Zoonotic transmission of hepatitis E virus in a pig farmer from Argentina: A case report.

Hepatitis E virus (HEV) is a public health concern due to its zoonotic transmission to human, being pigs a highly recognized reservoir. We previously demonstrated HEV genotype 3 infections in pig herds from the highest commercial active region from Argentina. Here, we present a case of acute symptomatic hepatitis E in an elderly man with occupational exposure to pigs who referred regular consumption of pork and sausages. HEV infection in this patient was demonstrated by serological methods, as well as by HEV RNA detection in serum and stool samples using the HEV/MS2 duplex RT-qPCR, formerly optimized in our laboratory. We further detected HEV RNA in pig faeces from the patient´s farm. To confirm the potential role of swine in the transmission, we performed a phylogenetic analysis of all HEV RNA derived from both, the patient and the pig samples. A 303 nt region within the HEV 5 'ORF2 was amplified by nested RT-PCR and subsequently sequenced. Phylogenetic analysis showed that the strains isolated from the farmer and from his pigs presented a nucleotide identity of 100%. These results support the zoonotic transmission of circulating HEV strains and confirm this epidemiological association for the first time in Argentina.