Genotype-4 hepatitis E in a human after ingesting roe deer meat in South Korea

Abstract

The recent increase in the number of cases of indigenous hepatitis E virus (HEV) infection highlights the importance of identifying the transmission routes for the prevention of such infections. Presented herein is the first case of acute HEV infection after ingesting wild roe deer meat in South Korea. A 43-year-old male presented with abdominal discomfort and jaundice. He had not recently traveled abroad, but had eaten raw roe-deer meat 6-8 weeks before the presentation. On the 7th day of hospitalization the patient was diagnosed with acute viral hepatitis E. Phylogenetic analysis of his serum revealed genotype-4 HEV. This case supports the possibility of zoonotic transmission of HEV because the patient appears to have been infected with genotype-4 HEV after ingesting raw deer meat.

Keywords: Genotype 4 hepatitis E; Roe deer; South Korea.

Figure 1

Patient's clinical course with changes in ALT, TB and results of IgM / IgG anti-HEV. ALT, alanine aminotransferase; TB, total bilirubin; HEV, hepatitis E virus.

Figure 2

A phylogenetic tree constructed by the neighbor-joining method based on the ORF2 sequence of the Korean HEV in question, 2010-JKSH-CYY (HM769726), and 42 HEV reference strains with genotypes 1 - 4 (G1-G4). All strains were separated into four groups according to their genotype. H: isolated from humans; P: isolated from pigs. Sequence analysis was conducted using the software VectorNTI and MEGA 5.04. Bootstrap values are indicated for the major nodes as a percentage of the data obtained from 1000 resamplings.