Seroprevalence of hepatitis E virus in dromedary camels, Bedouins, Muslim Arabs and Jews in Israel, 2009-2017

Epidemiol Infect. 2019 Jan:147:e92. doi: 10.1017/S0950268819000062.

Abstract

Hepatitis E virus (HEV) is an emerging cause of viral hepatitis worldwide. Recently, HEV-7 has been shown to infect camels and humans. We studied HEV seroprevalence in dromedary camels and among Bedouins, Arabs (Muslims, none-Bedouins) and Jews and assessed factors associated with anti-HEV seropositivity. Serum samples from dromedary camels (n = 86) were used to determine camel anti-HEV IgG and HEV RNA positivity. Human samples collected between 2009 and 2016 from >20 years old Bedouins (n = 305), non-Bedouin Arabs (n = 320) and Jews (n = 195), were randomly selected using an age-stratified sampling design. Human HEV IgG levels were determined using Wantai IgG ELISA assay. Of the samples obtained from camels, 68.6% were anti-HEV positive. Among the human populations, Bedouins and non-Bedouin Arabs had a significantly higher prevalence of HEV antibodies (21.6% and 15.0%, respectively) compared with the Jewish population (3.1%). Seropositivity increased significantly with age in all human populations, reaching 47.6% and 34.8% among ⩾40 years old, in Bedouins and non-Bedouin Arabs, respectively. The high seropositivity in camels and in ⩾40 years old Bedouins and non-Bedouin Arabs suggests that HEV is endemic in Israel. The low HEV seroprevalence in Jews could be attributed to higher socio-economic status.

Keywords: non-Bedouins); Arabs (Muslims; Bedouins; dromedary camels; hepatitis E; jews; seroprevalence; zoonozis.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Animals
  • Arabs / statistics & numerical data
  • Camelus*
  • Female
  • Hepatitis E / epidemiology*
  • Hepatitis E virus / isolation & purification*
  • Humans
  • Israel / epidemiology
  • Israel / ethnology
  • Jews / statistics & numerical data
  • Male
  • Middle Aged
  • Prevalence
  • Seroepidemiologic Studies
  • Young Adult