Hepatitis E

Hepatitis E is a viral infection of the liver caused by the hepatitis E virus (HEV). It is spread through the ingestion of contaminated water. In most individuals, the illness is mild and recovery is complete.

However pregnant females in their 2nd and 3rd trimesters develop severe disease with fulminant hepatitis, fetal death and maternal death in nearly 25% of cases.

Where does it occur?

It occurs in developing countries with inadequate hygiene and sanitation systems. Map

How is it transmitted?

Travelers contract the infection by ingesting water contaminated with feces of infected individuals.

Is it contagious from person to person?

It is contagious from person to person through the ingestion of virus in the feces of infected individuals through soiled hands.

What is the risk for travelers?

Risk is felt to be low for most people; pregnant females are probably at greatest risk in areas of poor hygiene and sanitation.

How soon after exposure will one develop symptoms?

One generally develops symptoms 4-6 weeks after exposure, but can range from 2 to 8 weeks after exposure.

What are the signs and symptoms?

Approximately 4-5 weeks after exposure adults can develop symptoms of fatigue, loss of appetite, nausea, abdominal pain and jaundice. In this initial phase, Hepatitis E virus may cause more severe symptoms compared to other hepatitis viruses. Symptoms resolve in nearly all individuals in a few weeks.

The exception is in pregnant females in the 2nd and 3rd trimesters; when severe liver disease occurs with liver failure resulting in loss of fetus and a maternal death rate nearing 25%.

Is there any treatment?

There is no specific anti-viral treatment; supportive care is standard practice.

Are there any lab tests to diagnose illness?

Blood antibody tests like HEV Ab are available.

What preventive measures can be taken?

Currently there is no vaccine available and Immune Globulins are ineffective.

Strict food safety and water safety precautions and hand washing are recommended.

Pregnant females in their 2nd and 3rd trimesters should carefully evaluate risk versus benefit of travel to high-risk areas.

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