanta, GA 30333; email: jqd6@cdc.gov

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Article Title: 
Laboratory-based Surveillance for Hepatitis E Virus Infection, United States, 2005–2012

CME Questions

1. You are a consultant advising an HMO regarding the percentage of hepatitis E among US patients with hepatitis. Based on the study by Dr. Drobeniuc and colleagues, which of the following statements would most likely appear in your report?

A. Hepatitis E was present in more than half of patients who were seronegative for acute hepatitis A and B

B. Among patients with hepatitis E, only one quarter had recently traveled abroad

C. Among patients with hepatitis E, half the patients had acute and half the patients had chronic hepatitis

D. Hepatitis E virus (HEV) infection was determined by testing for IgM and IgG anti-HEV and for HEV RNA

2. Based on the study by Dr. Drobeniuc and colleagues, which of the following statements about group characteristics of nontravelers vs travelers with hepatitis E is most likely correct?

A. Nontravelers were older than travelers

B. Nontravelers were more likely than travelers to be jaundiced

C. Nontravelers comprised fewer South Asians than travelers

D. Nontravelers were less likely than travelers to be solid organ transplant recipients

3. Based on the study by Dr. Drobeniuc and colleagues, which of the following statements about HEV genotypes among nontravelers vs travelers with hepatitis E is most likely correct?

A. Nontravelers were infected exclusively by HEV genotype 1 strains

B. Nontravelers were infected by HEV genotype 3 and 4 strains

C. Travelers were infected exclusively by HEV genotype 3 strains

D. The findings suggest that the nontravelers were infected by HEV that was circulating autochthonously in the United States.


Activity Evaluation

Notes

Suggested citation for this article: Drobeniuc J, Greene-Montfort T, Le N-T, Mixson-Hayden TR, Ganova-Raeva L, Dong C, et al. Laboratory-based surveillance for hepatitis E virus infection, United States, 2005–2012. Emerg Infect Dis [Internet]. 2013 Feb [date cited]. http://dx.doi.org/10.3201/eid1902.120961


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Article Categories:
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Keywords: Keywords: jaundice, incidence, infectious disease transmission, travel, immunocompromised host, diagnostic techniques, hepatitis E, hepatitis E virus, HEV, Unites States, differential diagnosis, travel-related infections, surveillance, viruses.

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