Volume 96, Issue 4
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645



We determined the prevalence of IgG antibodies to hepatitis E virus (anti-HEV IgG) among travelers attending Boston-area travel health clinics from 2009 to 2010. Pre-travel samples were available for 1,356 travelers, with paired pre- and post-travel samples for 450 (33%). Eighty of 1,356 (6%) pre-travel samples were positive for anti-HEV IgG. Compared with participants who had never lived in nor traveled to a highly endemic country, the pre-travel prevalence odds ratio (POR) of anti-HEV IgG among participants born in or with a history of previous travel to a highly endemic country was increased (POR = 4.8, 95% CI = 2.3–10.3 and POR = 2.6, 95% CI = 1.4–5.0, respectively). Among participants with previous travel to a highly endemic country, anti-HEV IgG was associated with age > 40 years (POR = 3.7, 95% CI = 1.3–10.2) and travel history to ≥ 3 highly endemic countries (POR = 2.7, 95% CI = 1.2–5.9). Two participants may have contracted HEV infection during their 2009–2010 trip.


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  1. Navaneethan U, Mohajer MA, Shata MT, , 2008. Hepatitis E and pregnancy: understanding the pathogenesis. Liver Int 28: 11901199.[Crossref]
  2. Kamar N, Selves J, Mansuy JM, Ouezzani L, Peron JM, Guitard J, Cointault O, Esposito L, Abravanel F, Danjoux M, Durand D, Vinel JP, Izopet J, Rostaing L, , 2008. Hepatitis E virus and chronic hepatitis in organ-transplant recipients. N Engl J Med 358: 811817.[Crossref]
  3. World Health Organization, 2015. Hepatitis E. Available at: http://www.who.int/mediacentre/factsheets/fs280/en/. Accessed August 31, 2016.
  4. Rein DB, Stevens GA, Theaker J, Wittenborn JS, Wiersma ST, , 2012. The global burden of hepatitis E virus genotypes 1 and 2 in 2005. Hepatology 55: 988997.[Crossref]
  5. Lu L, Li C, Hagedorn CH, , 2006. Phylogenetic analysis of global hepatitis E virus sequences: genetic diversity, subtypes and zoonosis. Rev Med Virol 16: 536.[Crossref]
  6. Khuroo MS, Khuroo MS, , 2016. Hepatitis E: an emerging global disease—from discovery towards control and cure. J Viral Hepat 23: 6879.[Crossref]
  7. Kmush BL, Nelson KE, Labrique AB, , 2015. Risk factors for hepatitis E virus infection and disease. Expert Rev Anti-infe 13: 4153.[Crossref]
  8. Teshale EH, Denniston MM, Drobeniuc J, Kamili S, Teo CG, Holmberg SD, , 2015. Decline in hepatitis E virus antibody prevalence in the United States from 1988–1994 to 2009–2010. J Infect Dis 211: 366373.[Crossref]
  9. Kuniholm MH, Purcell RH, McQuillan GM, Engle RE, Wasley A, Nelson KE, , 2009. Epidemiology of hepatitis E virus in the United States: results from the Third National Health and Nutrition Examination Survey, 1988–1994. J Infect Dis 200: 4856.[Crossref]
  10. Tarrago D, Lopez-Velez R, Turrientes C, Baquero F, Mateos ML, , 2000. Prevalence of hepatitis E antibodies in immigrants from developing countries. Eur J Clin Microbiol Infect Dis 19: 309311.[Crossref]
  11. Scotto G, Martinelli D, Giammario A, Prato R, Fazio V, , 2013. Prevalence of antibodies to hepatitis E virus in immigrants: a seroepidemiological survey in the district of Foggia (Apulia-southern Italy). J Med Virol 85: 261265.[Crossref]
  12. Mast EE, Kuramoto IK, Favorov MO, Schoening VR, Burkholder BT, Shapiro CN, Holland PV, , 1997. Prevalence of and risk factors for antibody to hepatitis E virus seroreactivity among blood donors in northern California. J Infect Dis 176: 3440.[Crossref]
  13. Elfrink F, van Rijekevorsal GGC, van Gool T, van den Hoek A, Sonder GJB, , 2012. Low risk of hepatitis E among Dutch short-term travelers. J Travel Med 19: 202204.[Crossref]
  14. Potasman I, Koren L, Peterman M, Srugo I, , 2000. Lack of hepatitis E infection among backpackers to tropical countries. J Travel Med 7: 208210.[Crossref]
  15. Ooi WW, Gawoski JM, Yarbough PO, Pankey GA, , 1999. Hepatitis E seroconversion in United States travelers abroad. Am J Trop Med Hyg 61: 822824.
  16. Sanchez-Vegas C, Hamer DH, Chen LH, Wilson ME, Benoit C, Hunsperger E, MacLeod WB, Jentes ES, Ooi WW, Karchmer AW, Kogelman L, Yanni E, Marano N, Barnett ED, , 2013. Prevalence of dengue virus infection in United States travelers who have lived in or traveled to dengue-endemic countries. J Travel Med 20: 352360.[Crossref]
  17. Olivero RM, Hamer DH, MacLeod WB, Benoit CM, Sanchez-Vegas C, Jentes ES, Chen LH, Wilson ME, Marano N, Yanni EA, Ooi WW, Karchmer AW, Kogelman L, Barnett ED, , 2016. Dengue virus seroconversion in travelers to dengue-endemic areas. Am J Trop Med Hyg 95: 11301136.[Crossref]
  18. Teo CG, Brunette GW, Kozarsky PM, Magill AJ, Shlim DR, Whatley A, , 2012. Hepatitis E. , eds. CDC Health Information for International Travel. New York, NY: Oxford University Press.
  19. Centers for Disease Control and Prevention, 1993. Hepatitis E among U.S. travelers, 1989–1992. Morb Mortal Wkly Rep 42: 14.
  20. Skidmore SJ, Yarbough PO, Gabor KA, Tam AW, Reyes GR, Flower AJE, , 1991. Imported hepatitis E in UK. Lancet 8756: 1541.[Crossref]
  21. Drobeniuc J, Greene-Montfort T, Lee NT, Mixson-Hayden TR, Ganova-Raeva L, Dong C, Novak RT, Sharapov UM, Tohme RA, Teshale E, Kamili S, Teo CG, , 2013. Laboratory-based surveillance for hepatitis E infection, United States, 2005–2012. Emerg Infect Dis 19: 218222.[Crossref]

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  • Received : 07 Sep 2016
  • Accepted : 16 Dec 2016

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