Authorities are investigating three human cases of rat hepatitis E virus (rat HEV) in Hong Kong, including one death.
The three cases were identified among men aged above 65 years, all with underlying conditions, in Kowloon City and Southern Districts and Tuen Mun. Kowloon City borders Wong Tai Sin where previous cases of hepatitis E virus were reported in 2018.
All three individuals reported no direct contact with rodents or their excreta nor noticed rodents in their residence. One patient had travelled to Taiwan and Korea during the incubation period (IP) while the other two patients had no travel history during the IP, authorities said. The source and the route of infection could not be determined in the cases.
Last year, three cases of rat HEV with exposure to rodents or their excreta were reported in Hong Kong (n=2) and Canada (n=1). According to the European Centre for Disease Prevention and Control (ECDC), while no acute human case due to rat HEV infection has been reported in Europe, a previous study reported the identification of anti-rat HEV antibodies in blood donors and forestry workers in Germany. Serological evidence was also found in patients in Vietnam.