We encountered 13 cases of hepatitis E in Gifu, Japan. All cases occurred sporadically, and 13 different hepatitis E virus (HEV) strains were detected. For 11 strains detected, similar strains were found in DNA databases. Eight strains were similar to those detected in patients with hepatitis E, wild animals, or pig liver within the economic zone, including Gifu. Two other strains were closely related to the strains found in a patient or blood donor living far from Gifu. The other strain from a patient with no travel history abroad had high homologies with strains circulating in France and Spain. Consumption of domestically and internationally distributed pork may be a possible cause for the three patterns of HEV diffusion identified in this study.
