Clinical Gastroenterology Vol.21 No.5(4-3)

Theme Update on Hepatitis E
Title Consumption of Uncooked Deer Meat as Risk Factor for Hepatitis E Virus Infection
Publish Date 2006/05
Author Naoto Kitajima Department of Internal Medicine, Kasai City Hospital
Author Shuchin Tei Department of Gastroenterology and Hepatology, Shimane University School of Medicine
Author Yoshikazu Kinoshita Department of Gastroenterology and Hepatology, Shimane University School of Medicine
Author Kazuaki Takahashi Department of Medical Sciences, Toshiba General Hospital
Author Natsumi Abe Department of Medical Sciences, Toshiba General Hospital
Author Shunji Mishiro Department of Medical Sciences, Toshiba General Hospital
[ Summary ] Zoonosis has been suggested as a causative factor for hepatitis E virus (HEV) infection. However, this assumption is based only on indirect evidence. We recently experienced a series of hepatitis E cases that occurred in those who had eaten uncooked deer meat 6 - 7 weeks before. A leftover portion of the deer meat tested positive for HEV RNA, the nucleotide sequence of which was identical to those from the patients. We attempted to clarify whether eating uncooked deer meat is a major epidemiological risk factor for HEV infection. Forty five volunteer subjects who had eaten raw deer meat were enrolled in our study. An equivalent number of people from the same area who had never eaten raw deer meat served as control subjects. Eight (17.8 %) of the subjects but only one (2.2 %) of the controls had measurable serum anti-HEV IgG levels (p = 0.014). Finally, we undertook a survey to see if wild deer might be an HEV reservoir. Of 179 deers, only one liver (0.6 %) was positive for HEV RNA. These findings provide the first direct evidence for HEV infection being related to zoonosis, and suggest that HEV is rarely positive in wild deer in this region. However, eating uncooked deer meat is an epidemiological risk factor for HEV infection in the area studied.
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