Objective:

To explore the role of a One Health approach in enhancing surveillance and diagnostic strategies for hepatitis E virus (HEV) in Europe, focusing on the integration of animal, human, and environmental health data.

Key Findings:

• HEV is under-recognized in Europe, with a significant antibody prevalence among blood donors, indicating a potential public health risk.
• Main reservoirs of HEV genotype 3 are domestic pigs and wild boars, with close genetic links to human strains, highlighting the zoonotic nature of the virus.
• Foodborne transmission is the primary route, particularly through undercooked pork and wild boar meat, necessitating improved food safety measures.
• Environmental water sources contain HEV, but the direct risk of infection is low; however, indirect risks exist through contaminated food, emphasizing the need for environmental monitoring.
• Surveillance systems for human, veterinary, and environmental health are not well aligned, limiting understanding of HEV transmission and complicating public health responses.

Interpretation:

A comprehensive One Health approach is essential for effective HEV surveillance and management, specifically addressing gaps in environmental monitoring and animal reservoir research to enhance public health outcomes.

Limitations:

• Limited environmental surveillance and research on animal reservoirs hinder comprehensive understanding of HEV transmission dynamics.
• Lack of standardized methods for sampling and surveillance across sectors complicates data comparison and integration.

Conclusion:

Improving food safety and biosecurity, alongside enhanced environmental monitoring, are critical for reducing HEV transmission in Europe, with potential policy implications for public health strategies.