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Epidemiology of viral hepatitis E
KOPAL, Jiří
To write this thesis, I chose a topic related to viral hepatitis E. In my opinion, this topic is clearly highly topical and the issue of VHE will be increasingly discussed in the future. Viral hepatitis are in general frequent diseases in developed countries, as well as in the Czech Republic. Nowadays there are known 5 types of hepatitis that to a greater or lesser extent occur in the population. In the Current Status section I will acquaint the reader with the basic anatomical and physiological patterns of functions and structures of the liver tissue, because viral hepatitis - as the name suggests - affects hepatocytes, thus the liver cells. Furthermore, I described from the literature all types of viral hepatitis and introduced differences which occur between them. In particular, I focused intensely on hepatitis E. Before writing this thesis I have identified several hypotheses and objectives. H1: The overall morbidity of VHE for the period 2000-2010 in the Czech Republic is comparable with morbidity in other European countries during the same period. H2: In the Czech Republic, the case of an infection of VHE is more of an occupational disease. From the available literature it was determined that the incidence of VHE in Europe is increasing. The literature also introduced several known cases of occupational disease of VHE for professionals working with pork or pigs and veterinarians, but these cases are rather sporadic. Thus, hypothesis 2 was not confirmed. In my thesis I have also determined a few objectives. Objective 1: To provide an overview of the prevalence of VHE for the period of 2000-2010 in Europe and in the Czech Republic and to determine whether the patterns of the spread of VHE differ in the Czech Republic and in Europe. Objective 2: To determine whether the case of viral hepatitis E in the Czech Republic is a greater occurrence as an occupational illness or a disease with a traveling history. Objective 3: To evaluate the efficacy of preventive and anti-epidemic measures which are applied as a protection against the infection with hepatitis E. The overview of the incidence of infection is presented in tables and graphs in the chapter Results, part of it is listed in the chapter Attachments. Scientific researches of VHE are still basically in the world and in Europe at their beginning. From the literature, I found that not only in Czech Republic but also in other European countries, the VHE is more abundant. Currently it is not known much unambiguous information that would lead to improved effectiveness transmission prevention of VHE in developed countries. Increase in incidence of VHE is here attributed to more frequent examinations of chronic liver disease, thorough diagnosis of drug-induced liver failure and other diseases whose cause has not been definitely clarified. Until recently, the idea of VHE infection amongst patients with no history of traveling was almost taboo. Only further research in this area may help us to better understand the disease and to ensure the prevention, diagnosis and specific treatment. In the meantime, we should follow the precautionary principle.
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Viral hepatitis E
ANDĚLOVÁ, Šárka
The thesis contains basic information regarding Viral hepatitis E, particularly the causative agents, human and animal strains, the clinical picture and occurrence in the Czech Republic as well as abroad. The practical part is focused on analysis of trends of occurrence of the viral hepatitis E in the Czech Republic from the very earliest, up until the present time. The research further looks at morbidity in the different regions of the Czech Republic, which is compared to the morbidity in Plzen region. The practical part further focuses on the specific source, route of transmission and possible preventive measures against viral hepatitis E. In this work, both quantitative and qualitative types of research were used. In quantitative research, secondary analysis of data was used from various sources like EPIDAT. In the qualitative research, semi standardised interviews with doc. MUDr. Petr Pazdiora CSc, and with MVDR. Vaclav Polacek. Based on the interviews, an educational material in form of a leaflet was created. From the year 1996 to the year 2012, a total of 894 cases of HEV where recorded. In 1996, there was only one case of Viral hepatitis E which was recorded. From 1997 to 2005, the occurrence was sporadic and negligible. From 2006, there was a linear increase in viral hepatitis E. The incidence significantly increased in the year 2009 and 2011. In the Czech Republic, Viral Hepatitis E has an upward trend of occurrence. Viral hepatitis E cannot be prevented by active immunization, possibility of a vaccine is still being investigated. Basic preventive measures include maintaining principles of hygiene like avoiding drinking water from unknown sources, food should be prepared using drinking water and fruit should be properly washed and then peeled before consumption. It is important to find out about the occurrence of viral hepatitis E, before travelling to any foreign country. During meat processing, it is important to avoid cross contamination between clean and unclean operations. Before consuming foods like black pudding, sausages, steaks and pies, it is important to ensure that this food is properly cooked using adequate heat and for a period of time. From the research, it can be concluded that, there is need to devote adequate attention to viral hepatitis E. It may seem that the incidence in the Czech Republic is not serious, but it is important to focus on public awareness of this disease, especially the preventive measures so as to stop it from spreading.
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