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In Hong Kong, mysterious rat hepatitis E continues to spread

In Hong Kong, several patients tested positive for rat hepatitis E. This virus therefore seems to be able to be transmitted from animals to humans, but researchers still do not know how. And the cases are multiplying.

It all started in 2018 when a 56-year-old man from Hong Kong, who had just undergone a major liver transplant, began to show abnormal liver functions, without that doctors can understand the origin. Tests finally showed that the patient suffered from hepatitis E. However, no human strain of the virus was found in his body . New tests then made it possible to isolate another strain, which rats usually carry.

At the time, doctors assumed that this was an isolated case. However, since this first case, ten others have been reported , still in Hong Kong (and one in Canada in 2019). The most recent testimony of infection dates from April 30, involving a 61-year-old patient. Doctors now believe there could be hundreds more that have gone unnoticed. A report has also been sent to the World Health Organization (WHO), proof that the threat is now taken very seriously by the health authorities.

Hepatitis E:symptoms and routes of transmission

Hepatitis E (HEV) is a disease caused by a virus transmitted by the faecal-oral route, mainly in developing countries, where the level of hygiene is low. However, since the early 2000s, it has appeared in industrialized countries. Worldwide, it is estimated that this disease affects 20 million people each year, leading to the death of 44,000 of them.

Most often the disease is mild, but it can sometimes be manifested by symptoms such as jaundice, headache, nausea and vomiting, muscle pain, significant fatigue, or even dark urine.

Hepatitis E is transmitted mainly through the consumption of unsafe water, food infected by contaminated water (shellfish, fruit and vegetables) or products made from an animal carrying the virus (pig, wild boar or rabbit). In France, the virus is transmitted to humans mainly through the consumption of undercooked pork.

In Hong Kong, mysterious rat hepatitis E continues to spread

Many unanswered questions

This strain isolated in Hong Kong, which rats carry (rat HEV), had never been transmitted to humans until recently. This is why researchers are still in the dark. Is the mode of transmission similar? Unable to answer at this time. Especially since, concerning the most recent case at least, the investigation did not isolate any rats or droppings from these rodents in the patient's house. He is also the only one in his household to have been infected.

In addition to this question, there are also other questions:how long is the incubation period? How to effectively treat the sick? In these ten cases, the drugs normally used to treat hepatitis were used, but they had uneven results.

While waiting to find answers, the Hong Kong authorities have launched awareness campaigns. Rat populations are now being tested in order to be able to detect the famous "clusters" that are so much talked about in the context of the Covid-19 pandemic, and thus slow the spread of the disease to humans.

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