IMPORTANT FOODBORNE VIRAL AGENTS IN TERMS OF PUBLIC HEALTH

Year 2022, Volume: 13 Issue: 1, 11 - 25, 30.04.2022

Ömer Çakmak Ulaş Acaröz Hüseyin Gün

https://doi.org/10.38137/vftd.1056066

Cited By: 1

Abstract

In recent years, foodborne viral infections have acquired increasing importance. This study will provide an update on the literature and findings related to foodborne viruses. Viruses are obligate intracellular microorganisms that have a low infection dose, stable, and can remain in foods for a long time without loss of infectivity. For this reason, foods are vectors for the transmission of viral agents to humans. They can survive in adverse conditions such as stomach acidity, intestinal enzymes, alkaline conditions, and host defense system. Human norovirus (HuNoV), human rotavirus (HRV), hepatitis A virus (HAV), hepatitis E virus (HEV), human astrovirus (HAstV), Aichi virus (AiV), sapovirus (SaV), human adenovirus HAdV), and enterovirus (EV) are known as the most important viral agents of food origin in terms of public health. In addition, infectious avian influenza virus (H5N1) and Nipah virus (NiV) are important zoonotic agents that have been seen as the cause of serious disease in both humans and animals in recent years. In foodborne viral infections, transmission is mainly by the fecal-oral route. Some foods or water, especially shellfish caught from waters contaminated with feces, are potential sources of viral agents. On the other hand, raw or uncooked food prepared by infected personnel or contaminated after cooking is also an important source of contamination. Nowadays, PCR (Polymerase Chain Reaction)-based methods are widely used in the detection of food-borne viral agents. Apart from the cooling and freezing processes applied to foodstuffs in the control of viruses. In recent years, non-thermal technological food processing methods such as high pressure processing (HPP: High pressure processing), cold plasma (CP: Cold plasma), ultraviolet light (UV: Ultraviolet light), irradiation, and pulsed electric field (PEF: Pulsed electric field) usage is also gaining importance.

Keywords

Risk of infection,, Foodborne viruses,, Public Health,, qRT-PCR

HALK SAĞLIĞI AÇISINDAN ÖNEMLİ GIDA KAYNAKLI VİRAL ETKENLER

Abstract

Son yıllarda gıda kaynaklı viral enfeksiyonlar artan bir önem kazanmaktadır. Bu derleme çalışması, gıda kaynaklı virüsler ile ilgili literatür ve bulgular hakkında bir güncelleme sağlamaktadır. Virüsler düşük enfeksiyon dozuna sahip olan stabil ve enfektivite kaybı olmaksızın gıdalarda uzun süre kalabilen zorunlu hücre içi mikroorganizmalardır. Bu nedenle gıdalar viral etkenlerin insanlara bulaşmasında vektör durumundadır. Mide asiditesi, bağırsak enzimleri ile alkali şartlar ve konakçı savunma sistemi gibi olumsuz koşullarda canlılıklarını sürdürebilirler. İnsan norovirüsü (HuNoV), insan rota virüsü (HRV), hepatit A virüsü (HAV), hepatit E virüsü (HEV), insan astrovirüsü (HAstV), Aichi virüsü (AiV), sapovirüs (SaV), insan adenovirüsü HAdV) ve enterovirüs (EV) halk sağlığı açısından gıda kaynaklı en önemli viral etkenler olarak bilinmektedir. Ayrıca, bulaşıcı kuş gribi virüsü (H5N1) ve Nipah virüsü (NiV) hem insan hem de hayvanlarda son yıllarda ciddi hastalık nedeni olarak görülen önemli zoonoz etkenlerdir. Gıda kaynaklı viral enfeksiyonlarda bulaşma esas olarak, fekal-oral yolla olmaktadır. Dışkı ile kontamine sulardan avlanan kabuklu deniz ürünleri başta olmak üzere bazı gıdalar veya su viral etkenlerin potansiyel kaynağını oluşturmaktadır. Diğer taraftan enfekte personel tarafından hazırlanan çiğ veya yeterince pişirilmeden tüketilen ya da pişirildikten sonra kontamine olan gıdalar da önemli bulaşma kaynağıdır. Günümüzde gıda kaynaklı viral etkenlerin tespitinde PCR (Polymerase Chain Reaction) temelli yöntemler yaygın olarak kullanılmaktadır. Virüslerin kontrolünde gıda maddelerine uygulanan soğutma ve dondurma işlemlerinin haricinde son dönemlerde yüksek basınçlı işleme (HPP: High pressure processing), soğuk plazma (CP: Cold plasma), ultraviyole ışık (UV: Ultraviolet light), ışınlama ve darbeli elektrik alanı (PEF: Pulsed electric field) gibi termal olmayan teknolojik gıda işleme yöntemlerinin kullanımı da önem kazanmaktadır.

