Spreading of the new rat hepatitis E virus (rHEV) into humans

Abstract Human infection with the hepatitis E virus (HEV) is the most common etiology of acute viral hepatitis globally. Estimates are of 20 million cases and 40,000 deaths per year. Researchers in Germany reported in 2009 a new 40–45 % genomic divergent hepevirus species in rats, named Rocahepevirus ratti . Human cases of both acute and chronic hepatitis due to rat HEV (rHEV) were first identified in Hong Kong in 2017. Since then, 49 individuals infected with rHEV have been confirmed worldwide. Herein, we provide an update on the virology, epidemiology, diagnosis, and clinical manifestations of this emerging zoonosis. Specific interventions, including vaccines and antivirals, as ribavirin, are being investigated. Ultimately holistic One Health approaches should be undertaken to confront this new health threat.