Epidemiology

Japanese deer meat can transmit hepatitis E virus

Last Updated: 2003-08-01 14:44:02 -0400 (Reuters Health)

NEW YORK (Reuters Health) - Four individuals who ate the raw meet of a Japanese deer (Sika deer) infected with hepatitis E virus (HEV) became infected themselves, Japanese investigators report in the August 2nd issue of The Lancet.

HEV has been detected in swine, cattle, goats and rodents, senior author Dr. Shunji Mishiro, of Toshiba General Hospital, Tokyo, and colleagues note, but evidence of zoonotic transmission to humans has been indirect.

They report that a 44-year-old man presented on April 16 with fever, nausea and malaise. Raised levels of liver enzymes and bilirubin led to a diagnosis of acute hepatitis. By the end of the month, three more patients -- two family members and a friend of the index case -- also presented with hepatitis. The patients were negative for hepatitis A, B and C viruses, but later testing revealed the presence of HEV RNA and elevated antibody levels to HEV.

Patient history revealed that all had eaten the meat of two wild Japanese deer three times during the 7 weeks preceding their diagnosis.

When Dr. Mishiro's group examined frozen portions, the meat of one was positive for HEV RNA. The RNA sequences from three patients and from the meat were identical, while the fourth patient's sequence differed by only one nucleotide.

The son of one of the men had also eaten a small portion of infected meat but remained uninfected.

"We suggest the Sika deer and consumption of its raw meat be added to the list of foods with a risk of transmitting HEV," the authors of the report conclude.

Lancet 2003;362:371-373.