Yesterday I was researching the history of human plasma collection and eventually found myself reading the long transcript of an FDA meeting: 104th Meeting of the Blood Products Advisory Committee on September 20, 2012.
The purpose of the hearing was to see if the experts thought that the blood supply should be tested for HEV. Big shots on the panel included Robert H. Purcell (NIAID/NIH) who wrote A novel virus in swine is closely related to the human hepatitis E virus in 1997 (free on PUBMED). At the time, Purcell wrote that HEV is not endemic in the United States; Sixteen years later, a CDC map shows that this epidemic is not just in “developing” countries.
Anyone who is immunosuppressed, pregnant, or has liver disease will benefit from reading “Hepatitis E Virus: Waterborne, Foodborne, and Zoonotic Transmission.” in a 2013 report (free on PUBMED).
(See page 5) Complications for pregnant women: “Complications with concurrent HEV infection during pregnancy include death of both the mother and fetus, abortion, premature birth, and death of the baby shortly after birth. Vertical transmission from the mother to fetus was reported in 33% of cases and HEV RNA was reportedly detected in human colostrum as well. Unfortunately it is not understood why pregnancy resulted in severe hepatitis E manifestation.”
Another recent report estimates 3000 of stillborn babies in yearly in Africa and Asia.
At the FDA meeting referenced above, Dr. Purcell explains cooking risks:
“In saline, HEV is inactivated at 10 degrees Celsius lower temperature than HAV, about 56 degrees versus 66 degrees. When suspended in something like ground meat, which has a protective effect, HEV is not inactivated at temperatures below 72 degrees Celsius, or about 160 degrees Fahrenheit, the temperature that the Department of
Agriculture has long recommended for cooking pork products.”
But the USDA promotes pink in the “other white meat.” Dr. Purcell doesn’t know that the USDA dropped their pork-temperature recommendations to 145 degrees. Is this merely irresponsible or, hmmmm, criminal because they read the research literature. They know.
The ancient biblical prohibition to not eat certain foods turns out to be excellent health advice and not merely a spiritual discipline. Eating pork etc. doesn’t make you a bad person but it might make you feel bad, very sick or even dead if you are at risk.
Is HEV also a blood-borne virus (BBV)? Yes, there is growing evidence that HEV is associated with transfusions. And that brings me back to HEV in blood donors, recipients, and the FDA, protectors of our the blood supply in which we are all stakeholders. I’ll post about that next time. But I am perplexed at the USDA’s reduction in cooking temps when they know the harm it can cause. Are the fresh salads we love safe? Not if “undercooked” pig manure compost is used to fertilize fields!
The approximately 112 million hogs slaughtered in 2013 (table 4) made a lot of HEV-loaded feces so I think it’s fair to guess it’s used extensively. (Sorry to mention this. Makes greenhouses even more attractive.)