Detection and quantification of hepatitis E virus RNA in ready to eat raw pork sausages in the Netherlands

The aim of the present study was to assess raw pork sausages collected on the Dutch market for the presence of hepatitis E virus (HEV) RNA. 46 of 316 (14.6%) products sampled from Dutch retail stores in 2017–2019 were positive for HEV RNA. HEV RNA was detected in 10.8% of “cervelaat” (n = 74), 18.5% of salami (n = 92), 26.1% of “metworst” (n = 46), 16.3% of “snijworst” (n = 43) samples. This was significantly more often than in other raw pork sausages like dried sausages, fuet or chorizo (3.3%, n = 61). The percentage of HEV RNA positive products was not significantly different for products sold as either sliced or unsliced deli meat. The average viral load in positive tested products was 2.76 log10 genome copies per 5 g, incidentally reaching up to 4.5 log10 genome copies per 5 g. The average HEV RNA level was significantly higher in samples collected in 2017 than those in samples collected in 2018, and most of the samples in 2019. Typing by sequence analysis was successful for 33 samples, all revealing genotype 3c. The results support recent epidemiological studies that identified specific raw pork sausages as risk factor for hepatitis E virus infection in the Netherlands. Persons at risk, including Dutch transplant recipients, have been advised to avoid the consumption of raw pork sausages. The study warrants a continuation of monitoring to follow the HEV RNA levels in pork products for use in risk assessments and risk management.