A case of acute hepatitis E who was suspected to have contracted hepatitis E virus infection via consumption of dried gall bladders from wild boars

Abstract

We describe a 92-year-old man who developed acute hepatitis E living in the mountains in Tottori, Japan. He had no history of travel abroad and blood transfusion as well as consumption of animal meat/viscera and raw seafood within three months before the disease onset. However, he had a peculiar habit of drinking diluted bile of dried gall bladders obtained from wild boars. Although leftover bile suspensions were not available, seven (39%) of the 18 stored gall bladders had detectable hepatitis E virus (HEV) RNA at the viral load of up to 4.6×105 copies/ml in 10% bile suspension. The wild boar HEV isolates shared 99.0-99.8% nucleotide sequence identities with a subgenotype 3a HEV strain recovered from the index patient. These results suggest that dried gall bladders obtained from HEV-infected wild boars may have been a source of HEV infection in this patient.