Description
Hepatitis E virus (HEV) is nowadays considered an emerging agent in industrialized countries, with an established zoonotic transmission through swines. In Portugal only a few geographically focused studies on HEV are available and no large-scale HEV seroprevalence studies have ever been done, no risk groups have been identified and the risk of blood donations from infected donors is unknown. Portugal is a pioneer in vaccination programs and a top example in Europe. To help maintain the leading position in vaccine preventable diseases, this project will generate data needed for the decision on the introduction of a HEV vaccine already available. The Portuguese population is expected to benefit from this project. The cooperation between Norway (donor) and Portugal (beneficiary) will provide mutual transfer of knowledge and innovation, supporting the network here established and envisioning future collaborations and projects that will promote the cohesion in the bilateral relations.
Summary of project results
Hepatitis E virus (HEV) is nowadays considered an emerging agent in industrialized countries, with an established zoonotic transmission through swine. In Portugal only a few geographically focused studies on HEV were available and no large-scale HEV seroprevalence study was ever been done. The project HEPeCONTROL was the first to provide a nation-wide serosurvey of HEV infection in Portugal, studying people from all regions from Portugal (from the north to the south, including islands of Madeira and Azores). The study revealed a 16% global HEV seroprevalence in the general population, which is similar to other European countries. Until this project no risk groups have been identified and the results available have shown that workers that are occupationally exposed to swine (WOES) –slaughterhouse workers, butchers, pig farmers, veterinarians – are a risk group for HEV infection when compared to the general population. The project HEPeCONTROL has also studied for the first time the risk of silent HEV infection in 2115 Portuguese blood donors, showing that the blood samples from this cohort were absent of HEV viraemia and were hence safe for this virus transmission. The project HEPeCONTROL has studied different commercial porcine-derived pharmaceutical products such as heparins, rotavirus vaccines and surfactants but, showing that these products were absent of HEV and were hence safe for this virus transmission. HEPeCONTROL has provided valuable data for future sustained Public Health interventions which can include vaccination, not only by providing for the first time important data on the prevalence of HEV infection in the Portuguese population and in the WOES, but also disclosing information on the safety of blood donations and porcine-derived pharmaceutics in Portugal, regarding the transmission of HEV. The information on the high seroprevalence found in the WOES group (36% vs 19% in general population), will be of good help on future decisions regarding the potential HEV vaccine introduction in this professional risk group. The knowledge of the HEV immunological profile of the Portuguese general population through the mapping of HEV seroprevalence according to the regions of Portugal allowed mapping the risk to HEV infection not only according to the age group and gender but also concerning the region of Portugal where they live. Since HEV transmission can be associated to rurality, as swine manipulation is a well-known risk factor for HEV viral introduction in the community, it has also addressed the problematic of social inequalities.
Summary of bilateral results
i) Internships by the scholarship recipients were made to the partners in Oslo (Norwegian University of Life Sciences and Norwegian Institute of Public Health) under the Bilateral Ralations Fund (FBR) where they gained knowledge on the laboratory techniques currently used by the partners. ii) Mette Myrmel (NMBU partner and expert in viral detection in complex matrices) has provided close supervision on the task related with the searching for HEV in porcine derived pharmaceutical products. Problems arising on this task (concerning the complexity of the matrices of pharmaceutical products) were surpassed not only by the internships of the young fellows in the NMBU but also due to Mette´s expertise. iii) NIPH has retested several samples sent from Portugal for confirmation of results. iv) The national partner João Mesquita (Instituto Politécnico de Viseu) has provided constant consultancy throughout the 4 tasks, having had direct contact with the PI for the full duration of the Project.