Nine-Year Nationwide Environmental Surveillance of Hepatitis E Virus in Urban Wastewaters in Italy (2011–2019)

Marcello Iaconelli, Giusy Bonanno Ferraro, Pamela Mancini, Elisabetta Suffredini, Carolina Veneri, Anna Rita Ciccaglione, Roberto Bruni, Simonetta Della Libera, Francesco Bignami, Massimo Brambilla, Dario De Medici, David Brandtner, Pietro Schembri, Stefania D’Amato and Giuseppina La Rosa
Additional contact information
Marcello Iaconelli: Department of Environment and Health - Istituto Superiore di Sanità, 00161 Rome, Italy
Giusy Bonanno Ferraro: Department of Environment and Health - Istituto Superiore di Sanità, 00161 Rome, Italy
Pamela Mancini: Department of Environment and Health - Istituto Superiore di Sanità, 00161 Rome, Italy
Elisabetta Suffredini: Department of Food Safety, Nutrition and Veterinary Public Health, Istituto Superiore di Sanità, 00161 Rome, Italy
Carolina Veneri: Department of Environment and Health - Istituto Superiore di Sanità, 00161 Rome, Italy
Anna Rita Ciccaglione: Department Infectious Diseases, Istituto Superiore di Sanità, 00161 Rome, Italy
Roberto Bruni: Department Infectious Diseases, Istituto Superiore di Sanità, 00161 Rome, Italy
Simonetta Della Libera: Department of Environment and Health - Istituto Superiore di Sanità, 00161 Rome, Italy
Francesco Bignami: Department of Environment and Health - Istituto Superiore di Sanità, 00161 Rome, Italy
Massimo Brambilla: Consiglio per la ricerca in agricoltura e l’analisi dell’economia agraria (CREA), Research Centre for Engineering and Agri Food Processing, 24047 Treviglio, BG, Italy
Dario De Medici: Department of Food Safety, Nutrition and Veterinary Public Health, Istituto Superiore di Sanità, 00161 Rome, Italy
David Brandtner: Indipendent Researcher, 00156 Rome, Italy
Pietro Schembri: Regional Department for Health Activities and Epidemiological Observatory of the Sicilian Region, 90146 Palermo, Italy
Stefania D’Amato: Ministry of Health, Directorate-General for Prevention, 00144 Rome, Italy
Giuseppina La Rosa: Department of Environment and Health - Istituto Superiore di Sanità, 00161 Rome, Italy

IJERPH, 2020, vol. 17, issue 6, 1-18

Abstract: Hepatitis E virus (HEV) is an emerging causative agent of acute hepatitis worldwide. To provide insights into the epidemiology of HEV in Italy, a large-scale investigation was conducted into urban sewage over nine years (2011–2019), collecting 1374 sewage samples from 48 wastewater treatment plants located in all the 20 regions of Italy. Broadly reactive primers targeting the ORF1 and ORF2 regions were used for the detection and typing of HEV, followed by Sanger and next generation sequencing (NGS). Real-time RT-qPCR was also used to attempt quantification of positive samples. HEV RNA detection occurred in 74 urban sewage samples (5.4%), with a statistically significant higher frequency (7.1%) in central Italy. Fifty-six samples were characterized as G3 strains and 18 as G1. While the detection of G3 strains occurred in all the surveillance period, G1 strains were mainly detected in 2011–2012, and never in 2017–2019. Typing was achieved in 2 samples (3f subtype). Viral concentrations in quantifiable samples ranged from 1.2 × 10 3 g.c./L to 2.8 × 10 4 g.c./L. Our results suggest the considerable circulation of the virus in the Italian population, despite a relatively small number of notified cases, a higher occurrence in central Italy, and a noteworthy predominance of G3 strains.

Keywords: hepatitis E virus; sewage; sequencing; typing; PCR; prevalence (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
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