18 April 2016

Rada Rouse

Hepatitis E may be a cause of acute hepatitis even in people who have not recently travelled, indicating the disease exists in Australia. Hepatitis E is normally a disease contracted in developing countries, via contaminated water or the faecal-oral route, where faecal matter finds its way into the mouth via food or unwashed hands.

NSW Health’s account of the first reported outbreak of hepatitis E in Australia, published on Monday in the MJA, underlines the threat of local transmission, infectious diseases experts say.

Public health authorities were last year criticised for their failure to act quickly after notification of hepatitis E virus (HEV) in a medical oncology registrar.  GPs were notified in September 2014 of the outbreak, which was linked to pork liver pate served at a Sydney restaurant.

NSW Health’s investigation of the cluster of notified cases of HEV in May of that year found that among 55 confirmed cases, 24 people had not travelled overseas in the incubation period.

Public health officers found 17 cases were linked to pork liver products at one restaurant and 7 cases were linked to pork products bought from butchers and supermarkets involving at least 2 suppliers. “Our investigation concurs with previous French, English and Japanese studies that have linked hepatitis E virus infection with consumption of undercooked pork products,” they write.

Pork products, particularly livers, should be cooked until they reach 75 degrees Celsius at the thickest part for 2 minutes as HEV is inactivated at temperatures above 71 degrees, they say.

In an editorial, Melbourne specialists warn HEV infection in pregnancy is associated with a high risk of death.

“This outbreak lasted 9 months and shows that HEV transmission should be considered an ongoing risk in Australia,” they write.

Last Reviewed: 18/04/2016

Medical Observer


1. Study: First reported outbreak of locally acquired hepatitis E virus infection in Australia. Med J Aust 2016; online 18 April. https://www.mja.com.au/journal/2016/204/7/first-reported-outbreak-locally-acquired-hepatitis-e-virus-infection-australia.
2. Comment: Med J Aust 2016; online 18 April