Hepatitis E infection in children: Study of an outbreak

Background: Hepatitis E virus (HEV) is responsible for most of the hepatiti s epidemics in the developing world and it frequently affects young adults. Therefore, common perception is that it does not affect children. Methods: A group of 20 school children (13 years old) were possibly exposed to hepatitis E virus infection during a 2 day trekking trip. Epidemiologic al and clinical information was correlated to the presence of the hepatitis E virus genome and antibodies to HEV structural and non-structural protein s found in the blood of the children, using polymerase chain reaction and l ine immunoassay techniques. Results: Ten children developed icteric hepatitis, seven prodrome-like illn ess without jaundice while three remained asymptomatic. Immunoglobulin M (I gM) antibodies to open reading frame (ORF)2 protein (pORF2) were detected i n all 19 children tested, whereas 11 and 10 of the children were positive f or IgM antibodies against ORF1 (pORF1) and ORF3 (pORF3) proteins, respectiv ely The rate of HEV infection was found to be 85%. Viraemia was observed in 11 children and was present in four of the seven anicteric patients (55%) compared with six of the nine (66%) icteric patients. One child without any symptom also had viraemia. Conclusions: The data obtained indicate a high susceptibility of children f or HEV infection and a frequently prolonged viraemia in those infected. (C) 1999 Blackwell Science Asia Pty Ltd.