Transfusion-transmitted hepatitis E caused by apparently indigenous hepatitis E virus strain in Hokkaido, Japan

Authors

  • Keiji Matsubayashi,

    Corresponding author
    1. From the Hokkaido Red Cross Blood Center, Sapporo; the Department of Internal Medicine, Nikko Memorial Hospital, Muroran; the Department of Medical Sciences, Toshiba General Hospital, Tokyo; the Department of Microbiology, Kanagawa Prefectural Public Health Laboratory, Chigasaki; and the Department of Virology II, National Institute of Infectious Diseases, Tokyo, Japan.
    Search for more papers by this author
  • Yasuhiro Nagaoka,

    1. From the Hokkaido Red Cross Blood Center, Sapporo; the Department of Internal Medicine, Nikko Memorial Hospital, Muroran; the Department of Medical Sciences, Toshiba General Hospital, Tokyo; the Department of Microbiology, Kanagawa Prefectural Public Health Laboratory, Chigasaki; and the Department of Virology II, National Institute of Infectious Diseases, Tokyo, Japan.
    Search for more papers by this author
  • Hidekatsu Sakata,

    1. From the Hokkaido Red Cross Blood Center, Sapporo; the Department of Internal Medicine, Nikko Memorial Hospital, Muroran; the Department of Medical Sciences, Toshiba General Hospital, Tokyo; the Department of Microbiology, Kanagawa Prefectural Public Health Laboratory, Chigasaki; and the Department of Virology II, National Institute of Infectious Diseases, Tokyo, Japan.
    Search for more papers by this author
  • Shinichiro Sato,

    1. From the Hokkaido Red Cross Blood Center, Sapporo; the Department of Internal Medicine, Nikko Memorial Hospital, Muroran; the Department of Medical Sciences, Toshiba General Hospital, Tokyo; the Department of Microbiology, Kanagawa Prefectural Public Health Laboratory, Chigasaki; and the Department of Virology II, National Institute of Infectious Diseases, Tokyo, Japan.
    Search for more papers by this author
  • Kanji Fukai,

    1. From the Hokkaido Red Cross Blood Center, Sapporo; the Department of Internal Medicine, Nikko Memorial Hospital, Muroran; the Department of Medical Sciences, Toshiba General Hospital, Tokyo; the Department of Microbiology, Kanagawa Prefectural Public Health Laboratory, Chigasaki; and the Department of Virology II, National Institute of Infectious Diseases, Tokyo, Japan.
    Search for more papers by this author
  • Toshiaki Kato,

    1. From the Hokkaido Red Cross Blood Center, Sapporo; the Department of Internal Medicine, Nikko Memorial Hospital, Muroran; the Department of Medical Sciences, Toshiba General Hospital, Tokyo; the Department of Microbiology, Kanagawa Prefectural Public Health Laboratory, Chigasaki; and the Department of Virology II, National Institute of Infectious Diseases, Tokyo, Japan.
    Search for more papers by this author
  • Kazuaki Takahashi,

    1. From the Hokkaido Red Cross Blood Center, Sapporo; the Department of Internal Medicine, Nikko Memorial Hospital, Muroran; the Department of Medical Sciences, Toshiba General Hospital, Tokyo; the Department of Microbiology, Kanagawa Prefectural Public Health Laboratory, Chigasaki; and the Department of Virology II, National Institute of Infectious Diseases, Tokyo, Japan.
    Search for more papers by this author
  • Shunji Mishiro,

    1. From the Hokkaido Red Cross Blood Center, Sapporo; the Department of Internal Medicine, Nikko Memorial Hospital, Muroran; the Department of Medical Sciences, Toshiba General Hospital, Tokyo; the Department of Microbiology, Kanagawa Prefectural Public Health Laboratory, Chigasaki; and the Department of Virology II, National Institute of Infectious Diseases, Tokyo, Japan.
    Search for more papers by this author
  • Mitsunobu Imai,

    1. From the Hokkaido Red Cross Blood Center, Sapporo; the Department of Internal Medicine, Nikko Memorial Hospital, Muroran; the Department of Medical Sciences, Toshiba General Hospital, Tokyo; the Department of Microbiology, Kanagawa Prefectural Public Health Laboratory, Chigasaki; and the Department of Virology II, National Institute of Infectious Diseases, Tokyo, Japan.
    Search for more papers by this author
  • Naokazu Takeda,

    1. From the Hokkaido Red Cross Blood Center, Sapporo; the Department of Internal Medicine, Nikko Memorial Hospital, Muroran; the Department of Medical Sciences, Toshiba General Hospital, Tokyo; the Department of Microbiology, Kanagawa Prefectural Public Health Laboratory, Chigasaki; and the Department of Virology II, National Institute of Infectious Diseases, Tokyo, Japan.
    Search for more papers by this author
  • Hisami Ikeda

    1. From the Hokkaido Red Cross Blood Center, Sapporo; the Department of Internal Medicine, Nikko Memorial Hospital, Muroran; the Department of Medical Sciences, Toshiba General Hospital, Tokyo; the Department of Microbiology, Kanagawa Prefectural Public Health Laboratory, Chigasaki; and the Department of Virology II, National Institute of Infectious Diseases, Tokyo, Japan.
    Search for more papers by this author

Keiji Matsubayashi, MS, Hokkaido Red Cross Blood Center, 2-2 Yamanote, Nishi-ku, Sapporo, Japan 063-0002; e-mail: kmatsu@hokkaido.bc.jrc.or.jp.

Abstract

BACKGROUND:  In industrialized countries, sporadic cases of hepatitis E have been reported in individuals who have never been in an endemic area. Hepatitis E virus (HEV) infection commonly occurs via the fecal-oral route but a potential risk of transfusion transmission route has been suggested.

STUDY DESIGN AND METHODS:  A 67-year-old Japanese male patient who had never been abroad received a transfusion of blood from 23 voluntary donors and developed acute hepatitis with unknown etiology after transfusion. His blood samples were tested for viral markers of hepatitis viruses.

RESULTS:  HAV, HBV, HCV, CMV, and EBV were ruled out as causative agents in this case. The patient's blood sample in the acute phase contained HEV RNA as well as IgM and IgG anti-HEV. HEV RNA was also detected in one of the FFP units transfused. The donor had no history of traveling abroad and had a normal ALT level at the time of donation. The PCR products from the patient and the donor showed complete identity for two distinct regions of HEV within open reading frame 1.

CONCLUSION:  The patient was infected with HEV via transfused blood from a volunteer donor. A potential risk of posttransfusion hepatitis E should be considered even in nonendemic countries.

Ancillary