▎ WuXi AppTec content team editor
Some fans quickly guessed liver poisoning/liver damage, and the answer was close.
What the hell is going on? Let's see the truth.
The last issue of the truth review
We mentioned in the title that in addition to the symptoms of the digestive tract (nausea and vomiting), Uncle Ming also has obvious yellowing of the whole body skin, yellowing of the eyes, and clay-colored stools and fatigue -
Friends who often watch popular science should guess that this is a typical symptom of an acute hepatitis attack.
Indeed, his alanine transaminases (ALT) are dozens of times higher than normal, a frightening number.
So what exactly is hepatitis?
It turned out that in addition to the hepatitis B he already had, there was also hepatitis E virus in his body!
This also starts with the porridge bottom hot pot that Uncle Ming and his friends eat.
This is a common specialty in Guangdong: bring the porridge to a boil, reduce the heat, and start scalding a variety of meats.
One of the most commonly used hot foods is pork liver, which many people love to eat (Cantonese-style raw porridge and soup noodles are also often seen).
As mentioned at the beginning, Uncle Ming is very particular about eating. In order to keep the pork liver crisp and tender, he only boiled it for one minute at a time and fished it up.
But he never expected that there was hepatitis E virus in the uncooked pig liver.
Image credit: 123RF
To make matters worse, he has chronic hepatitis B and has been taking antiviral drugs, but in recent months he has stopped the drugs himself, and viral replication has escalated again.
The elderly, who had poor resistance, were even worse infected with hepatitis E, which eventually led to liver failure.
Fortunately, I went to the hospital in time, but the consequences were unimaginable.
Popular science time
Viral hepatitis E (hereinafter referred to as hepatitis E), as the name suggests, is a viral hepatitis caused by the hepatitis E virus (HEV).
According to the World Health Organization, about 20 million people worldwide are infected with hepatitis E virus each year, of which an estimated 3.3 million people develop hepatitis E symptoms.
Compared with the familiar hepatitis A, hepatitis B and C, although hepatitis E is not so famous, it is a zoonotic infectious disease.
In other words, HEV can be transmitted from person to person, or it can be transmitted to humans by other animals such as infected pigs, cattle, sheep, shellfish, and deer.
Hepatitis E infection is a self-limiting disease. For ordinary people, they can generally rely on immunity to heal themselves within 2 weeks, and there are no sequelae.
However, pregnant women, chronic hepatitis B patients, and the elderly are at risk, which may cause serious complications and even death.
How is hepatitis E transmitted?
The most important type is manure-oral transmission – pig manure with HEV is used as fertilizer, contaminating vegetables, fruits, water sources, shellfish aquatic products, and finally being eaten raw by humans.
This is common in areas with poor sanitation, where a large group of people can be "brought down" at a time.
People who regularly work with pig droppings, raw pork and organs (such as pork farming, slaughtering, and selling) are also susceptible. Some people already have antibodies in their bodies, but they don't necessarily develop the disease.
There are also a few rare cases of human-to-human transmission, such as irregular blood transfusions, organ transplantation, mother-to-child transmission, etc.
Pork-like foods with viruses, which are not cooked thoroughly and sent to the table, are also a potential source of infection.
Studies across China comparing hepatitis E virus contamination in various parts of pigs (pork, pork liver, pig blood, pig loin, pig bile) in slaughterhouses and farmers' markets have found that:
The positive rate of hepatitis E virus nucleic acid in pig internal organs is relatively high, especially in pig liver (the positive rate can reach up to 18%). ）
Foreign studies have found that pig liver products (such as pork liver sauce), sausages, pork skin jelly, etc. are contaminated by hepatitis E virus.
There are still relatively few research in this area in China, but whether it is pork, offal or pork products, we must pay attention when eating.
Liver and kidneys of heV-infected dead pigs (Image source: Reference[8])
So, when pork food is cooked, how can we ensure that the hepatitis E virus is completely killed?
Some disease control personnel have specially done relevant research, soaked the heV-positive fresh pork liver with boiled marinade, and then put it into the microwave oven to heat, and found that there are viral nucleic acid detection in 5 minutes and 10 minutes. Until heating for 15 minutes, the hepatitis E virus in pig liver can be effectively killed.
Another foreign study also found that raw or semi-cooked pig foods must be heated to 71 ° C for 20 minutes to kill HEV.
It is more important to note that sometimes the meat looks cooked on the surface, which does not mean that the inside is also thoroughly cooked.
And many people who love to eat stir-fried pork liver, pork offal soup, pork liver porridge, and cold mixed pork liver want to "eat while tender", and only heat up for 1-3 minutes to serve it on the table, which is more dangerous.
So, here are some suggestions for foodie friends:
1. Pork and bivalve shellfish must be thoroughly cooked before eating.
2. When eating at home or going out to eat hot pot, use two sets of utensils to handle raw and cooked food separately to avoid cross-contamination.
3. When buying vegetables and putting them in the refrigerator, separate the bags of raw food and cooked food, cooked on the top and raw on the bottom, to avoid pollution caused by juice flowing down.
4. When cooking, raw meat and offal must be cut into thin slices, which can speed up the heating speed, especially when hot pot, porridge, and stir-fry. thereinto:
Pork liver (sliced): depending on the thickness and amount, at least boiled or fried/stir-fried for 3 to 5 minutes before eating;
Bivalve shellfish aquatic products: heated at least to a central temperature of 90 ° C, maintained for 1 minute and 30 seconds. It is best to boil in boiling water until the crust is open and cook for another 3 to 5 minutes.
5. When ordering from a restaurant, it is also best to ask the chef to thin the meat so that it is easy to judge the raw and cooked situation. By the way, don't be tender, but cook thoroughly (for the sake of good health, you can only sacrifice the taste).
For regular cooks or food processors (chefs, slaughterers), etc., it is also recommended:
Utensils and countertops for processing hog meat were washed with hot water and detergent each time.
Tools for making raw food (including raw meat and offal), cooked or ready-to-eat foods (cutting boards, kitchen knives, etc.) should be separated and not mixed.
After processing raw meat, or before using related tools and equipment, wash your hands thoroughly with running water and hand sanitizer for 20 seconds.
For high-risk groups of long-term exposure to livestock, hepatitis E vaccine can also be given to prevent infection.