Hepatitis E infections surge in Singapore, virus found in raw pork liver: SGH

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SINGAPORE: Hepatitis E (HEV) infections surged in Singapore between 2012 and 2016, according to a study led by the Singapore General Hospital (SGH).

In a media release on Wednesday (Oct 9), SGH said that the incidence of the infection more than doubled, from 1.7 cases per 100,000 residents in 2012 to 4.1 cases per 100,000 residents in 2016.

The individuals infected by HEV tend to be Chinese men aged 55 years and above.

The findings of the study were published in medical journal Zoonoses Public Health in July.

HEV can be acquired by ingesting faecally contaminated water or eating raw or undercooked products from infected animals. 

Worldwide, HEV foodborne infection is generally associated with the consumption of pork meat or offal, game meat, and shellfish.

An analysis on HEV samples showed the same HEV subtype detected in three raw pork liver samples, said SGH.

Hepatitis E (3)

Electron micrograph of Hepatitis E viruses (HEV). (Photo: Wikimedia Commons/CDC/PHIL #5605)

“Although we could not ascertain if pig liver is the main contributor of HEV cases in Singapore, we observed that pig liver can be found in many local dishes,” said Dr Chan Kwai Peng, senior author of the study and Senior Consultant at SGH’s Department of Microbiology.

“As most people like it a little undercooked for its texture, this may put them at risk of hepatitis E infection. The safest way of consuming food, including pork, is to cook it thoroughly.”

The virus infects the liver, with infections going away on their own within a few weeks.

Most patients show no symptoms but if they do, the symptoms include fever, feeling very tired, nausea and jaundice.

Infections do not usually lead to long-term illness or liver damage, but can be dangerous for pregnant women or people with weak immune systems like transplant patients or people with pre-existing chronic liver disease.

In 2010, Hong Kong’s Centre for Food Safety had issued a report about eating undercooked pig liver and the associated risk of HEV infection.

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