Keywords

Enfeksiyon riski,, Gıda kaynaklı virüsler,, Halk Sağlığı,, qRT-PCR

References

• Bachofen, C. (2018). Selected Viruses Detected on and in our Food. Curr Clin Microbiol Rep, 5 (2), 143-153.
• Baert, L., Mattison, K., Loisy-Hamon, F., Harlow, J., Martyres, A., Lebeau, B., Stals, A., Van Coillie, E., Herman, L. & Uyttendaele, M. (2011). Review: Norovirus prevalence in Belgian, Canadian and French fresh produce: A threat to human health? Int J Food Microbiol, 151 (3), 261-269.
• Balada-Llasat, J. M., Rosenthal, N., Hasbun, R., Zimmer, L., Bozzette, S., Duff, S., Chung, J. & Ginocchio, C. C. (2019). Cost of managing meningitis and encephalitis among infants and children in the United States. Diagn Microbiol Infect Dis, 93 (4), 349-354.
• Banerjee, A., De, P., Manna, B. & Chawla-Sarkar, M. (2017). Molecular characterization of enteric adenovirus genotypes 40 and 41 identified in children with acute gastroenteritis in Kolkata, India during 2013–2014. J Med Virol, 89 (4), 606-614.
• Beigel, J. H., Farrar, J., Han. A. M., Hayden, F. G., Hyer, R., De Jong, M., Lochindarat, S., Nguyen, T. K. T., Nguyen, T. H., Tran, T. H., Nicoll, A., Touch, S. & Yuen, K. Y. (2005). Avian influenza A (H5N1) infection in humans. N Engl J Med, 353 (13), 1374-1385.
• Bosch, A., Pinto, R. M. & Guix, S. (2016). Foodborne viruses. Curr Opin Food Sci, 2016, 8, 110-119.
• Bosch, A., Gkogka, E., Le Guyader, F. S., Loisy-Hamon, F., Lee, A., van Lieshout, L., Marthi, B., Myrmel, M., Sansom, A., Schultz, A. C., Winkler, A., Zuber, S. & Phister, T. (2018). Foodborne viruses: Detection, risk assessment, and control options in food processing. Int J Food Microbiol, 285, 110-128.
• Boxman, L. A. (2013). Viral contamination by food handlers and recommended procedural controls. In, Cook N, Ed. Viruses in food and water: risks, surveillance and control. Cambridge, United Kingdom: Woodhead Publishing Ltd; 2013. pp. 217-232.
• Burbelo, P. D., Ching, K. H., Esper, F., Iadarola, M. J., Delwart, E., Lipkin, W. I. & Kapoor, A. (2011). Serological studies confirm the novel astrovirus HMOAstV-C as a highly prevalent human infectious agent. PLoS ONE, 6 (8), e22576. CDC (2013). West Nile virus and other arboviral diseases-United States, 2012. MMWR Morb Mortal Wkly Rep, 62 (25), 513-517.
• Chen, B. S., Lee, H. C., Lee, K.. M., Gong, Y. N. & Shih, S. R. (2020). Enterovirus and Encephalitis. Front Microbiol, 11 (261), 1-15.
• Choo, Y. J & Kim, S. J (2006). Detection of human adenoviruses and enteroviruses in Korean oysters using cell culture, integrated cell culture-PCR, and direct PCR. J Microbiol, 44 (2), 162-170.
• Chung, H., Jaykus, L. A. & Sobsey, M. D. (1996). Detection of human enteric viruses in oysters by in vivo and in vitro amplification of nucleic acids. Appl Environ Microbiol, 62 (10), 3772-3778.
• Costafreda, M. I., Bosch, A. & Pintó, R. M. (2006). Development, evaluation, and standardization of a Real-Time TaqMan Reverse Transcription-PCR assay for quantification of hepatitis A virus in clinical and shellfish samples. Appl Environ Microbiol, 72 (6), 3846-3855.
• Croci, L., De Medici, D., Di Pasquale, S. & Toti, L. (2005). Resistance of hepatitis A virus in mussels subjected to different domestic cookings. Int J Food Microbiol, 105 (2), 139-144.
