About Hepatitis E

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Hepatitis E is an infection of the liver caused by the hepatitis E virus. It is not common in the United States. Hepatitis E typically causes an acute illness. Chronic infections are rare, but have been reported in recipients of solid organ transplants and people with severe immunodeficiency.

Anyone can get hepatitis E, but those at greater risk include travelers to developing countries, particularly Asia, Africa, and the Indian subcontinent. However, rare cases have occurred in the United States among people with no history of travel to endemic countries.

Some people with hepatitis E may not have symptoms. When symptoms do occur, they are similar to those of other types of viral hepatitis. Signs and symptoms may include fever, fatigue, loss of appetite, nausea, abdominal discomfort, vomiting, dark urine, jaundice (i.e., yellowing of skin or whites of eyes), clay-colored stool, and joint pain. Hepatitis E can cause serious illness in pregnant women, especially during the third trimester of pregnancy.

Symptoms may appear 15 to 64 days after exposure, but usually appear within 26 to 42 days.

Hepatitis E virus is found in the stool (feces) of infected people. The virus is usually spread by eating or drinking contaminated food or water. Most outbreaks in developing countries have been associated with fecally contaminated drinking water. The virus has also been found in certain animals, and foodborne transmission can occur by eating uncooked or undercooked pig, boar, and deer meat. Mother-to-infant transmission of hepatitis E virus occurs frequently in endemic areas. Transmission though blood product transfusions is rare, but possible.

The period of infectiousness is unknown.

A blood test is used to diagnose hepatitis E.

Treatment is supportive care in the acute phase of the infection. If chronic infection develops, antiviral medications may be used.

It is unknown whether past infection provides immunity.

Yes. Children and adults with acute hepatitis E infection should be excluded for one week after onset of the illness.

Travelers to developing countries should avoid consuming water and beverages with ice of unknown purity, uncooked shellfish, and raw or undercooked pork and venison. Boiling and chlorination of water will inactivate the hepatitis E virus. Person-to-person transmission can be prevented with careful hand washing after using the bathroom, changing diapers, and before preparing and/or eating food.

Additional information is available at www.ndhealth.gov/disease or by calling the North Dakota Department of Health at 800.472.2180.

This disease is a reportable condition. As mandated by North Dakota law, any incidence of this disease shall be reported to the North Dakota Department of Health.

Risk Assessment

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