Skip to main content Accessibility help
×
Home

Bayesian estimation of hepatitis E virus seroprevalence for populations with different exposure levels to swine in The Netherlands

  • M. BOUWKNEGT (a1) (a2), B. ENGEL (a3), M. M. P. T. HERREMANS (a4), M. A. WIDDOWSON (a5), H. C. WORM (a6), M. P. G. KOOPMANS (a4), K. FRANKENA (a2), A. M. De RODA HUSMAN (a1), M. C. M. De JONG (a3) and W. H. M. VAN DER POEL (a1)...

Summary

Hepatitis E virus (HEV) is ubiquitous in pigs worldwide and may be zoonotic. Previous HEV seroprevalence estimates for groups of people working with swine were higher than for control groups. However, discordance among results of anti-HEV assays means that true seroprevalence estimates, i.e. seroprevalence due to previous exposure to HEV, depends on choice of seroassay. We tested blood samples from three subpopulations (49 swine veterinarians, 153 non-swine veterinarians and 644 randomly selected individuals from the general population) with one IgM and two IgG ELISAs, and subsets with IgG and/or IgM Western blots. A Bayesian stochastical model was used to combine results of all assays. The model accounted for imperfection of each assay by estimating sensitivity and specificity, and accounted for dependence between serological assays. As expected, discordance among assay results occurred. Applying the model yielded seroprevalence estimates of ~11% for swine veterinarians, ~6% for non-swine veterinarians and ~2% for the general population. By combining the results of five serological assays in a Bayesian stochastical model we confirmed that exposure to swine or their environment was associated with elevated HEV seroprevalence.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Bayesian estimation of hepatitis E virus seroprevalence for populations with different exposure levels to swine in The Netherlands
      Available formats
      ×

      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Bayesian estimation of hepatitis E virus seroprevalence for populations with different exposure levels to swine in The Netherlands
      Available formats
      ×

      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Bayesian estimation of hepatitis E virus seroprevalence for populations with different exposure levels to swine in The Netherlands
      Available formats
      ×

Copyright

Corresponding author

*Address for correspondence: Ir. M. Bouwknegt, Laboratory for Zoonoses and Environmental Microbiology (Pb. 63), National Institute of Public Health and the Environment, PO Box 1, NL-3720 BA Bilthoven, The Netherlands. (Email: martijn.bouwknegt@rivm.nl)

