| Abstract | Purpose: In Lao People's Democratic Republic (PDR), overlapping habitats of the population and livestock create a propitious environment for zoonoses. Insufficient hygienic measures in slaughterhouses and in rural settings further increase the risk for zoonotic transmission. Limited laboratory capacity as well as lack of background knowledge prevent timely control of disease oubreaks. Here, we assess the occurrence and transmission of Hepatits E virus (HEV), as well as public awareness of zoonoses.
Methods & Materials: In 2015 and 2016, samples were collected from ruminants in rural areas (n=211), as well as from slaughterhouse workers (n=129) and slaughter pigs (n=290) in Lao PDR. Using commercial ELISAs, presence of antibodies (IgG, IgM and IgA) against HEV was assessed. Fecal shedding of HEV by animals was investigated using a generic real-time PCR. Detected viruses were characterized by Sanger sequencing if feasible. Using a standardized questionnaire, data on risk factors for zoonotic pathogen transmission and awareness on zoonoses were captured. Much emphasis was placed on collaborating with local actors and on strengthening laboratory capacities.
Results: Anti-HEV antibodies were detected in 13% of ruminants in rural settings and in 46% of slaughter pigs. 7% of the ruminants and 2% of the pigs shed HEV that were thus far not characterizable. While anti-HEV antibody seroprevalence was of 33% in people exposed to pigs, only 15% of the non-exposed control group were seropositive (p= 0.001). Awareness of zoonoses among farmers and slaughterhouse workers was low. Wearing protective equipment was associated with a decrease in anti-HEV antibody detection (p=0.024). Limiting the consumption and use of groundwater and cooking of meat further reduced the risk for HEV infection in a domestic context.
Conclusion: We could show that people who are exposed to livestock and pigs are at higher risk for contracting HEV than the general population. Although shedding rates were relatively low, animals may represent an infection source that can be controlled by applying personal protective equipment. Building the capacity for the detection and prevention of infectious diseases and increasing awareness about zoonoses in developing countries is a prerequisite for combating infectious disease outbreaks in future. |
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