That HEV was transmitted through ingestion of contaminated food is supported by the following evidence. First, 3 case reports have provided direct evidence of HEV transmission through ingestion of contaminated animal food products with identical or near identical sequences between the patients and the contaminated food they ate. Two cases occurred in the early 2000s in Japan through consumption of grilled wild boar (4) or sashimi of Sika deer (5); the third, reported recently in Spain, was transmitted through ingestion of pig meat (6). Second, HEV widely infects domestic pigs and wild boar (7). Third, swine and human HEV strains have genetic similarities and, in some cases, are indistinguishable (1). Fourth, in Marseille, France, a case–control study identified ingestion of figatellu as a risk factor for HEV infection. Genetic similarities were found between sequences isolated from patients with autochthonous hepatitis E and nonrelated figatelli purchased in the same region (8). Finally, infectious virus, replicating in a 3-dimensional culture system, was identified in a HEV RNA-positive figatellu (9).