Hepatitis E infection is an infectious disease of the liver caused by the hepatitis E virus (HEV). This virus attacks the liver and leads to the inflammation of liver tissue. There are 5 different viruses that can cause inflammation of the liver. A person can become infected with hepatitis E virus when that individual drinks water which is contaminated by the stool of an infected person. Outbreaks of hepatitis E usually occurs in areas with poor sanitation and the disease is most common in East and South Asia, the Middle East, Africa, and Central America.
Under rare circumstances, hepatitis E can also be spread from a pregnant woman to her fetus and through transfusion of infected blood products. Hepatitis E infection usually resolves on its own without you needing any medication. But it can sometimes progress into chronic hepatitis which may lead to acute liver failure. A vaccine to prevent hepatitis E virus infection has been developed and is licensed in China, but is not yet available elsewhere.
Who is most at Risk?
WHO estimates that there are about 20 million hepatitis E infections occurring worldwide every year and that hepatitis E caused approximately 44 000 deaths in 2015. Those most at risk of getting hepatitis E infection include :
- Those living in areas where there is very poor sanitation and water supply.
- People who travel to areas where hepatitis E infection is very common.
- Individuals requiring blood transfusion.
- A fetus whose mother has hepatitis E infection.
Children don’t seem to show any noticeable symptoms when infected with hepatitis E virus. However, teenagers and adults may present with the following symptoms if infected with hepatitis E :
- Loss of appetite.
- Abdominal pain.
- Dark urine.
- Clay-colored stool.
- Joint pain.
You should see your doctor if you or your child is experiencing any of these symptoms.
Diagnosis and Treatment
The diagnosis can be confirmed only by testing for the presence of antibody against HEV or HEV RNA. This is because cases of Hepatitis E are not clinically distinguishable from other types of acute viral hepatitis. In addition, your doctor may suspect the disease after asking you some question to determine whether you were at risk of being exposed to the hepatitis E virus.
Treatment with medication is not usually required for hepatitis E infection because the immune system fights it successfully. Your doctor will ask you to go rest at home, eat good nutrition, take plenty of water and avoid alcohol or drugs like paracetamol which can do more damage to the liver. Only in cases of chronic hepatitis E infection where there is risk of acute liver failure that will require hospitalization. Antiviral drugs may benefit some patients but most will require liver transplant when liver failure sets in.
Vaccines for hepatitis E are not widely available. Therefore prevention of Hepatitis E relies primarily on good sanitation and the availability of clean drinking water. Those living or traveling to areas where hepatitis E is common should :
- Avoid eating raw fruit and raw vegetables unless they can peel them.
- Only drink water that has been boiled or drink sealed bottled water.
- Not use tap water to clean their teeth. They can use water that has been boiled.
- Avoid eating ice or add ice to their drinks.
- WHO – hepatitis E fact sheet
- CDC – questions and answers about hepatitis E
- SA Health – hepatitis E symptoms, treatment and prevention.