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Raw is risky: Eating raw pig liver from Singapore market may increase risk of hepatitis E

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Danielle Ann of Alvinology reports researchers at the Singapore General Hospital have found definite similarities between the virus strains of Hepatitis E virus or (HEV) in pig liver and human liver.

This means that ingesting raw pork liver could mean you’re ingesting a strain of HEV that’s similar enough to human HEV that it could cause you get infected.

The same report said that people who have contracted HEV has risen steadily over the years. While the researchers could not say if the ingestion of raw pig liver is the main cause of the rise in cases, many local dishes feature this ingredient and do not cook the meat thoroughly.

The same report said that you can acquire the disease from eating contaminated food or substances. Ingesting water that is laced with the disease or accidentally drinking water that has trace amounts of faeces. Eating raw or half-cooked meat that is infected can also transmit the virus to you.

17 sickened with Hepatitis E linked to undercooked pig-liver stuffing

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Background – On 11 December 2013, 3 clustered cases of hepatitis E were reported on a coastal island in Brittany. Cases had consumed spit-roasted and stuffed piglet during a wedding meal. The raw stuffing was partly made from the piglet liver. Investigations were carried out to identify the source and vehicle of contamination, and evaluate the dispersion of the hepatitis E virus (HEV) in the environment.

spit-roast-pigMethods – A questionnaire was administered to 98 wedding participants who were asked to give a blood sample. Cases were identified by RT-PCR and anti-HEV serological tests. A retrospective cohort study was conducted among 38 blood sampled participants after the exclusion of participants with evidence of past HEV immunity. Relative risks (RR) with their 95% confidence intervals were calculated based on foods consumed at the wedding meal using univariate and multivariable Poisson regressions.

The human HEV strains were compared with the strains detected in the liquid manure sampled at the farm where the piglet was born and at the inlet of the island wastewater treatment plants.

Results – 17 cases, including 3 confirmed cases, were identified and 70.6% were asymptomatic. Acute HEV infection was independently associated with piglet stuffing consumption (RR=1.69 [1.04-2.73]). Human strains from the index cases, veterinary and environmental HEV strains were identical.

Discussion – The outbreak was attributable to the consumption of an undercooked pig liver-based stuffing. After infection, the cases have probably become a temporary reservoir for HEV, which was detected in the island’s untreated wastewater.

Hepatitis E outbreak associated with the consumption of a spit-roasted piglet, Brittany (France), 2013

Épidémie d’hépatite E associée à la consommation d’un porcelet grillé à la broche, Bretagne, 2013. Bull Epidémiol Hebd. 2016;(26-27):444-9

Y Guillois, F Abravanel, T Miura, N Pavio, V Vaillant, S Lhomme, et al.

http://invs.santepubliquefrance.fr/beh/2016/26-27/2016_26-27_3.html