Abstract
Hepatitis E virus (HEV) represents an important public health concern in many developing countries, including Africa. Transmission of HEV to humans by contaminated drinking water is the most important mode of transmission in low- and middle-income countries. This study aimed to assess the presence of HEV in the environment in Cameroon through molecular analysis of sewage samples. Retrospectively, a total of 157 sewage samples collected between January 2018 and December 2019 were randomly selected and analyzed by molecular techniques to detect and characterize the HEV followed by sequencing and phylogenetic analysis. Three samples (1.9%) collected from North, Far North, and Adamawa regions were positive by real-time reverse transcription polymerization chain reaction. Among these, 2 samples were positive for HEV ribonucleic acid by nested reverse transcription polymerization chain reaction and only one yielded a good sequencing product. Phylogenetic analysis of this unique HEV strain showed that this HEV strain belonged to genotype 3, subtype 3a, and clustered with swine HEV strains from Cameroon, Argentina, and the USA. This study provides preliminary data on the circulation of HEV in wastewater in Cameroon. Further studies will be needed to assess the overall situation in Cameroon.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Aggarwal, R., & Jameel, S. (2011). Hepatitis E. Hepatology, 54(6), 2218–2226. https://doi.org/10.1002/hep.24674
Aggarwal, R., & Krawczynski, K. (2000). Hepatitis E: An overview and recent advances in clinical and laboratory research. Journal of Gastroenterology and Hepatology, 15(1), 9–20. https://doi.org/10.1046/j.1440-1746.2000.02006.x
Ahmed, A., Ali, Y., Siddig, E. E., Hamed, J., Mohamed, N. S., Khairy, A., & Zinsstag, J. (2022). Hepatitis E Virus outbreak among Tigray war refugees from Ethiopia Sudan. Emerging Infectious Disease, 28(8), 1722–1724. https://doi.org/10.3201/eid2808.220397
Bagulo, H., Majekodunmi, A. O., & Welburn, S. C. (2021). Hepatitis E in Sub Saharan Africa - A significant emerging disease. One Health, 11, 100186. https://doi.org/10.1016/j.onehlt.2020.100186
Béji-Hamza, A., Hassine-Zaafrane, M., Khélifi-Gharbi, H., Della Libera, S., Iaconelli, M., Muscillo, M., & La Rosa, G. (2015). Hepatitis E virus genotypes 1 and 3 in wastewater samples in Tunisia. Archives of Virology, 160(1), 183–189. https://doi.org/10.1007/s00705-014-2251-8
Browne, L. B., Menkir, Z., Kahi, V., Maina, G., Asnakew, S., Tubman, M., & Shahpar, C. (2015). Notes from the field: hepatitis E outbreak among refugees from South Sudan - Gambella, Ethiopia, April 2014-January 2015. MMWR Morbidity and Mortality Weekly Report, 64(19), 537.
de Paula, V. S., Wiele, M., Mbunkah, A. H., Daniel, A. M., Kingsley, M. T., & Schmidt-Chanasit, J. (2013). Hepatitis E virus genotype 3 strains in domestic pigs Cameroon. Emerging Infectious Diseases, 19(4), 666–668. https://doi.org/10.3201/eid1904.121634
Demanou, M., Mahamat, A., Nimpa, M. M., & Njouom, R. (2013). First documented outbreak of Hepatitis E in Northern Cameroon. Annals of Tropical Medicine and Public Health, 6, 682.
El-Esnawy, N. A. (2000). Examination for hepatitis E virus in wastewater treatment plants and workers by nested RT-PCR and ELISA. Journal of the Egyptian Public Health Association, 75(1–2), 219–231.
El-Esnawy, N. A., Gamil, M. A., & El-Wakkad, A. S. (1998). Detection of hepatitis E virus in greater Cairo. Two wastewater treatment plants and its prevalence among workers of these plants. Journal of the Egyptian Public Health Association, 73(5–6), 597–619.
