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dc.contributor.authorHunter, JG
dc.contributor.authorMadden, RG
dc.contributor.authorStone, AM
dc.contributor.authorOsborne, N
dc.contributor.authorWheeler, B
dc.contributor.authorVine, L
dc.contributor.authorDickson, A
dc.contributor.authorBarlow, M
dc.contributor.authorLewis, J
dc.contributor.authorBendall, RP
dc.contributor.authorLin, NX
dc.contributor.authorHenley, WE
dc.contributor.authorGaze, WH
dc.contributor.authorDalton, HR
dc.date.accessioned2016-03-14T16:53:24Z
dc.date.issued2016-03
dc.description.abstractBACKGROUND AND AIMS: Autochthonous hepatitis E virus (HEV) infection is a porcine zoonosis and increasingly recognized in developed countries. In most cases the route of infection is uncertain. A previous study showed that HEV was associated geographically with pig farms and coastal areas. AIM: The aim of the present research was to study the geographical, environmental and social factors in autochthonous HEV infection. METHODS: Cases of HEV genotype 3 infection and controls were identified from 2047 consecutive patients attending a rapid-access hepatology clinic. For each case/control the following were recorded: distance from home to nearest pig farm, distance from home to coast, rainfall levels during the 8 weeks before presentation, and socioeconomic status. RESULTS: A total of 36 acute hepatitis E cases, 170 age/sex-matched controls and 53 hepatitis controls were identified. The geographical spread of hepatitis E cases was not even when compared with both control groups. Cases were more likely to live within 2000 m of the coast (odds ratio=2.32, 95% confidence interval=1.08-5.19, P=0.03). There was no regional difference in the incidence of cases and controls between west and central Cornwall. There was no difference between cases and controls in terms of distance from the nearest pig farm, socioeconomic status or rainfall during the 8 weeks before disease presentation. CONCLUSION: Cases of HEV infection in Cornwall are associated with coastal residence. The reason for this observation is uncertain, but might be related to recreational exposure to beach areas exposed to HEV-contaminated 'run-off' from pig farms. This hypothesis merits further study.en_GB
dc.description.sponsorshipThe European Centre for the Environment and Human Health (part of the Peninsula College of Medicine and Dentistry which is a joint entity of the University of Exeter, the University of Plymouth and the NHS in the South West) is supported by investment from the European Regional Development Fund and the European Social Fund Convergence Programme for Cornwall and the Isles of Scilly.en_GB
dc.identifier.citationEuropean Journal of Gastroenterology and Hepatology, 2016, Vol. 28 93), pp. 323 - 327en_GB
dc.identifier.doi10.1097/MEG.0000000000000518
dc.identifier.urihttp://hdl.handle.net/10871/20714
dc.language.isoenen_GB
dc.publisherLippincott, Williams & Wilkinsen_GB
dc.relation.urlhttp://www.ncbi.nlm.nih.gov/pubmed/26709884en_GB
dc.rights.embargoreasonPublisher policyen_GB
dc.rightsThis is the author accepted manuscript. The final version is available from Lippincott, Williams & Wilkins via the DOI in this record.en_GB
dc.titleCoastal clustering of HEV; Cornwall, UK.en_GB
dc.typeArticleen_GB
dc.identifier.issn0954-691X
exeter.place-of-publicationEngland
dc.descriptionPublisheden_GB
dc.identifier.journalEuropean Journal of Gastroenterology and Hepatologyen_GB


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