References

Hide All
1. Wong, DC, et al. Epidemic and endemic hepatitis in India: evidence for a non-A, non-B hepatitis virus aetiology. Lancet 1980; 2: 876879.
2. Emerson, SU, Purcell, RH. Hepatitis E virus. Reviews in Medical Virology 2003; 13: 145154.
3. Kumar, A, et al. Hepatitis E in pregnancy. International Journal of Gynaecology and Obstetrics 2004; 85: 240244.
4. Worm, HC, Van der Poel, WH, Brandstatter, G. Hepatitis E: an overview. Microbes and Infection 2002; 4: 657666.
5. Tei, S, et al. Zoonotic transmission of hepatitis E virus from deer to human beings. Lancet 2003; 362: 371373.
6. Yazaki, Y, et al. Sporadic acute or fulminant hepatitis E in Hokkaido, Japan, may be food-borne, as suggested by the presence of hepatitis E virus in pig liver as food. Journal of General Virology 2003; 84: 23512357.
7. Takahashi, K, et al. Complete or near-complete nucleotide sequences of hepatitis E virus genome recovered from a wild boar, a deer, and four patients who ate the deer. Virology 2004; 330: 501505.
8. Zanetti, AR, et al. Identification of a novel variant of hepatitis E virus in Italy. Journal of Medical Virology 1999; 57: 356360.
9. Widdowson, MA, et al. Cluster of cases of acute hepatitis associated with hepatitis E virus infection acquired in the Netherlands. Clinical Infectious Diseases 2003; 36: 2933.
10. Buti, M, et al. Sporadic cases of acute autochthonous hepatitis E in Spain. Journal of Hepatology 2004; 41: 126131.
11. Mansuy, JM, et al. Hepatitis E in the south west of France in individuals who have never visited an endemic area. Journal of Medical Virology 2004; 74: 419424.
12. Meng, XJ, et al. A novel virus in swine is closely related to the human hepatitis E virus. Proceedings of the National Academy of Sciences USA 1997; 94: 98609865.
13. Meng, XJ, et al. Genetic and experimental evidence for cross-species infection by swine hepatitis E virus. Journal of Virology 1998; 72: 97149721.
14. Hsieh, SY, et al. Identity of a novel swine hepatitis E virus in Taiwan forming a monophyletic group with Taiwan isolates of human hepatitis E virus. Journal of Clinical Microbiology 1999; 37: 38283834.
15. Drobeniuc, J, et al. Hepatitis E virus antibody prevalence among persons who work with swine. Journal of Infectious Diseases 2001; 184: 15941597.
16. Meng, XJ, et al. Prevalence of antibodies to hepatitis E virus in veterinarians working with swine and in normal blood donors in the United States and other countries. Journal of Clinical Microbiology 2002; 40: 117122.
17. Withers, MR, et al. Antibody levels to hepatitis E virus in North Carolina swine workers, non-swine workers, swine, and murids. American Journal of Tropical Medicine and Hygiene 2002; 66: 384388.
18. Ghabrah, TM, et al. Comparison of tests for antibody to hepatitis E virus. Journal of Medical Virology 1998; 55: 134137.
19. Mast, EE, et al. Evaluation of assays for antibody to hepatitis E virus by a serum panel. Hepatitis E Virus Antibody Serum Panel Evaluation Group. Hepatology 1998; 27: 857861.
20. Enoe, C, Georgiadis, MP, Johnson, WO. Estimation of sensitivity and specificity of diagnostic tests and disease prevalence when the true disease state is unknown. Preventive Veterinary Medicine 2000; 45: 6181.
21. Hui, SL, Walter, SD. Estimating the error rates of diagnostic tests. Biometrics 1980; 36: 167171.
22. Joseph, L, Gyorkos, TW, Coupal, L. Bayesian estimation of disease prevalence and the parameters of diagnostic tests in the absence of a gold standard. American Journal of Epidemiology 1995; 141: 263272.
23. Widdowson, MA, et al. Detection of serum antibodies to bovine norovirus in veterinarians and the general population in the Netherlands. Journal of Medical Virology 2005; 76: 119128.
24. Thrusfield, M. Veterinary Epidemiology, 2nd edn. Oxford: Blackwell Science, 1995, pp. 483.
25. Engel, B, et al. Estimation of sensitivity and specificity of three conditionally dependent diagnostic tests in the absence of a gold standard. Journal of Agricultural, Biological, and Environmental Statistics 2006; 11: 360380.
26. Spiegelhalter, D, et al. Winbugs user manual. Version 1.4.1, 2004 (http://www.mrc-bsu.cam.ac.uk/bugs). Accessed 17 January 2005.
27. Olsen, B, et al. Unexpected high prevalence of IgG-antibodies to hepatitis E virus in Swedish pig farmers and controls. Scandinavian Journal of Infectious Diseases 2006; 38: 5558.
28. Rutjes, SA, et al. Increased hepatitis E virus prevalence on Dutch pig farms from 33 to 55% by using appropriate internal quality controls for RT-PCR. Journal of Virological Methods. Published online: 23 February 2007. doi: 10.1016/j.jviromet.2007.1001.1.030.
29. Mathur, P, et al. Sero-epidemiology of hepatitis E virus (HEV) in urban and rural children of North India. Indian Pediatrics 2001; 38: 461475.
30. Zaaijer, HL, et al. Hepatitis E in The Netherlands: imported and endemic. Lancet 1993; 341: 826.
31. Herremans, M, et al. Swine-like hepatitis E viruses are a cause of unexplained hepatitis in the Netherlands. Journal of Viral Hepatitis 2007; 14: 140146.
32. Roitt, IM, Brostoff, J, Male, DK. Immunology, 4th edn. London: Mosby, 1995, pp. 416.

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed