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A case of infection with the human hepatitis E virus has been documented in Canada, the first to have been reported outside of Hong Kong.
The case, concerning a middle-aged Canadian who had visited Africa, showed that even healthy adults could become infected with rodent disease, said Professor Yuen Kwok-yung, principal expert in infectious diseases at the University of Hong Kong.
Yuen's team revealed the world's first two infections in humans in Hong Kong last year. Both patients had weakened immune systems and one of them lived in a public housing complex with a rat problem.
The Canadian patient, who was otherwise healthy, was carrying a strain of "genetically distinct" hepatitis E virus from that found in the first Hong Kong patient.
Rat hepatitis E: an "awakening" for Hong Kong to prepare for public hygiene
"[The case shows that] even if you are healthy, without immunosuppression, you can be very sick after contracting hepatitis E in the rat, "said Yuen, who was not involved in the case at Canada.
Dr. Siddharth Sridhar of HKU, who worked with Yuen on the Hong Kong cases, said that he was surprised to see the findings of the latest report.
"My conclusion, based on the two previous cases in Hong Kong, was that this infection was more likely to affect people whose immune systems were weakened," Sridhar said. "But this report showed that a normal patient who did not have low immunity could also be infected."
The details of the results were recently published online in the Infectious Diseases Journal.
The hepatitis E virus is transmitted primarily through the consumption of contaminated food and water. Although the infection usually goes away without treatment, it can be a serious disease in people with low immunity.
According to the report, the man, then 49, was admitted to a hospital in Halifax, Canada, in early April 2017 for severe acute hepatitis. He had symptoms such as hives and jaundice, and it was later discovered that he was carrying the hepatitis E virus.
One in 100 Hong Kong rats could carry the hepatitis virus that could infect humans
The man did not have a history of serious illness, with the exception of abnormal levels of lipids in the blood.
Before his condition, he was based at the United Nations premises in Gabon and the Democratic Republic of Congo between January and the end of March 2017.
The patient stated that he had no contact with rats, rat droppings or live animals during his stay in Africa.
He had eaten at the United Nations bases, his hotel and a local Indian restaurant. The report indicated that only United Nations bases would have adopted approved sanitary and cooking standards.
The researchers estimated that the man had been infected while working in African countries.
"There is no direct evidence linking the patient to the rat, which could imply an unknown secondary pathway," the report says, adding that new studies are needed to understand the mode of transmission. of the virus in humans.
The second case in the world of hepatitis E in rats has been reported in Hong Kong
Yuen said that the man could have been infected by eating food contaminated with rats.
The two experts from the HKU urged the public to take note of food and environmental hygiene, for example by eating well-cooked meals.
Sridhar advised travelers to pay attention to their food choices in countries where hygiene is less good. For example, he said, avoid eating ice-cold drinks with water from unknown sources and do not drink tap water.
A spokeswoman for the Public Health Agency of Canada, who participated in the review of the latest case to date, said the health risk of rat hepatitis for Canadians was considered weak.
"The hepatitis E virus, including the human form, is not common in Canada," she said in an email. To post.
The world's first case of hepatitis E in rats was reported at the end of September last year, about a 56-year-old man living on the Choi Wan estate in Kowloon.
The second case involved a 70-year-old woman who lived about 3 km from the first patient.
Infections have proven that rat hepatitis E can attack people, raising concerns in the city about pest control.
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