Hepatitis E from rats: a new public health threat in Europe?

Abstract

Hepatitis E virus is a leading cause of hepatitis globally, affecting both humans and a wide range of animal species. Recent studies have brought attention to Rocahepevirus ratti (ratHEV), a zoonotic variant of HEV initially believed to infect only rodents. The discovery of human cases caused by ratHEV highlights its emerging public health significance. This virus has been documented in various regions, with Asia reporting the highest prevalence, followed by Europe, the Americas, and a single case in Africa. Rodents, particularly rats, act as primary reservoirs, shedding the virus into the environment and facilitating transmission. Interactions with livestock, particularly pigs, and contamination of food or water are potential pathways for cross-species transmission. The detection of ratHEV in bivalve mollusks has further underscored its ecological versatility, highlighting the role of contaminated shellfish as a vehicle for zoonotic transmission. This raises significant food safety concerns due to the potential for human exposure through the consumption of raw or undercooked seafood. The emergence of ratHEV as a zoonotic pathogen emphasizes the need for comprehensive surveillance, improved diagnostic tools, and control measures in agricultural and aquatic systems.