• D’Souza, D. H. (2015) 5-Update on foodborne viruses: Types, concentration and sampling methods. In, Sofos J, Ed. Advances in Microbial Food Safety. Woodhead Publishing Series in Food Science, Technology and Nutrition; 2015. Vol 2, pp. 102-116.
• Dancho, B. A., Chen, H. & Kingsley, D. H. (2012). Discrimination between infectious and non-infectious human norovirus using porcine gastric mucin. Int J Food Microbiol, 155 (3), 222-226.
• Dashti, A. S., Ghahremani, P., Hashempoor, T. & Karimi, A. (2016). Molecular epidemiology of enteric adenovirus gastroenteritis in under five-year-old children in Iran. Gastroenterol Res Pract, 2016, 2045697.
• De Medici, D., Croci, L., Di Pasquale, S., Fiore, A. & Toti, L. (2001). Detecting the presence of infectious hepatitis A virus in molluscs positive to RT-nested-PCR. Lett Appl Microbiol, 33 (5), 362-366.
• Di Bartolo, I., Diez-Valcarce, M., Vasickova, P., Kralik, P., Hernandez, M., Angeloni, G., Ostanello, F., Bouwknegt, M., Rodriguez-Lazaro, D., Pavlik, I. & Ruggeri, F. M. (2012). Hepatitis E virus in pork production chain in Czech Republic, Italy, and Spain, 2010. Emerg Infect Dis, 18 (8), 1282-1289.
• EFSA (2011). Scientific opinion on an update on the present knowledge on the occurrence and control of foodborne viruses. EFSA J, 9 (7), 2190, pp. 96.
• EFSA (2015). The European Union Summary Report on Trends and Sources of Zoonoses, Zoonotic Agents and Food-borne Outbreaks in 2013. EFSA J, 13 (1), 3991, pp. 165.
• EFSA (2019). The European Union One Health 2018 Zoonoses Report. EFSA J, 17 (12), 5926, pp. 276.
• Escudero-Abarca, B.I., Suh, S. H., Moore, M. D., Dwivedi, H. P. & Jaykus, L. A. (2014). Selection, characterization and application of nucleic acid aptamers for the capture and detection of Human Norovirus strains. PLoS One, 9 (9), e106805.
• Esona, M. D. & Gautam, R. (2015). Rotavirus. Clin Lab Med, 35 (2), 363-391.
• Gao, S., Li, D., Zha, E., Zhou, T., Wang, S. & Yue, X. (2015). Surveillance of hepatitis E virus contamination in shellfish in China. Int J Environ Res Public Health, 12 (2), 2026-2036.
• Gentry, J., Vinjé, J., Guadagnoli, D. & Lipp, E. K. (2009). Norovirus distribution within an estuarine environment. Appl Environ Microbiol, 75 (17), 5474-5480.
• Hagström, A. E. V., Garvey, G., Paterson, A. S., Dhamane, S., Adhikari, M., Estes, M. K., Strych, U., Kourentzi, K., Atmar, R. L. & Willson, R. C. (2015). Sensitive detection of Norovirus using phage nanoparticle reporters in lateral-flow assay. PLoS One, 10 (5), e0126571.
• Hata, A., Katayama, H., Kitajima, M., Visvanathan, C., Nol, C. & Furumai, H. (2011). Validation of internal controls for extraction and amplification of nucleic acids from enteric viruses in water samples. Appl Environ Microbiol, 77 (13), 4336-4343.
• ISO (2017). Microbiology of the food chain-Horizontal method for determination of hepatitis A virus and norovirus in using real-time RT-PCR. Part 1: Method for quantification, ISO/TS 15216-1.
• Iturriza-Gomara, M. & O’Brien, S. J. (2016). Foodborne viral infections. Curr Opin Infect Dis, 29 (5), 495-501.
• Jones, K. E., Patel, N. G., Levy, M. A., Storeygard, A., Balk, D., Gittleman, J. L. & Daszak, P. (2008). Global trends in emerging infectious diseases. Nature, 451 (7181), 990-993.
• Kishida, N., Noda, N., Haramoto, E., Kawaharasaki, M., Akiba, M. & Sekiguchi, Y. (2014). Quantitative detection of human enteric adenoviruses in river water by microfluidic digital polymerase chain reaction. Water Sci Technol, 70 (3), 555-560.
