Epidemic of hepatitis E in a military unit in Abbottabad, Pakistan

被引:47
作者
Bryan, JP
Iqbal, M
Tsarev, S
Malik, IA
Duncan, JF
Ahmed, A
Khan, A
Khan, A
Rafiqui, AR
Purcell, RH
Legters, LJ
机构
[1] Uniformed Serv Univ Hlth Sci, Dept Prevent Med & Biometr, Bethesda, MD 20814 USA
[2] Pakistan US Lab Seroepidemiol, Rawalpindi, Pakistan
[3] NIAID, Hepatitis Viruses Sect, Infect Dis Lab, NIH, Bethesda, MD 20892 USA
关键词
D O I
10.4269/ajtmh.2002.67.662
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
An outbreak of hepatitis caused by hepatitis E virus (HEV) in Abbottabad, Pakistan was traced to fecal contamination of a water system. Of 109 men hospitalized with hepatitis, 104 (95%) had serologic evidence of acute hepatitis E (IgM antibody to HEV [anti-HEV]), three (3%) probably had acute hepatitis E (high titers of IgG anti-HEV without IgM), and two had acute hepatitis A. Among a subset of 44 men with acute hepatitis E from whom three serum specimens were obtained over a four-month period, the anti-HEV IgG geometric mean titers (GMTs) decreased from 1 519 during the outbreak to 657 at four months. The IgM anti-HEV was detected in 40 (91%) of 44 sera obtained at admission (GMT = 533 during acute disease). but in only six (14%) four months later. The prevalence of anti-HEV in this population before the outbreak was estimated to e 30%. The presence of IgG anti-HEV appeared to protect against clinical hepatitis or development of serologic evidence of new infection with HEV. This is the second major epidemic of hepatitis E in the Pakistani military confirmed by an anti-HEV enzyme-linked immunosorbent assay (ELISA). Evidence that pre-existing antibody as measured by this ELISA protects against disease is important for assessment of vaccine development.
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页码:662 / 668
页数:7
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