Researchers from the Royal Cornwall Hospital in Truro have received a grant of -337,000 to carry out a two-year study with partners in Glasgow and Norwich into a rare form of Hepatitis - Hepatitis E. The grant has come from the Chief Scientist's Office for Scotland and will be divided between the three centres taking part in the study.
Dr Harry Dalton, a Consultant Gastroenterologist at the Royal Cornwall Hospitals Trust and affiliate member of the Peninsula College of Medicine and Dentistry's European Centre for Environment and Human Health (ECEHH), will be leading a team in Cornwall. Dr Dalton and his team in Truro have been involved in developing tests to diagnose Hepatitis E, and they are regarded as one of the world leaders in this condition. In fact an unusual strain of the virus, which was found in a patient in the Cornish Centre, was sent to the National Institutes of Health in Maryland, USA. They sequenced the viral genome and it has been named Kernow C1.
Dr Dalton said: "This came about in Cornwall because I run a jaundice clinic twice a week. We had a small proportion of patients and we couldn't work out what was wrong with them and that's when we discovered it was Hepatitis E."
Hepatitis E is an infection which is normally associated with developing countries such as India, Central Africa and Nepal and is generally thought to be caused by poor sanitary conditions. Previously it had always been assumed that in countries like Britain if Hepatitis E showed up it was in people who had travelled abroad. However, that was proving to not be the situation in many cases found in Cornwall and the rest of the UK.
Dr Dalton said: "Not only had the patients not travelled abroad but they didn't fit the normal age range for the virus. In other parts of the world it usually affects the young and they usually get over it. However, in the cases being seen in the UK it is the middle aged and elderly, particularly men, who are getting it. Since we have started looking we have seen 55 cases mainly in Cornwall, but also Devon, and some patients have died as a result."
It is believed a large proportion of Hepatitis E cases in the UK are caused by contact with pigs and products from pigs. Dr Dalton said: "Hepatitis E can be transmitted through blood transfusions and contaminated shellfish but it is mainly found in pigs, and we have found it in the human food chain. We are not suggesting people should not eat pork - simply that if you do make sure it is cooked thoroughly and if handling raw meat make sure you wash your hands thoroughly."
The study will look at patients with existing liver problems who have been admitted to hospital with a worsening of their existing conditions to see whether any of the new problems have been caused by exposure to the Hepatitis E virus. The aim will be to try and better understand the virus and its effects. The three teams are expecting to study around 800 people across the three sites during the two year study and they are expecting to see a 70 per cent mortality rate in patients exposed to the virus.
Dr Dalton said: "If our study shows that contact with Hepatitis E is the cause of deterioration in patients who have damaged livers, such patients may be candidates for vaccination to prevent them getting the virus in the first place. A Chinese team are in the process of developing a vaccine."
The HEV programme is the first major grant project which will be partly based at the Peninsula Medical School's new European Centre for Health and the Environment which is based at the Knowledge Spa in Truro. Dr Dalton is a Senior Lecturer at the centre. He said: "This is quite a significant piece of research funding and will sit alongside our other ongoing collaboration with teams in France, China and the USA."
Professor Michael Depledge, Interim Director of ECEHH and Chair of the Advisory Board, said: "This is an excellent achievement by Dr Harry Dalton and his team and represents a bright start for ECEHH bringing research funding in to Cornwall."
Professor Janice Kay, Senior Deputy Vice Chancellor of the University of Exeter, said: "This is an important piece of research that will contribute significantly to enhancing the health not only of people in Cornwall, but also elsewhere in the world. It's great to see this achievement of Dr Harry Dalton and his team so early in the development of the ECEHH."
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