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Archive Number 20090917.3267
Published Date 17-SEP-2009
Subject PRO/AH/EDR> Hepatitis E - France: (Marseille) pig liver sausage
HEPATITIS E - FRANCE: (MARSEILLE) PIG LIVER SAUSAGE
***************************************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>
Date: Thu 17 Sep 2009 [1st submitted mid-August]
From: Philipe Colson <philippe.colson@mail.ap-hm.fr>
8 autochthonous hepatitis E cases have been diagnosed since 2007 in
the microbiology laboratory of Timone Hospital in Marseille
(southeastern France) in individuals who ate raw figatellu, a
traditional sausage of Corsica, France. Figatelli are widely consumed
in France, and they are good candidates for hepatitis E virus (HEV)
transmission because they are made with pig liver and are commonly
eaten raw.
A case-control study revealed that acute or recent HEV infection was
significantly linked with consumption of raw figatellu. Moreover,
genotype 3 HEV sequences were recovered from 7 figatelli purchased in
supermarkets in southeastern France, and genetic links were found
between these sequences and those recovered from patients who ate raw
figatellu. In each case, the delay between figatellu consumption and
hepatitis onset was compatible with the incubation period of hepatitis
E.
Autochthonous hepatitis E is an emerging disease in industrialized
countries, but the source and route of HEV infections are not known in
most cases despite increasing evidence that it is a zoonosis with pigs
as reservoirs.
In France, more than 100 autochthonous cases are notified per year.
Most of them have occurred in the South, where HEV seroprevalence was
found to be higher than in the North (16.6 percent versus 3.4 percent)
and where 7 fatal cases have been reported. Our findings have been
notified to the French public health authorities, and since May 2009,
an official policy compels the manufacturers of pig liver sausages to
recommend cooking these sausages thoroughly. Indeed, it has been shown
that cooking HEV-containing food products limits their ability to
transmit infectious HEV.
--
Philippe Colson PharmD PhD
Pole des Maladies Infectieuses et Tropicales Clinique et Biologique,
Federation de Bacteriologie-Hygiene-Virologie,
Centre Hospitalo-Universitaire Timone, AP-HM,
264, rue Saint-Pierre 13385 Marseille cedex 5, France
<philippe.colson@ap-hm.fr>
&
Rene Gerolami MD PhD
Service d'Hepato-Gastro-Enterologie
Centre Hospitalo-Universitaire Conception
147 boulevard Baille, 13385 Marseille CEDEX 05, France
<rene.gerolami@ap-hm.fr>
[ProMED-mail thanks Drs Colson and Gerolami for drawing attention to
this unique example of food-borne transmission of hepatitis E virus
(HEV) infection. We regret an inadvertent delay in posting this
meticulous report.
Although humans have been considered the natural host for HEV,
antibodies to HEV or closely related viruses have been detected in
primates and several other animal species, domestic pigs in particular.
HEV is normally considered to be transmitted via the faecal-oral
route, and hepatitis E is usually regarded as a waterborne disease.
Consumption of faecally contaminated drinking water has been the cause
of most epidemics, but the ingestion of raw or uncooked shellfish has
been the source of sporadic cases in endemic areas. To this can now be
added the consumption of raw pig liver sausages (figatellu). Indeed,
any food product derived from pig liver should not be consumed
uncooked. - Mod.CP]
[See photo of figatelli at:
<http://iledebeaute.i.l.pic.centerblog.net/p6fd1zci.jpg>
- Mod.JW]
[see also:
2007
----
Hepatitis E, porcine carriers - UK (England) 20070218.0615
Hepatitis E, porcine carriers - Spain 20070215.0561]
...................................................cp/msp/jw
*##########################################################*
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ProMED-mail makes every effort to verify the reports that
are posted, but the accuracy and completeness of the
information, and of any statements or opinions based
thereon, are not guaranteed. The reader assumes all risks in
using information posted or archived by ProMED-mail. ISID
and its associated service providers shall not be held
responsible for errors or omissions or held liable for any
damages incurred as a result of use or reliance upon posted
or archived material.
