Hepatitis E Disease Emerges from Rats in the First Time in History
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In 2018 an unidentified patient was observed by infectious disease specialists at Hong Kong University. The 56-year-old man, who had undergone a liver transplant, showed no apparent reason for abnormal liver functions. Tests found that his immune system was responding to hepatitis E — but the human strain of the hepatitis E virus (HEV) could not actually be found in his blood. Hepatitis E is a disease of the liver that can cause fever, jaundice and an enlarged liver too. The virus occurs in four species that circulate in various animals; at that time, only one of these four is known to infect humans.
The researchers updated the diagnostic test with tests for the human HEV-negative strain, tested it again — and detected rat hepatitis E in a person for the first time in history.
Siddharth Sridhar, a microbiologist who made the discovery, and one of the researchers at HKU.
But it did happen again then. And then again. 10 more Hong Kong residents have been tested positive with rat hepatitis E, also recognized as rat HEV, since the first study. The new case came around a week ago; on April 30 a 61-year-old man with impaired liver function tested positive. And there may be hundreds of more undiagnosed infected people out there, Sridhar said.
According to the World Health Organisation, the human strain of hepatitis E is usually transmits via faecal potable water contamination. But the rat strain raises a new mystery: no one knows precisely how sick these people are. The exact route of transmission from rats to humans to find by researchers in the two years after the discovery. The ideas may say the patients drinking polluting water like the normal human strain, or treat polluting items — but nothing shows to be conclusive.
61-Year-old Patient Stumps Officials
The recent 61-year-old patient has especially stumped authorities; there are no rats or rat excrements in his home, no one else in his household shows symptoms, and he is no recent history of travel.
The man is now in hospital and there is a pending inquiry by the CHP. Since 2018 the study team and the city authorities have sought to better grasp this emerging threat to health. They made some headway. Their diagnostic tests refine and improve. They have spread awareness among the healthcare sector so doctors know how to check for rat HEV, and have launched campaigns for public awareness.
Scientists are studying citywide rat populations to try to locate clusters before they can leap to humans, which gave data on how many city rodents bear rat HEV and which neighbourhoods have the most rats. Yet much remains unexplained as yet. They don’t know how long the incubation period of this virus is — which means how long it takes for patients to become sick after exposure. They are also seeking to find a cure, as the medication always had to treat the human form of hepatitis E has seen inconsistent outcomes on rat HEV patients. And the biggest unknown which continues to plague scientists, of course, is how.
Data Shows the Rats to Humans Transmission
Not understanding how the virus jumps through rats to humans makes avoiding more infections very difficult. Or even making sense of all the data researchers that have gathered. For example, people living in rat-infested areas would be at higher risk theoretically. But some infected patients come from barrios with low rat numbers.
One answer may be to also get rid of all the Hong Kong rats. But the eradication of rats is a long, complicates process that is not very feasible. It will entail a reduction in the places they can shelter as well as their access to food. It is with steps such as stopping the discarding of food in back alleys.
For now, all authorities should advise people to take preventive steps. It is such as washing their hands before eating, storing food properly or in the refrigerator. It is keeping the household clean and disinfected for rodents with limited nesting places.