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FN1Authors' addresses: Esmeralda Chi-Yuan Teo, Department of Haematology, Singapore General Hospital, Singapore, E-mail: email@example.com. Boon-Huan Tan, Pui-San Wong, and Pei-Jun Ting, DSO National Laboratories, Singapore, E-mails: firstname.lastname@example.org, email@example.com, and firstname.lastname@example.org. Michael A Purdy, Amanda Sue, and Chong-Gee Teo, Centers for Disease Control and Prevention, Atlanta, GA, E-mails: email@example.com, firstname.lastname@example.org, and email@example.com. Pik-Eu Jason Chang and Chee-Kiat Tan, Department of Gastroenterology and Hepatology, Singapore General Hospital, Singapore, E-mails: firstname.lastname@example.org and email@example.com. Lynette Lin-Ean Oon, Department of Pathology, Singapore General Hospital, Singapore, E-mail: firstname.lastname@example.org.Notes
Disclaimer: The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Singapore General Hospital, the National University of Singapore, or the Centers for Disease Control and Prevention.
- The American Society of Tropical Medicine and Hygiene
- Source: The American Journal of Tropical Medicine and Hygiene, Volume 96, Issue 4, Apr 2017, p. 922 - 928
Hepatitis E in Singapore: A Case-Series and Viral Phylodynamics Study
The incidence of hepatitis E in Singapore appears to be increasing. A retrospective case-series study of patients diagnosed with hepatitis E in a tertiary hospital from 2009 to 2013 was conducted. Of 16 cases, eight (50%) were solid-organ transplant recipients (SOTRs), and 14 (88%) were found infected by genotype 3 hepatitis E virus (HEV-3). Bayesian inferences based on HEV subgenomic sequences from seven cases suggest that HEV-3 strains were introduced to Singapore as two principal lineages. Within limitations of the study, it can be inferred that one lineage, in the 3efg clade, emerged about 83 years ago, probably originating from Japan, whereas the other, in the 3abchij clade, emerged about 40 years ago, from the United States. Establishment and subsequent transmissions of strains from these two lineages likely contribute to the current endemicity of hepatitis E in Singapore.