In the last decade, the number of reported hepatitis E virus (HEV) infections in Germany, including Bavaria, has continued to rise. In order to identify risk factors associated with HEV infection, we investigated notified hepatitis E cases from Bavaria during 2017. The project “Intensified Hepatitis E Surveillance in Bavaria” included interviews with questionnaires, collection and genotyping of stool, serum and food samples. In addition, certain risk factors were examined in a sample comparison with healthy population using univariable analysis and logistic regression. In total, 135 hepatitis E cases from Bavaria were included in the analysis. Mean age for women was 46 (range 20–74) years and 47.5 (range 20–85) for men. 56 of the cases (41.5%) were asymptomatic. Among the symptomatic cases, both men and women were equally affected with symptoms like fever (16.3%), jaundice (18.8%) and upper abdominal pain (28.2%). 145 human samples (serum, stool) and 6 food samples were collected. 15.9% of the human samples (n = 23) were positive for HEV RNA by reverse-transcription quantitative real-time PCR (RT-qPCR). Identified risk factors significantly associated with hepatitis E were sausage consumption with odds ratio 9.6 (CI 1.3–70.1), fish with OR 2.2 (CI 1.1–4.4) and cat ownership with OR 1.9 (CI 1.3–3.0) in multivariable analyses. Further investigation is needed to confirm the role of fish in HEV transmission. Autochthonous HEV genotype 3 is prevalent in Bavaria and there could be more transmission routes contributing to the spread of HEV than previously known. Undercooked meat, offal, sausages, fish, shellfish and contact with animals and pets are possible sources for infection.

在过去十年中，包括巴伐利亚在内的德国报告的戊型肝炎病毒 (HEV) 感染人数持续上升。为了确定与 HEV 感染相关的危险因素，我们调查了 2017 年巴伐利亚州通报的戊型肝炎病例。“巴伐利亚州加强戊型肝炎监测”项目包括问卷调查、粪便、血清和食物样本的收集和基因分型。此外，使用单变量分析和逻辑回归在与健康人群的样本比较中检查了某些风险因素。共有来自巴伐利亚的 135 例戊型肝炎病例被纳入分析。女性的平均年龄为 46（范围 20-74）岁，男性的平均年龄为 47.5（范围 20-85）。其中56例（41.5%）无症状。在有症状的病例中，男性和女性同样受到发烧（16.3%）、黄疸（18.8%）和上腹痛（28.2%）等症状的影响。收集了 145 个人体样本（血清、粪便）和 6 个食物样本。15.9% 的人体样本（n = 23) 通过逆转录定量实时 PCR (RT-qPCR) 对 HEV RNA 呈阳性。在多变量分析中，已确定与戊型肝炎显着相关的风险因素是香肠消费，优势比为 9.6（CI 1.3-70.1），鱼的 OR 为 2.2（CI 1.1-4.4）和养猫的 OR 为 1.9（CI 1.3-3.0）。需要进一步调查以确认鱼类在 HEV 传播中的作用。本土 HEV 基因型 3 在巴伐利亚流行，可能有比以前已知的更多的传播途径促成 HEV 的传播。未煮熟的肉类、内脏、香肠、鱼、贝类以及与动物和宠物的接触是可能的感染源。