High prevalence of hepatitis E and rat hepatitis E viruses in wastewater in Gothenburg, Sweden

Hepatitis E virus (HEV) and Rat Hepatitis E virus (RHEV), recognized for their zoonotic potential, pose significant public health concerns. Our previous research identified both viruses in effluent wastewater in Gothenburg, Sweden. However, there are lingering inquiries regarding the prevalence and...

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Main Authors: Marianela Patzi Churqui, Margarita Ghaleb, Timur Tunovic, Miriam Frankal, Lucica Enache, Kristina Nyström, Martin Lagging, Hao Wang
Format: Article
Language:English
Published: Elsevier 2024-12-01
Series:One Health
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Online Access:http://www.sciencedirect.com/science/article/pii/S2352771424002088
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author Marianela Patzi Churqui
Margarita Ghaleb
Timur Tunovic
Miriam Frankal
Lucica Enache
Kristina Nyström
Martin Lagging
Hao Wang
author_facet Marianela Patzi Churqui
Margarita Ghaleb
Timur Tunovic
Miriam Frankal
Lucica Enache
Kristina Nyström
Martin Lagging
Hao Wang
author_sort Marianela Patzi Churqui
collection DOAJ
description Hepatitis E virus (HEV) and Rat Hepatitis E virus (RHEV), recognized for their zoonotic potential, pose significant public health concerns. Our previous research identified both viruses in effluent wastewater in Gothenburg, Sweden. However, there are lingering inquiries regarding the prevalence and genetic diversity of these viruses in influent wastewater, as well as the utility of wastewater surveillance in elucidating their community circulation dynamics. To address these knowledge gaps, we conducted weekly collection of wastewater samples at the Rya wastewater treatment plant in Gothenburg throughout 2023. The concentrations of HEV and RHEV were quantified using quantitative polymerase chain reaction (qPCR). Additionally, two semi/nested-PCR were utilized to amplify viral strains. Furthermore, HEV strains from patients within the same region, as well as other regions in Sweden in 2023, were incorporated into the analysis. Remarkably, we observed a high prevalence of HEV (86%) and RHEV (98%) in wastewater samples, with the majority of HEV sequences identified as subtype 3c/i (9/12). In contrast, HEV subtype 3f was the most sequenced among clinical patient samples (6/12). Notably, previously unreported HEV-3b and unclassified strains were detected in wastewater. Almost all RHEV strains (20/21) were clustered into European groups, with none of the RHEV genetically close to strains previously found in human cases. The notable discordance in prevalence and identified subtypes of HEV-3 in wastewater compared to clinical samples suggests either a significant underdiagnosis of HEV infections or differences in viral loads and shedding durations among humans between HEV-3 subtypes. This underscores the urgent need for improved diagnostic techniques and heightened awareness of HEV transmission dynamics. Furthermore, the consistent detection of RHEV in wastewater underscores the necessity for further investigations to assess the potential role of RHEV in hepatitis cases of unknown etiology, given that most currently available clinical diagnostic assays fail to detect RHEV.
