ClinVir joins the new EU-project ONWARD: Together we move forward!
This project aims to combat the most common cause of acute viral hepatitis, zoonotic hepatitis E, in a One Health perspective. More than 30 European countries participate with a total of 150 members joining.
Susanne Dudman is representing Norway and is leading work group 2, focusing on clinical management. The group aims to establish robust and comparable clinical trial frameworks, standardize outcome measurements, and support the identification and development of antiviral therapies.
ONWARD (One Health Zoonotic Hepevirus Network, COST-CA24140), is a pan‑European multidisciplinary initiative to strengthen surveillance, research, clinical management and control of zoonotic hepeviruses, primarily hepatitis E virus (HEV, Paslahepevirus balayani) and rat-origin HEV (Rocahepevirus ratti). HEV is now recognised as the leading cause of acute viral hepatitis in Europe, yet its true burden remains substantially underestimated due to heterogeneous surveillance systems, non-standardised diagnostics and under-recognition of chronic and extrahepatic manifestations, particularly in immunocompromised hosts.
From a public health perspective, HEV is acknowledged by EFSA as a major food‑borne zoonotic threat for the EU, with pigs and wildlife as key reservoirs, and additional risk associated with blood transfusion and organ transplantation. Surveillance of HEV in humans, animals and along the food chain remains fragmented, with HEV notifiable only in a minority of EU Member States and ratHEV largely absent from official reporting. There is no EU‑wide harmonised surveillance or reference network, and molecular and serological assays differ across sectors, limiting reliable diagnosis, typing and data sharing. Preventive tools are also limited: no HEV vaccine is licensed in Europe, donor screening is inconsistent, and evidence-based guidance for control in animal production and food processing is scarce.
ONWARD responds to these challenges by establishing a coordinated One Health framework uniting virology, hepatology, infectious diseases, veterinary medicine, food safety, epidemiology, ecology and public health experts from 30 countries. The network is scientifically diverse, spanning virology/microbiology, veterinary medicine, infectious diseases/hepatology, epidemiology, food safety, environmental science, bioinformatics and modelling, with an emphasis on gender balance and early‑career researchers.
The Action pursues five main objectives:
- harmonisation of diagnostic and molecular tools for HEV and ratHEV;
- strengthening clinical research and evidence‑based management;
- integration of human, animal, food and environmental molecular surveillance;
- promotion of data sharing, capacity building and inclusiveness; and
- support for evidence‑based policy development and preparedness for emerging zoonotic threats.
These objectives are operationalised through five interconnected Working Groups (diagnostics, clinical research, integrated surveillance, communication/training and policy/synergies), supported by cross‑cutting task forces. Susanne Dudman is the leader of the working group focused on objective 2.
Over the coming years, ONWARD will standardise serological, molecular and whole‑genome sequencing methods, including non‑canonical sample types, and evaluate novel technologies such as biosensors, CRISPR‑based assays, next‑generation sequencing and AI‑supported analytics. In parallel, it will harmonise clinical trial standards, outcome measures and biomarkers for HEV and ratHEV, and systematically assess antiviral candidates and vaccine strategies. At the farm, food-chain and environmental levels, the network will identify risk factors linked to pig farming, wildlife, hunting, processing and culinary practices, and develop practical guidelines for risk reduction and viral inactivation along the farm‑to‑fork continuum.
Beyond technical work, ONWARD invests in communication, training and policy translation, aligning its activities with European health, food‑safety, water and environmental initiatives to avoid duplication and maximise impact. Supported by an External Scientific Advisory Committee from Africa, Asia and the Americas, it aims to position Europe as a proactive global actor in the response to zoonotic hepeviruses.
Overall, ONWARD is designed to transform fragmented efforts into a coherent European One Health response, generating tools, guidelines and collaborative platforms that will inform ECDC and EFSA roadmaps and strengthen resilience against current and future zoonotic and food‑borne threats.
Links:
COST Action CA24140 - One Health Network Against Zoonotic Hepeviruses (https://hev-onward.eu/)
Working group 2: Clinical Management and Therapeutic Approach for Zoonotic Hepeviruses
ClinVir – Clinical Virology Research Group - headed by Susanne G. Dudman