Rat hepatitis E case investigated in Hong Kong
Hong Kong health officials report investigating a case of human infection of rat Hepatitis E virus (HEV).
According to the Centre for Health Protection (CHP) of the Department of Health, the case involves a 61-year-old woman with underlying illnesses and immunosuppression. She had dark urine since early September and was found to have a persistently abnormal liver function during her follow-up consultation in Union Hospital. Her blood sample tested positive for rat HEV upon laboratory testing. The patient is now in stable condition.
The investigation revealed the patient is from Hung Hom. She claimed that she did not have direct contact with rodents or rats, and had no travel history during the incubation period, indicating that this is a locally acquired infection. The CHP does not rule out the possibility that the patient may have been indirectly exposed to places or food contaminated by rodents or their excreta during the incubation period, leading to the infection.
A site visit to the place where the patient lives shows some traces of rodents were found during the inspection. The property management of the patient's residence will set up thermal imaging cameras at the concerned places to conduct rodent activity survey.
Possible routes of transmission of rat HEV to humans include ingestion of food or water contaminated by rodents or their excreta, exposure to environments or objects contaminated by rodents or their excreta and direct contact with rodents or their excreta. The usual HEV causing human infection is transmitted mainly through the fecal-oral route.
To prevent Hepatitis E infection, members of the public should maintain good personal, food and environmental hygiene. For example, they should wash hands thoroughly before eating, store food properly or in the refrigerator, not leave food at room temperature for a long time, and use 1:99 diluted household bleach for general household cleaning and disinfection as household detergent may not be able to kill HEV. High-risk individuals, such as elderly persons with a major underlying illness (especially those who have undergone organ transplantation), pregnant women, patients with chronic liver disease and patients with Glucose-6-Phosphate Dehydrogenase Deficiency (also known as G6PD Deficiency), who are infected with HEV may develop a serious illness, so they should exercise extra caution.