Hepatitis E is caused by a virus, which is present in faeces of infected people and it spreads among social groups with imperfect hygiene (“disease of dirty hands”) or by contaminated food or water. In that regard, it is quite similar to hepatitis A. In addition, hepatitis E may be transmitted from sick pregnant woman to her fetus. In Europe and North America, the hepatitis E is rare, but the disease is common in Africa, Asia and Central America. The virus occurs not only in humans, but also in many domestic animals including pigs.
The incubation period from the infection to occurrence of first symptoms usually takes 4-6 weeks and the course of infection is again similar to hepatitis A. The symptoms include jaundice, fatigue, fever, loss of appetite, nausea, vomiting and diarrhea. Fetal infection usually leads to miscarriage. The infection usually does not last long and it is completely healed. However, in some people with weakened immune system, progression of the infection to chronic liver inflammation was reported.
The diagnosis can be confirmed by combination of clinical symptoms, elevated liver tests and serological confirmation of antibodies against hepatitis E virus in blood of the affected person.
There is no effective vaccine against the hepatitis E virus. People in high-risk areas may be infected by drinking contaminated water and food, especially pork meat and therefore, they should avoid any food or fluids from unknown sources.
The patient should be hospitalized in isolation ward as they may be infectious. During the acute phase of infection, the affected person should avoid alcohol and any medication toxic to liver. Low-fat diet is preferable. In addition, hepatoprotectives may be used, but their effectiveness is rather controversial.