• Kitajima, M. & Gerba, C. P. (2015). Aichi virus 1: Environmental occurrence and behavior. Pathogens, 4 (2), 256-268.
• Kohl, C., Brinkmann, A., Dabrowski, P. W., Radonić, A., Nitsche, A. & Kurth, A. (2015). Protocol for metagenomic virus detection in clinical specimens. Emerg Infect Dis, 21 (1), 48-57.
• Koopmans, M. (2012). Food-Borne Viruses From A Global Perspectıve. In: Choffnes ER, Relman DA, Olsen LA, Hutton R, Mack A. Editors. Improving Food Safety Through a One Health Approach: Workshop Summary. Institute of Medicine, Washington DC: The National Academies Press; pp. 225-251.
• Koopmans, M. & Brown, D. (1999). Seasonality and diversity of Group A rotaviruses in Europe. Acta Paediatr Suppl, 88 (426), 14-19.
• Koopmans, M. & Duizer, E. (2004). Foodborne viruses: an emerging problem. Int J Food Microbiol, 90 (1), 23-41.
• Kumthip, K., Khamrin, P., Ushijima, H. & Maneekarn, N. (2019). Enteric and non-enteric adenoviruses associated with acute gastroenteritis inpediatric patients in Thailand, 2011 to 2017. PLoS ONE, 14 (8), e0220263.
• Le Guyader, F. S., Krol, J., Ambert-Balay, K., Ruvoen-Clouet, N., Desaubliaux, B., Parnaudeau, S., Le Saux, J. C., Ponge, A., Pothier, P., Atmar, R. L. & Le Pendu, J. (2010). Comprehensive analysis of a Norovirus-associated gastroenteritis outbreak, from the environment to the consumer. J Clin Microbiol, 48 (3), 915-920.
• Lee, H. M., Kwon, J., Choi, J. S., Lee, K. H.., Yang, S., Ko, S. M., Chung, J. K., Cho, S.Y. & Kim, D. (2013). Rapid detection of Norovirus from fresh lettuce using Immunomagnetic Separation and a Quantum Dots Assay. J Food Prot, 76 (4), 707-711.
• Lodder, W. J., Rutjes, S. A., Takumi, K. & de Roda Husman, A. M. (2013). Aichi virus in sewage and surface water, the Netherlands. Emerg Infect Dis, 19 (8), 1222-1230.
• Luby, S. P, Rahman, M., Hossain, M. J., Blum, L. S., Husain, M. M., Gurley, E., Khan, R. Ahmed, B. N., Rahman, S., Nahar, N., Kenah, E., Comer, J. A. & Ksiazek, T. G. (2006). Foodborne transmission of Nipah virus, Bangladesh. Emerg Infect Dis, 12 (12), 1888-1894.
• Mann, T. Z., Haddad, L. B., Williams, T. R., Hills, S. L., Read, J. S., Dee, D. L., Dziuban, E. J., Pérez-Padilla, J., Jamieson, D. J., Honein, M. A. & Shapiro-Mendoza, C. K. (2018). Breast milk transmission of flaviviruses in the context of Zika Virus: A Systematic Review. Paediatr Perinat Epidemiol, 32 (4), 358-368.
• Marsh, Z., Shah, M. P., Wikswo, M. E., Barclay, L., Kisselburgh, H., Kambhampati, A., Cannon, J. L., Parashar, U. D., Vinjé, J. & Hall, A. J. (2018). Epidemiology of foodborne Norovirus outbreaks–United States, 2009–2015. Food Saf, 6 (2), 58-66.
• Mattison, K., Grudeski, E., Auk, B., Charest, H., Drews, S. J., Fritzinger, A., Gregoricus, N., Hayward, S., Houde, A., Lee, B. E., Pang, X. L., Wong, J., Booth, T. F. & Vinje, J. (2009). Multicenter comparison of two Norovirus ORF2-based genotyping protocols. J Clin Microbiol, 47 (12), 3927-3932.
• Miranda, R. C. & Schaffner, D. W. (2019). Virus risk in the food supply chain. Curr Opin Food Sci, 30, 43-48.
• Moore, D. M., Escudero-Abarca, B. I., Suh, S. H. & Jaykus, L. A. (2015). Generation and characterization of nucleic acid aptamers targeting the capsid P domain of a human norovirus GII. 4 strain. J Biotechnol, 209, 41-49.
• Moreno, L., Aznar, R. & Sánchez, G. (2015). Application of viability PCR to discriminate the infectivity of hepatitis A virus in food samples. Int J Food Microbiol, 201, 1-6.
