Standardising surveillance of hepatitis E virus infection in the EU/EEA: A review of national practices and suggestions for the way forward

Cornelia Adlhoch*, Zdenka Manďáková, Steen Ethelberg, Jevgenia Epštein, Ruska Rimhanen-Finne, Julie Figoni, Sally A. Baylis, Mirko Faber, Kassiani Mellou, Niamh Murphy, Joanne O'Gorman, Maria Elena Tosti, Anna Rita Ciccaglione, Agnetha Hofhuis, Hans Zaaijer, Heidi Lange, Rita de Sousa, Ana Avellón, Lena Sundqvist, Bengü SaidSamreen Ijaz

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

6 Citations (Scopus)

Abstract

Background: Hepatitis E virus (HEV) infection is not notifiable at EU/EEA level, therefore surveillance relies on national policies only. Between 2005 and 2015, more than 20,000 cases were reported in EU/EEA countries. HEV testing is established in 26 countries and 19 countries sequence HEV viruses. Objective and study design: WHO's European Action plan for viral hepatitis recommends harmonised surveillance objectives and case definitions. ECDC's HEV expert group developed minimal and optimal criteria for national hepatitis E surveillance to support EU/EEA countries in enhancing their capacity and to harmonise methods. Results: The experts agreed that the primary objectives of national surveillance for HEV infections should focus on the basic epidemiology of the disease: to monitor the incidence of acute cases and chronic infections. The secondary objectives should be to describe viral phylotypes or subtypes and to identify potential clusters/outbreaks and possible routes of transmission. Seventeen of 20 countries with existing surveillance systems collect the minimal data set required to describe the epidemiology of acute cases. Eleven countries test for chronic infections. Twelve countries collect data to identify potential clusters/outbreaks and information on possible routes of transmission. Discussion: Overall, the majority of EU/EEA countries collect the suggested data and meet the outlined requirements to confirm an acute case.

Original languageEnglish
Pages (from-to)63-67
Number of pages5
JournalJournal of Clinical Virology
Volume120
DOIs
Publication statusPublished - Nov 2019

Bibliographical note

Funding Information:
The authors would like to thank previous expert group members for their great commitment and support: Wilfrid van Pelt (Netherlands, until 2018), Lelia Thornton (Ireland, until 2018), Elisabeth Couturier (France, until 2018), ?gnes Feh?r (Hungary, until 2017), Rita Korotinska (Latvia), and Harry Dalton (United Kingdom). Representatives of the European Food Safety Authority (EFSA, Valentina Rizzi and Michaela Hempen) and the World Health Organization Regional Office for Europe (Antons Mozalevskis) were observers in this group. The work was supported by two service contracts No. ECD.7600 (HEV epidemiological support - NP/2017/OCS/253) and No. ID 5132: Hepatitis B, C, and E in the EU/EEA: monitoring and testing activities. Staff that were involved in the contracts: Esther Aspinall (Glasgow Caledonian University and Health Protection Scotland), Andrew Rideout (NHS Dumfries and Galloway), Chris Biggam (Glasgow Caledonian University), Gill Hawkins (Health Protection Scotland), and Alison Smith-Palmer (Health Protection Scotland). We would also like to acknowledge ECDC staff members who supported the project and critically reviewed all documents: Piotr Kramarz, Johanna Takkinen, and Phillip Zucs.

Funding Information:
The work was supported by two service contracts No. ECD.7600 (HEV epidemiological support - NP/2017/OCS/253) and No. ID 5132: Hepatitis B, C, and E in the EU/EEA: monitoring and testing activities. Staff that were involved in the contracts: Esther Aspinall (Glasgow Caledonian University and Health Protection Scotland), Andrew Rideout (NHS Dumfries and Galloway), Chris Biggam (Glasgow Caledonian University), Gill Hawkins (Health Protection Scotland), and Alison Smith-Palmer (Health Protection Scotland).

Publisher Copyright:
© 2019

Keywords

  • EU/EEA
  • Hepatitis E virus
  • Surveillance
  • Testing

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