Reviewed By: Pramod Kerkar, MD, FFARCSI

Hepatitis E is an enterically transmitted virus, which is responsible for 50% of cases of acute hepatitis in the endemic countries. It is responsible for 25% of acute hepatitis in Africa and 15 to 20% in Eastern-oriented countries. Each year, more than 70,000 mortality and 3000 fetal death cases estimated globally because of Hepatitis E.

Statistically, 3.4 million cases of HEV recorded every year.

How is Hepatitis E Transmitted?

It is predominantly transmitted through fecally contaminated water. Apart from the fecal-oral route, several cases of food-borne also have been identified because of intake of infected meat products, infected blood transfusion, and mother-to-child transmission during pregnancy. In developing countries, due to lack of standards in the supply of water and poor sanitation is the reason for transmission. In developed countries, such as Europe-oriented countries, ingestion of contaminated meat or meat products like pork and wild boar meat is the reason for infection.

Who is At Risk?

Hepatitis E has 4 genotypes, of which genotypes 1 and 2 exclusively infect humans and can lead to endemic HEV or outbreaks in countries with poor sanitation systems. Genotypes 3 and 4 can infect humans, pigs, and other animals, and can result in sporadic infection in both developed and developing countries

HEV incidence cases globally occur and traveling to high endemicity countries is highly risky. As many countries lack the water safety standards, outbreaks of HEV may possible. It particularly occurs in during rainy or after the monsoon because of a large proportion of water bodies favors the transmission. Till today, there is no specific drug or vaccine available for to prevent HEV infection.

How Do You Prevent Hepatitis E?

Travelers must avoid drinking tap water where safety standards and guidelines are not followed. Disinfected bottled water (boiled or treated), pasteurized milk, hot beverages, and carbonated sealed water is safe for travelers. The practice of cleanliness and hygiene can reduce the incidence rate among the general population in highly endemicity countries. Well-water, public tap water, beverages made of tap or well water, and unsterilized milk are at high risk of transmitting HEV.

Travelers who get HEV infections, sometimes they do not show any symptoms. Whereas, others vulnerable person show onset of fever, fatigue, nausea, loss of appetite, and jaundice which this condition exist for several weeks to months. The incubation period of HEV infection in the host is 2–9 weeks (mean 6 weeks). Among the general population, pregnant women are at serious risk which causes miscarriage, stillbirth, or neonatal death. Hepatitis E infection during pregnancy, especially in the third trimester with genotype 1, has a more severe outcome that might lead to fulminant hepatitis, increasing maternal and fetal mortality. Breastfeeding is generally considered as safe in asymptomatic women infected with HEV because of the presence of anti-HEV antibodies in the colostrum. But, this is risky as mother host plenty of viral loads and so the possibility of transmission is high from infected breast milk.

Eat Safe Foods

Food that is served hot with properly cooked meat, eggs, vegetables washed in clean water and pasteurized dairy milk products are safe to eat.

Food from the street, raw meat (For example, fish meat) or undercooked meat, unwashed vegetables or fruits, wild meats, and food served at room temperature are at risk of HEV infection. In France, the HEV infection acquired from eating figatellu, a sausage delicacy prepared from raw pig liver. A hepatitis E outbreak on a cruise ship was associated with consumption of shellfish.

Conclusion

Hepatitis E infection is a consequence of poor hygiene in developing and third world countries. HEV infection during pregnancy is life-threatening, which may cause liver injury and sometimes mortality occurs. Close by contact with infected individuals is not advised such as kissing, hugging or sharing foods.

Also Read:

Pramod Kerkar

Written, Edited or Reviewed By:

, MD,FFARCSI

Pain Assist Inc.

Last Modified On: June 21, 2018

This article does not provide medical advice. See disclaimer

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