• Muranyi, W., Bahr, Udo., Zeier, M. & van der Woude, F. J. (2005). Hantavirus Infection. J Am Soc Nephrol, 16, 3669-3679.
• Müller, L., Schultz, A. C., Fonager, J., Jensen, T., Lisby, M., Hindsdal, K., Krusell, L., Eshøj, A., Møller, L. T., Porsbo, L. J., Böttiger, B. E., Kuhn, K., Engberg, J. & Ethelberg, S. (2015). Separate norovirus outbreaks linked to one source of imported frozen raspberries by molecular analysis, Denmark, 2010–2011. Epidemiol Infect, 143 (11), 2299-2307.
• Neethirajan, S., Ahmed, S. R., Chand, R., Buozis, J. & Nagy, É. (2017). Recent advances in biosensor development for foodborne virus detection. Nanotheranostics, 1 (3), 272-295.
• Newell, D. G., Koopmans, M., Verhoef, L., Duizer, E., Aidara-Kane, A., Sprong, H., Opsteegh, M., Langelaar, M., Threfall, J., Scheutz, F., van der Giessen, J. & Kruse, H. (2010). Food-borne diseases the challenges of 20 years ago still persist while new ones continue to emerge Int J Food Microbiol, 139, 3-15.
• Oka, T., Wang, Q., Katayama, K. & Saif, L. J. (2015). Comprehensive review of Human Sapoviruses. Clin Microbiol Rev, 28 (1), 32-53.
• Perrin, A., Loutreul, J., Boudaud, N., Bertrand, I. & Gantzer, C. (2015). Rapid, simple and efficient method for detection of viral genomes on raspberries. J Virol Methods, 224, 95-101.
• Pexara, A. & Govaris, A. (2020). Foodborne Viruses and Innovative Non-Thermal Food-Processing Technologies. Foods, 9 (11), 1520.
• Pintó, R. M., Costafreda, M. I. & Bosch, A. (2009). Risk assessment in shellfish-borne out-breaks of hepatitis A. Appl Environ Microbiol, 75 (23), 7350-7355.
• Purdy, M. A., Harrison, T. J., Jameel, S., Meng, X. J., Okamoto, H.., Van der Poel W. H. M. & Smith, D. S. (2017). ICTV virus taxonomy profile: Hepeviridae. J Gen Virol, 98, 2645-2646.
• Razafimahefa, R. M., Ludwig-Begall, L. F. & Thiry, E. (2020). Cockles and mussels, alive, alive, oh* The role of bivalve molluscs as transmission vehicles for Human Norovirus infections. Transbound. Emerg Dis, 67 (S2), 9-25.
• Reuter, G., Boros, A. & Pankovics, P. (2011). Kobuviruses- a comprehensive review. Rev Med Virol, 21 (1), 32-41.
• Rivadulla, E. & Romalde, J. L. (2020). A comprehensive review on Human Aichi virus. Virol Sin, 35 (5), 501-516.
• Robilotti, E., Deresinski, S. & Pinsky, B. A. (2015). Norovirus. Clin Microbiol Rev, 28 (1), 134-164.
• Rzezutka, A. & Cook, N. (2004). Survival of human enteric viruses in the environment and food. FEMS Microbiology Rev, 28 (4), 441-453.
• Sanchez, G. (2015). Processing strategies to inactivate hepatitis A virus in food products: a critical review. Compr Rev Food Sci and Food Saf, 14 (6), 771-784.
• Sanchez, G. & Bosch, A. (2016). Survival of Enteric viruses in the environment and food. In, Goyal SM, Cannon JL. Editors. Viruses in Foods, Food Microbiology and Food Safety. Switzerland: Springer International Publishing; pp. 367-392.
• Sanchez, G., Elizaquível, P. & Aznar, R. (2012). Discrimination of infectious hepatitis A viruses by propidium monoazide real-time RT-PCR. Food Environ Virol, 4 (1), 21-25.
• Sanchez-Vega, R., Elez-Martínez, P. & Martín-Belloso, O. (2014). Influence of high intensity pulsed electric field processing parameters on antioxidant compounds of broccoli juice. Innov Food Sci Emerg Technol, 29, 70-77.
