Hepatitis E is a liver infection caused by the hepatitis E virus (HEV), which typically results in an acute, self-limiting illness. It is a significant public health concern, particularly in parts of the world with poor sanitation and limited access to clean water, where large outbreaks often occur. In developed nations, infections are less common and often linked to consuming contaminated food from animals (zoonotic transmission). Many people, especially children, may have no symptoms (asymptomatic). When symptoms do appear, they usually develop between 15 and 60 days after exposure and are similar to other forms of viral hepatitis, including:
- Jaundice (yellowing of the skin and eyes)
- Fatigue and general feeling of illness (malaise)
- Loss of appetite, nausea, and vomiting
- Abdominal pain, particularly in the liver area
- Fever
- Dark urine and light-colored stools
- Joint pain
While most people recover completely, pregnant women (especially with genotypes 1 and 2) and immunocompromised individuals are at higher risk for severe complications, including acute liver failure and death. TreatmentsThere is no specific cure or antiviral treatment for acute hepatitis E; the goal of treatment is supportive care to manage symptoms as the body's immune system clears the virus. This typically involves:
- Rest
- Staying hydrated with plenty of fluids
- Adequate nutrition
- Avoiding alcohol and other substances that may stress the liver
In rare cases where the infection becomes chronic (primarily in immunocompromised people), antiviral medication like ribavirin may be used under the guidance of a healthcare provider. Risks of Foodborne TransmissionFoodborne transmission is a major route of infection, particularly in industrialized countries where zoonotic genotypes (3 and 4) are common in animal reservoirs like domestic pigs, wild boar, and deer.
- Contaminated Water: In many parts of the world, drinking water contaminated with infected human feces is the most common source of large outbreaks.
- Undercooked Meat: Eating raw or undercooked pork, wild game meat (venison, boar), or internal organs (liver, offal) is a primary risk factor in non-endemic areas.
- Shellfish: Consuming raw or undercooked shellfish harvested from sewage-polluted waters can also be a source of infection.
- Contaminated Produce/Milk: Less often, contaminated fruits, vegetables, or unpasteurized milk can transmit the virus if they have come into contact with contaminated water or animal feces. The virus can survive on surfaces and withstand some food processing methods.
Prevention focuses on access to clean water, proper sanitation, and safe food handling.
- Ensure Safe Water: When traveling to areas where hepatitis E is common, avoid drinking water or using ice from unknown sources. Drinking boiled or bottled water is a key precaution.
- Practice Good Hygiene: Wash hands thoroughly with soap and water after using the bathroom, changing diapers, and before preparing or eating food.
- Cook Food Thoroughly: Ensure all meat, especially pork, wild game, and shellfish, is cooked thoroughly to an internal temperature that inactivates the virus (above 71°C or 160°F).
- Vaccination: A hepatitis E vaccine (HEV 239 or Hecolin®) has been developed and approved for use in China, but it is not currently licensed or available in the United States or most other countries.