Frías, M., López-López, P., Zafra, I., Caballero-Gómez, J., Machuca, I., Camacho, Á., & Rivero, A. (2020). Development and clinical validation of a pangenotypic PCR-based assay for the detection and quantification of hepatitis E virus (Orthopevirus A genus). Journal of Clinical Microbiology. https://doi.org/10.1128/jcm.02075-20
Kim, J. H., Nelson, K. E., Panzner, U., Kasture, Y., Labrique, A. B., & Wierzba, T. F. (2014). A systematic review of the epidemiology of hepatitis E virus in Africa. BMC Infectious Diseases, 14, 308. https://doi.org/10.1186/1471-2334-14-308
Lozano, R., Naghavi, M., Foreman, K., Lim, S., Shibuya, K., Aboyans, V., & Memish, Z. A. (2012). Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the global burden of disease study 2010. Lancet, 380(9859), 2095–2128. https://doi.org/10.1016/s0140-6736(12)61728-0
Modiyinji, A. F., Atsama, M. A., Monamele, G. C., Nola, M., & Njouom, R. (2018). High seroprevalence of hepatitis E among pigs suggests an animal reservoir in Cameroon. Journal of Infection in Developing Countries, 12(8), 676–679. https://doi.org/10.3855/jidc.10310
Modiyinji, A. F., Amougou-Atsama, M., Monamele, C. G., Nola, M., & Njouom, R. (2019a). Seroprevalence of hepatitis E virus antibodies in different human populations of Cameroon. Journal of Medical Virology, 91(11), 1989–1994. https://doi.org/10.1002/jmv.25545
Modiyinji, A. F., Amougou Atsama, M., Monamele Chavely, G., Nola, M., & Njouom, R. (2019b). Detection of hepatitis E virus antibodies among Cercopithecidae and Hominidae monkeys in Cameroon. Journal of Medical Primatology, 48(6), 364–366. https://doi.org/10.1111/jmp.12430
Modiyinji, A. F., Rivero-Juarez, A., Lopez-Lopez, P., Atsama, M. A., Monamele, C. G., Nola, M., & Njouom, R. (2021). First molecular characterization of the hepatitis E virus in humans in Cameroon: Confirmation of the HEV outbreak in Touboro North-Cameroon. Journal of Medical Virology, 93(6), 4018–4022. https://doi.org/10.1002/jmv.26277
Modiyinji, A. F., Sanding, G., Atsama, M. A., Monamele, C. G., Nola, M., & Njouom, R. (2020). Serological and molecular investigation of hepatitis E virus in pigs reservoirs from Cameroon reveals elevated seroprevalence and presence of genotype 3. PLoS ONE, 15(2), e0229073. https://doi.org/10.1371/journal.pone.0229073
Naik, S. R., Aggarwal, R., Salunke, P. N., & Mehrotra, N. N. (1992). A large waterborne viral hepatitis E epidemic in Kanpur. India. Bull World Health Organ, 70(5), 597–604.
Nimgaonkar, I., Ding, Q., Schwartz, R. E., & Ploss, A. (2018). Hepatitis E virus: Advances and challenges. Nature Reviews Gastroenterology & Hepatology, 15(2), 96–110. https://doi.org/10.1038/nrgastro.2017.150
Purdy, M. A., Drexler, J. F., Meng, X. J., Norder, H., Okamoto, H., Van der Poel, W. H. M., & Smith, D. B. (2022). ICTV virus taxonomy profile: Hepeviridae 2022. Journal of General Virology. https://doi.org/10.1099/jgv.0.001778
Rivero-Juarez, A., Frias, M., Martinez-Peinado, A., Risalde, M. A., Rodriguez-Cano, D., Camacho, A., & Rivero, A. (2017). Familial hepatitis E outbreak linked to wild boar meat consumption. Zoonoses and Public Health, 64(7), 561–565. https://doi.org/10.1111/zph.12343
Smith, D. B., Izopet, J., Nicot, F., Simmonds, P., Jameel, S., Meng, X. J., & Purdy, M. A. (2020). Update: proposed reference sequences for subtypes of hepatitis E virus (species Orthohepevirus A). Journal of General Virology, 101(7), 692–698. https://doi.org/10.1099/jgv.0.001435
Spina, A., & Lenglet, A. (2017). A large outbreak of Hepatitis E virus genotype 1 infection in an urban setting in chad likely linked to household level transmission factors, 2016–2017. PLoS ONE, 12(11), e0188240. https://doi.org/10.1371/journal.pone.0188240
Takuissu, G. R., Kenmoe, S., Ndip, L., Ebogo-Belobo, J. T., Kengne-Ndé, C., Mbaga, D. S., & La Rosa, G. (2022). Hepatitis E Virus in water environments: A systematic review and meta-analysis. Food and Environmental Virology, 14(3), 223–235. https://doi.org/10.1007/s12560-022-09530-3
Tekam, D. D., Vogue, N., Nkfusai, C. N., Ela, M. E., & Cumber, S. N. (2019). Access to safe drinking water and sanitation: A case study at the district community, in Douala V (Cameroon). Pan African Medical Journal, 2019(33), 244. https://doi.org/10.11604/pamj.2019.33.244.17974
Van der Poel, W. H. (2014). Food and environmental routes of Hepatitis E virus transmission. Current Opinion in Virology, 4, 91–96. https://doi.org/10.1016/j.coviro.2014.01.006
WHO. (2003). Department of immunization, vaccines and biologicals. Guidelines for environmental surveillance of poliovirus circulation. WHO/V&B/03.03. World Health Organization
WHO. (2014). Waterbone outbreaks of hepatitis E: Recognition, investigation and control: Technical report. World Health Organization
WHO. (2015). Progress on sanitation and drinking water: 2015 update and MDG assessment. World Health Organization
Yugo, D. M., & Meng, X. J. (2013). Hepatitis E virus: Foodborne, waterborne and zoonotic transmission. International Journal of Environmental Research and Public Health, 10(10), 4507–4533. https://doi.org/10.3390/ijerph10104507
Acknowledgements
We are grateful to field staffs of the polio environmental surveillance for the collection of samples.
Author information
Authors and Affiliations
Contributions
All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by MAF, MGC, MYMH, KND, EZMC, and NR. The first draft of the manuscript was written by MAF and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.
Corresponding author
Ethics declarations
Conflict of interest
The authors declare that there are no conflicts of interest.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
About this article
Cite this article
Fatawou, M.A., Chavely, M.G., Henri, M.Y.M. et al. First Detection and Characterization of Hepatitis E Virus in Sewage Samples in Cameroon. Food Environ Virol 15, 255–261 (2023). https://doi.org/10.1007/s12560-023-09562-3
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12560-023-09562-3