07 May
Hepatitis E was not recognized as a distinct human disease until 1980. Hepatitis E is caused by infection with the hepatitis E virus.

How is Hepatitis E transmitted?

Hepatitis E is transmitted via the faecal-oral route. Hepatitis E is a waterborne disease, and contaminated water or food supplies have been implicated in major outbreaks. Consumption of faecally contaminated drinking water has given rise to epidemics, and the ingestion of raw or uncooked shellfish has been the source of sporadic cases in endemic areas. Person-to-person transmission is uncommon. There is no evidence for sexual transmission or for transmission by transfusion.

Where is Hepatitis B a problem?

The highest rates of infection occur in Central and South-East Asia, North and West Africa, and in Mexico.

When is a HEV infection life-threatening?

In general, hepatitis E is a self-limiting viral infection followed by recovery and chronic infection does not occur.

Occasionally, a severe (fulminant) form of hepatitis develop with mortality 0.5% - 4.0%. Fulminate hepatitis occurs more frequently in pregnancy with mortality rate of 20% among pregnant women in the 3rd trimester.


The incubation period following exposure to Hepatitis E ranges from 3 to 8 weeks, with a mean of 40 days.

Symptomatic infection is most common in young adults aged 15-40 years. Although Hepatitis E infection is frequent in children, it is mostly asymptomatic or causes a very mild illness without jaundice that goes undiagnosed.

Typical signs and symptoms of hepatitis include jaundice (yellow discoloration of the skin and sclera of the eyes, dark urine and pale stools), loss of appetite, an enlarged, tender liver, abdominal pain and tenderness, nausea and vomiting, and fever, although the symptoms may vary from very mild to severe.


Since cases of Hepatitis E are not clinically distinguishable from other types of acute viral hepatitis, diagnosis is made by blood tests which detect specific antibodies to hepatitis E or by reverse transcriptase polymerase chain reaction (RT-PCR).


At present, no commercially available vaccines exist for the prevention of Hepatitis E.


As almost all hepatitis E infections are spread by the faecal-oral route. Good personal hygiene, high quality standards for public water supplies and proper disposal of sanitary waste are the most important requirements for prevention. For travellers, the precautions include avoiding drinking water and/or ice of unknown purity and eating uncooked shellfish, uncooked fruits or vegetables that are not peeled or prepared by the traveller.


Hepatitis E is a viral disease, and as such, antibiotics are of no value in the treatment of the infection. The infections are usually self-limited, and hospitalization is generally not required. Hospitalization is required for severe (fulminant) hepatitis and should be considered for infected pregnant women. No available therapy is capable of altering the course of acute infection.

Dr. Andrea

Dr. Andrea Rajnakova is our Consultant Gastroenterologist and Physician.


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