Hepatitis E, the “Brexit Virus”

This book charts the discovery of the hepatitis E virus (HEV) in Afghanistan and Russia in 1982 and its effects in developing countries, where it is spread by infected drinking water, producing spectacular outbreaks, with a high death rate in pregnant women. More recently, it has been discovered that HEV is very common in developed countries (over 3 million infections per year in Europe), where it is spread mainly via consumption of contaminated pork meat. There has been a major increase in cases of HEV across Europe in humans, including patients who have gone on to develop liver failure, some of whom have died. HEV is a ‘hot topic’ in blood transfusion circles and many European countries are considering introducing HEV screening for donors. This follows the lead of the UK and Ireland in 2016/17; 1 in 2,000 UK blood donors being currently viraemic at the time of donation. HEV has very recently been found to quite commonly damage the nervous system in humans. This discovery is discussed in some detail here.

This text explores the reasons for the major upswing in cases of HEV in humans in Europe, including the recent practice of using of HEV-contaminated pig serum in domesticated and farmed animal feed. Recent cases of HEV in the UK appear to have originated from pigs in Continental Europe. The reasons for this are uncertain, but HEV has been dubbed by the international press as the ‘Brexit Virus’, perhaps an early leaving present from our friends in the EU.

Accessible to lay readers, the book contains elements of the medical art versus science debate and explores the Greek concept of philotimo. It is leavened by case histories and medical stories from a health service increasingly under pressure, and given historical, political and geographical context by examples of medical discoveries and self-experimentation from the past, including inevitable comparisons with the BSE crisis of the 1980s.