• Laura Ambra P Nicolini, Rhett J Stoney, Della VecchiaAndreaADepartment of Health Sciences, University of Genova, Genova, Italy.Internal Medicine Unit, Hôpitaux Iris Sud, Bruxelles, Belgium., Martin Grobusch, Philippe Gautret, Kristina M Angelo, van GenderenPerry J JPJJErasmus MC University Hospital, Rotterdam, The Netherlands., Emmanuel Bottieau, Karin Leder, Hilmir Asgeirsson, Daniel T Leung, Bradley Connor, Prativa Pandey, Federica Toscanini, Federico Gobbi, Francesco Castelli, Matteo Bassetti, and Davidson H Hamer.
• Infectious Diseases, Ospedale Policlinico San Martino-IRCCS, Genova, Italy.
• J Travel Med. 2020 Nov 9; 27 (7).

BackgroundHepatitis E virus (HEV) is widely distributed worldwide and is endemic in developing countries. Travel-related HEV infection has been reported at national levels, but global data are missing. Moreover, the global availability of HEV diagnostic testing has not been explored so far. The aim of this study is to describe the epidemiology of HEV infections in returning travellers and availability of HEV diagnostic testing in the GeoSentinel surveillance network.MethodsThis was a multicentre retrospective cross-sectional study. All confirmed and probable HEV travel-related infections reported in the GeoSentinel Network between 1999 and 2018 were evaluated. GeoSentinel sites were asked to complete a survey in 2018 to assess the availability and accessibility of HEV diagnostic procedures (i.e. serology and molecular tests) throughout the study period.ResultsOverall, 165 travel-related HEV infections were reported, mainly since 2010 (60%) and in tourists (50%). Travellers were exposed to hepatitis E in 27 countries; most travellers (62%) were exposed to HEV in South Asia. One patient was pregnant at the time of HEV infection and 14 had a concomitant gastrointestinal infection. No deaths were reported. In the 51% of patients with information available, there was no pre-travel consultation. Among 44 GeoSentinel sites that responded to the survey, 73% have access to HEV serology at a local level, while 55% could perform (at a local or central level) molecular diagnostics.ConclusionReported access to HEV diagnostic testing is suboptimal among sites that responded to the survey; this could negatively affect diagnosing HEV. Pre-travel consultations before travel to South Asia and other low-income and high-prevalence areas with a focus on food and water precautions could be helpful in preventing hepatitis E infection. Improved HEV diagnostic capacity should be implemented to prevent and correctly diagnose travel-related HEV infection.© International Society of Travel Medicine 2020. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

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