• Sarvikivi, E., Roivainen, M., Maunula, L., Niskanen, T., Korhonen, T., Lappalainen, M. & Kuusi, M. (2012). Multiple norovirus outbreaks linked to imported frozen raspberries. Epidemiol Infect, 140 (2), 260-267.
• Sedlak, R. H. & Jerome, K. R. (2013). Viral diagnostics in the era of digital PCR. Diagn Microbiol Infect Dis, 75 (1), 1-4.
• Shah, M. P. & Hall, A. J. (2018). Norovirus illnesses in children and adolescents. Infect Dis Clin North Am, 32 (1), 103-118.
• Siebenga, J. J., Vennema, H., Zheng, D. P., Vinjé, J., Lee, B. E., Pang, X. L., Ho, E. C. M., Lim, W., Choudekar, A., Broor, S., Halperin, T., Rasool, N. B. G., Hewitt, J., Greening, G. E., Jin, M., Duan, Z. J., Lucero, Y., O’Ryan, M., Hoehne, M., Schreier, E., Ratcliff, R. M., White, P. A., Iritani, N., Reuter, G. & Koopmans, M. (2009). Norovirus illness is a global problem: Emergence and spread of Norovirus GII. 4 variants, 2001–2007. J Infect Dis, 200 (5), 802-812.
• Silva, M. M. O., Tauro, L. B., Kikuti, M., Anjos, R. O., Santos, V. C., Gonçalves, T. S. F., Paploski, I. A. D., Moreira, P. S. S., Nascimento, L. C. J., Campos, G. S., Ko, A. I., Weaver, S. C., Reis, M. G., Kitron, U. & Ribeiro, G. S. (2018). Concomitant Transmission of Dengue, Chikungunya, and Zika Viruses in Brazil: Clinical and Epidemiological Findings From Surveillance for Acute Febrile Illness. Clin Infect Dis, 69 (8), 1353-1359.
• Sun, Y., Laird, D. T. & Shieh, Y. C. (2012). Temperature dependent survival of hepatitis A virus during storage of contaminated onions. Appl Environ Microbiol, 78 (14), 4976-4983.
• Symes, S. J., Gunesekere, I. C., Marshall, J. A. & Wright, P. J. (2007). Norovirus mixed infection in an oyster-associated outbreak: an opportunity for recombination. Arch Virol, 152 (6), 1075-1086.
• Tang, J. W. & Holmes, C. W. (2017). Acute and chronic disease caused by enteroviruses. Virulence, 8 (7), 1062-1065.
• Todd, E. C. D. & Greig, J. D. (2015). Viruses of foodborne origin: A review. Virus Adapt Treat, 7, 25-45.
• Trostle, J. A., Hubbard, A., Scott, J., Cevallos, W., Bates, S. J. & Eisenberg, J. N. S. (2008). Raising the level of analysis of food-borne outbreaks: Food-sharing networks in rural coastal Ecuador. Epidemiology, 19 (3), 384-390.
• Uiprasertkul, M., Puthavathana, P., Sangsiriwut, K., Pooruk, P., Srisook, K., Peiris, M., Nicholls, J. M., Chokephaibulkit, K., Vanprapar, N. & Auewarakul, P. (2005). Influenza A H5N1 replication sites in humans. Emerg Infect Dis, 11 (7), 1036-1041.
• Vinje´, J. (2015). Advances in laboratory methods for detection and typing of Norovirus. J Clin Microbiol, 53 (2), 373-381.
• Vinjé, J., Hamidjaja, R. A. & Sobsey, M. D. (2004). Development and application of a capsid VP1 (region D) based reverse transcription PCR assay for genotyping of genogroup I and II noroviruses. J Virol Methods, 116 (2), 109-117.
• Webb, G. W. & Dalton, H. R. (2019). Hepatitis E: an underestimated emerging threat. Ther Adv Infect Dis, 6, 1-18.
• WHO (2008). Viruses in food: Scientific advice to support risk management. https://www.fao.org/3/i0451e/I0451E.pdf.
• Yamashita, T., Ito, M., Tsuzuki, H. & Sakae, K. (2001). Identification of Aichi virus infection by measurement of immunoglobulin responses in an Enzyme-Linked Immunosorbent Assay. J Clin Microbiol, 39 (11), 4178-4180.
• Yeargin, T. & Gibson, K. E. (2018). Key characteristics of foods with an elevated risk for viral enteropathogen contamination. J Appl Microbiol, 2018, 126 (4), 996-1010.