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The first case of hepatitis E virus infecting a human was discovered in a 56-year-old man from the city, revealed the Hong Kong University on Thursday night.
The case arose when the patient – who had undergone a liver transplant last May 14 at Queen Mary University Hospital and was on immunosuppressive medication – had unusually persistent liver function tests. This indicated problems with his liver transplant.
Additional tests showed that he was carrying a species of hepatitis virus that, until then, was only present in the rat and was "very divergent" from the strain affecting the man.
The man was living in a subdivision "with evidence of infestation of rats in garbage cans outside his home," said HKU researchers who studied the case.
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"We postulate that contamination of food by infected rat feces in the food supply is possible," they said in a report, although they noted that the route of transmission of the virus remained unclear.
The man, a resident of Choi Wan Estate, had noticed rodent feces but had not seen rats inside his house, according to the report. Tests on rodent feces, swab specimens from the drain and floor of the waste room, and even rats from the area, gave negative results for hepatitis E in the rat.
However, frozen samples of a rat taken by food and environmental health authorities in the district in 2012 proved to be carriers of the virus.
The patient was treated with an oral medication called ribavirin and recovered.
Hong Kong has experienced rodent infestations during its hot, humid summers, and the Hygiene Authority has produced a rodent infestation index for 18 years in the areas it manages.
Last year, the rate of rodent infestation (RIR) for the city as a whole was 3.5%, compared to 4% for the same period a year earlier. But officials admitted that the RIR may not fully reflect the situation in the different districts.
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Prior to this case, there was no prior evidence that rat hepatitis E, one of the variants of the virus affecting mammals, could be transmitted to humans.
About 20 million people worldwide suffer from a hepatitis E strain transmitted by food or water contaminated with faeces containing pathogens. Patients also contracted the virus by eating undercooked meat from infected animals and by blood transfusions from infected donors.
Symptoms of infection with the hepatitis E virus include fever, decreased appetite, abdominal pain and jaundice. In rare cases, it could lead to acute liver failure and death.
The details of the study, led by Professor Yuen Kwok-yung and Dr. Siddharth Sridhar of the University's Department of Microbiology, will be published in the medical journal. Emerging infectious diseases in December.
HKU will hold a press conference Friday afternoon to learn more about the case.
In early summer, Hong Kong faced a rampant rodent problem, with screening officers recording double-digit growth in demand for services in recent months. Facebook messages from Tseung Kwan O, Ma On Shan and Ho Man Tin users showed images of rats or mice caught on glue boards or exploring packaged foods in supermarket refrigerators.
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