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spelling doaj-art-e4aa113cf1dc48db8f5d2bad1a0109242024-12-18T08:49:23ZengElsevierOne Health2352-77142024-12-0119100882High prevalence of hepatitis E and rat hepatitis E viruses in wastewater in Gothenburg, SwedenMarianela Patzi Churqui0Margarita Ghaleb1Timur Tunovic2Miriam Frankal3Lucica Enache4Kristina Nyström5Martin Lagging6Hao Wang7Institute of Biomedicine, Department of Infectious Diseases, University of Gothenburg, Gothenburg, Sweden; Sahlgrenska University Hospital, Department of Clinical Microbiology, Region Västra Götaland, Gothenburg, SwedenFaculty of Medicine and Health Sciences, Linköping University, Linköping, SwedenInstitute of Biomedicine, Department of Infectious Diseases, University of Gothenburg, Gothenburg, SwedenInstitute of Biomedicine, Department of Infectious Diseases, University of Gothenburg, Gothenburg, Sweden; Region Västra Götaland, Södra Älvsborg Hospital, Clinic of Infectious Diseases, Borås, Sweden; Department of Research, Education and Innovation, Region Västra Götaland, Södra Älvsborg Hospital, Borås, SwedenGryaab AB, Gothenburg, SwedenInstitute of Biomedicine, Department of Infectious Diseases, University of Gothenburg, Gothenburg, Sweden; Sahlgrenska University Hospital, Department of Clinical Microbiology, Region Västra Götaland, Gothenburg, SwedenInstitute of Biomedicine, Department of Infectious Diseases, University of Gothenburg, Gothenburg, Sweden; Sahlgrenska University Hospital, Department of Clinical Microbiology, Region Västra Götaland, Gothenburg, SwedenInstitute of Biomedicine, Department of Infectious Diseases, University of Gothenburg, Gothenburg, Sweden; Sahlgrenska University Hospital, Department of Clinical Microbiology, Region Västra Götaland, Gothenburg, Sweden; Corresponding author.Hepatitis E virus (HEV) and Rat Hepatitis E virus (RHEV), recognized for their zoonotic potential, pose significant public health concerns. Our previous research identified both viruses in effluent wastewater in Gothenburg, Sweden. However, there are lingering inquiries regarding the prevalence and genetic diversity of these viruses in influent wastewater, as well as the utility of wastewater surveillance in elucidating their community circulation dynamics. To address these knowledge gaps, we conducted weekly collection of wastewater samples at the Rya wastewater treatment plant in Gothenburg throughout 2023. The concentrations of HEV and RHEV were quantified using quantitative polymerase chain reaction (qPCR). Additionally, two semi/nested-PCR were utilized to amplify viral strains. Furthermore, HEV strains from patients within the same region, as well as other regions in Sweden in 2023, were incorporated into the analysis. Remarkably, we observed a high prevalence of HEV (86%) and RHEV (98%) in wastewater samples, with the majority of HEV sequences identified as subtype 3c/i (9/12). In contrast, HEV subtype 3f was the most sequenced among clinical patient samples (6/12). Notably, previously unreported HEV-3b and unclassified strains were detected in wastewater. Almost all RHEV strains (20/21) were clustered into European groups, with none of the RHEV genetically close to strains previously found in human cases. The notable discordance in prevalence and identified subtypes of HEV-3 in wastewater compared to clinical samples suggests either a significant underdiagnosis of HEV infections or differences in viral loads and shedding durations among humans between HEV-3 subtypes. This underscores the urgent need for improved diagnostic techniques and heightened awareness of HEV transmission dynamics. Furthermore, the consistent detection of RHEV in wastewater underscores the necessity for further investigations to assess the potential role of RHEV in hepatitis cases of unknown etiology, given that most currently available clinical diagnostic assays fail to detect RHEV.http://www.sciencedirect.com/science/article/pii/S2352771424002088Wastewater-based epidemiologyZoonotic transmissionSurveillanceSewageHEV-CSubtype
spellingShingle Marianela Patzi Churqui
Margarita Ghaleb
Timur Tunovic
Miriam Frankal
Lucica Enache
Kristina Nyström
Martin Lagging
Hao Wang
High prevalence of hepatitis E and rat hepatitis E viruses in wastewater in Gothenburg, Sweden
One Health
Wastewater-based epidemiology
Zoonotic transmission
Surveillance
Sewage
HEV-C
Subtype
title High prevalence of hepatitis E and rat hepatitis E viruses in wastewater in Gothenburg, Sweden
title_full High prevalence of hepatitis E and rat hepatitis E viruses in wastewater in Gothenburg, Sweden
title_fullStr High prevalence of hepatitis E and rat hepatitis E viruses in wastewater in Gothenburg, Sweden
title_full_unstemmed High prevalence of hepatitis E and rat hepatitis E viruses in wastewater in Gothenburg, Sweden
title_short High prevalence of hepatitis E and rat hepatitis E viruses in wastewater in Gothenburg, Sweden
title_sort high prevalence of hepatitis e and rat hepatitis e viruses in wastewater in gothenburg sweden
topic Wastewater-based epidemiology
Zoonotic transmission
Surveillance
Sewage
HEV-C
Subtype
url http://www.sciencedirect.com/science/article/pii/S2352771424002088
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