CHP investigates a case of human infection of rat Hepatitis E virus
The Centre for Health Protection (CHP) of the Department of Health today (July 13) is investigating a case of human infection of rat Hepatitis E virus (HEV). The CHP urged the public to maintain good personal, food and environmental hygiene, and to implement effective rodent prevention and control measures to prevent rat HEV infection.
Case details
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The case involves a 72-year-old male with underlying illnesses and weakened immunity. On July 9, during a follow-up visit to Queen Mary Hospital for his pre-existing condition, he was found to have abnormal liver function. His blood sample tested positive for rat HEV upon laboratory testing by the Public Health Laboratory Services Branch under the CHP. The patient remains in stable condition. He has not developed symptoms and did not require hospitalisation.
The CHP's epidemiological investigation revealed that the patient lives in Sham Shui Po District and primarily spends his time in the vicinity of Sham Shui Po and Tsim Sha Tsui districts. He had outbound travel with his family member from late May to early June (within the incubation period). He reported having no direct contact with rodents or rats, nor has seen any rats at his residence or places visited. The CHP does not rule out thatthe patient might have come into indirect contact with places or food contaminated by rats or their excreta during the incubation period, either locally or during outbound travel. His household contact (also his travel collateral) has no symptoms currently and has been put under medical surveillance.
Investigations into the source and route of infection are ongoing.
Although the place of infection cannot be ascertained at this stage, staff from the CHP and the Food and Environmental Hygiene Department (FEHD) have conducted site inspections of the patient's residence and the his routine activity areas to assess environmental hygiene conditions. Investigation staff detected minor signs of rodent activity in the refuse collection room of his residential building, on the streets around his residence, on the streets in the vicinity of his activity areas in Tsim Sha Tsui, as well as in the food premises he had visited. Apart from stepping up the cleansing and disinfection, as well asanti-rodent work in the public areas in the vicinity of the locations visited by the patient, the FEHD will serve a Notice of Elimination of Vermin under section 47 of the Public Health and Municipal Ordinance (Cap. 132) requesting the licensee of concerned food premises and owners' corporations of the concerned building to take appropriate actions within a specified timeframe to eliminate vermin in the concerned food premises and common parts of the building.
The CHP and the FEHD will continue to investigate and follow up on the case.
This is the second case of human infection of rat HEV recorded so far this year. In the past five years (from 2021 to 2025), Hong Kong recorded an average of zero to two cases of rat HEV per year.
Symptoms of rat hepatitis E
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Human cases of rat hepatitis E virus infection affected mostly immunocompromised persons. Most cases were asymptomatic, while symptomatic patients reported mild symptoms, such as fatigue, abdominal pain and loss in appetite. It is less likely for patients with rat HEV infection to develop jaundice compared to HEV infected patients.
Prevention
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The possible routes of transmission of rat HEV to humans include ingestion of food or water contaminated by rodents or their excreta, exposure to environments or objects contaminated by rodents or their excreta and direct contact with rodents or their excreta. The HEV that usually causes human infection is mainly transmitted through the fecal-oral route.
To prevent Hepatitis E infection, the public should maintain good personal, food and environmental hygiene. For example, they should wash their hands thoroughly before eating, store food properly or in the refrigerator, avoid leaving food at room temperature for a long time, and use 1:99 diluted household bleach for general household cleaning and disinfection as household detergents may not kill HEV.
The Five Keys to Food Safety should be adopted when handling food, i.e. Choose (choose safe raw materials), Clean (keep hands and utensils clean), Separate (separate raw and cooked food), Cook (cook thoroughly) and Safe Temperature (keep food at a safe temperature), to prevent food-borne diseases.
In general, rodents (such as rats) can transmit multiple diseases to humans, both directly and indirectly. The public is advised to take the following measures:
- Eliminate sources of food and nesting places for rodents in the living environments. Store food in covered containers and handle pet food properly to prevent it frombecoming food for rodents;
- Store all refuse and food remnants in dustbins with well-fitted covers. Dustbins must be emptied at least once a day;
- Keep premises, especially refuse rooms and stairways, clean. Avoid accumulation of articles;
- Inspect all flower beds and pavements regularly for signs of rodent infestation; and
- Avoid the high-risk activities below to reduce rodent contact:
- Avoid contact with rodents and areas contaminated by rodent excreta;
- Avoid handling rodents with bare hands;
- Wash hands with liquid soap and water immediately after handling animals, and disinfect contaminated areas; and
- If a wound appears, clean the broken skin immediately and cover it properly with waterproof adhesive dressings.
Rodent control requires co-operation from all sectors of society. The CHP urged the public to strengthen rodent prevention and control measures and co-operate with government's efforts to reduce the risk of rat HEV transmission.
CHP investigates a case of human infection of rat Hepatitis E virus Source: HKSAR Government Press Releases
