Hepatitis E

(Non-A, Non-B Hepatitis)

Hepatitis E causes acute hepatitis but does not lead to chronic hepatitis. It is similar to hepatitis A in that it occurs mainly by contamination of food and water.

Occurance

It occurs mostly in developing countries and is widespread in India, Asia, Africa and Central America. Epidemics normally happen after water supplies are contaminated with sewage after monsoons or flooding. Infected individuals in the United States have usually returned from travel to an area where the virus is more common. Young and middle-aged adults are most frequently symptomatic with younger individuals thought to have subacute or asymtpomatic disease.

Incubation

The virus has a 15-60 day incubation period and infected persons may be contagious for up to two weeks after symptoms appear. The acute phase is mild but there is a 1-2% chance of developing sudden and severe liver disease in which case a liver transplant might be needed.

Transmission

HEV is spread by just like HAV through contamination of food and water. It is not transmitted through needles, blood or other body fluids or through sexual contact.

Symptoms

The symptoms are the same as for HBV with jaundice and flu-like aches and pains. Testing for HEV is reserved for travelers returning from developing countries in whom hepatitis is present but other hepatitis viruses cannot be detected.

Travelers

Travelers to areas where hepatitis E occurs may be at some risk of acquiring this disease by close contact with cases or through contaminated food or water. Immune globulin (IG) prepared from plasma collected in non-HEV endemic areas has not been effective in preventing clinical disease during hepatitis E outbreaks. The efficacy of IG prepared from plasma collected in HEV endemic areas is unclear. Travelers to these areas should receive IG for protection against hepatitis A, but they should not assume that they are protected against hepatitis E. The best prevention of infection is to avoid potentially contaminated food and water, as with hepatitis A and other enteric infections.

There is no treatment for HEV hepatitis.

Diseases