************************************************************
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Archive Number 20090917.3267
Published Date 17-SEP-2009
Subject PRO/AH/EDR> Hepatitis E - France: (Marseille) pig liver sausage
HEPATITIS E - FRANCE: (MARSEILLE) PIG LIVER SAUSAGE
***************************************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>
Date: Thu 17 Sep 2009 [1st submitted mid-August]
From: Philipe Colson <philippe.colson@mail.ap-hm.fr>
8 autochthonous hepatitis E cases have been diagnosed since 2007 in
the microbiology laboratory of Timone Hospital in Marseille
(southeastern France) in individuals who ate raw figatellu, a
traditional sausage of Corsica, France. Figatelli are widely consumed
in France, and they are good candidates for hepatitis E virus (HEV)
transmission because they are made with pig liver and are commonly
eaten raw.
A case-control study revealed that acute or recent HEV infection was
significantly linked with consumption of raw figatellu. Moreover,
genotype 3 HEV sequences were recovered from 7 figatelli purchased in
supermarkets in southeastern France, and genetic links were found
between these sequences and those recovered from patients who ate raw
figatellu. In each case, the delay between figatellu consumption and
hepatitis onset was compatible with the incubation period of hepatitis
E.
Autochthonous hepatitis E is an emerging disease in industrialized
countries, but the source and route of HEV infections are not known in
most cases despite increasing evidence that it is a zoonosis with pigs
as reservoirs.
In France, more than 100 autochthonous cases are notified per year.
Most of them have occurred in the South, where HEV seroprevalence was
found to be higher than in the North (16.6 percent versus 3.4 percent)
and where 7 fatal cases have been reported. Our findings have been
notified to the French public health authorities, and since May 2009,
an official policy compels the manufacturers of pig liver sausages to
recommend cooking these sausages thoroughly. Indeed, it has been shown
that cooking HEV-containing food products limits their ability to
transmit infectious HEV.
--
Philippe Colson PharmD PhD
Pole des Maladies Infectieuses et Tropicales Clinique et Biologique,
Federation de Bacteriologie-Hygiene-Virologie,
Centre Hospitalo-Universitaire Timone, AP-HM,
264, rue Saint-Pierre 13385 Marseille cedex 5, France
<philippe.colson@ap-hm.fr>
&
Rene Gerolami MD PhD
Service d'Hepato-Gastro-Enterologie
Centre Hospitalo-Universitaire Conception
147 boulevard Baille, 13385 Marseille CEDEX 05, France
<rene.gerolami@ap-hm.fr>
[ProMED-mail thanks Drs Colson and Gerolami for drawing attention to
this unique example of food-borne transmission of hepatitis E virus
(HEV) infection. We regret an inadvertent delay in posting this
meticulous report.
Although humans have been considered the natural host for HEV,
antibodies to HEV or closely related viruses have been detected in
primates and several other animal species, domestic pigs in particular.
HEV is normally considered to be transmitted via the faecal-oral
route, and hepatitis E is usually regarded as a waterborne disease.
Consumption of faecally contaminated drinking water has been the cause
of most epidemics, but the ingestion of raw or uncooked shellfish has
been the source of sporadic cases in endemic areas. To this can now be
added the consumption of raw pig liver sausages (figatellu). Indeed,
any food product derived from pig liver should not be consumed
uncooked. - Mod.CP]
[See photo of figatelli at:
<http://iledebeaute.i.l.pic.centerblog.net/p6fd1zci.jpg>
- Mod.JW]
[see also:
2007
----
Hepatitis E, porcine carriers - UK (England) 20070218.0615
Hepatitis E, porcine carriers - Spain 20070215.0561]
...................................................cp/msp/jw
*##########################################################*
************************************************************
ProMED-mail makes every effort to verify the reports that
are posted, but the accuracy and completeness of the
information, and of any statements or opinions based
thereon, are not guaranteed. The reader assumes all risks in
using information posted or archived by ProMED-mail. ISID
and its associated service providers shall not be held
responsible for errors or omissions or held liable for any
damages incurred as a result of use or reliance upon posted
or archived material.
************************************************************
Become a ProMED-mail Premium Subscriber at
<http://www.isid.org/ProMEDMail_Premium.shtml>
************************************************************
Visit ProMED-mail's web site at <http://www.promedmail.org>.
Send all items for posting to: promed@promedmail.org
(NOT to an individual moderator). If you do not give your
full name and affiliation, it may not be posted. Send
commands to subscribe/unsubscribe, get archives, help,
etc. to: majordomo@promedmail.org. For assistance from a
human being send mail to: owner-promed@promedmail.org.
############################################################
############################################################