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ISDH Home > Health Information by Topic - A-Z >> > Communicable Disease Quick Facts > Hepatitis E Hepatitis E

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About... Hepatitis E

 

What is hepatitis E?

Hepatitis (hep-ah-TY-tiss) E is an inflammation of the liver caused by the hepatitis E virus, which is found in the stool of an infected person. There are several other very different “hepatitis” viruses that cause the same symptoms but are completely unrelated diseases. Hepatitis E rarely causes long-term liver damage or death but can cause very serious infection in pregnant women, especially during the third trimester (last three months of pregnancy). Hepatitis E is extremely rare in the United States and is almost always related to travel to a country where hepatitis E is common, e.g., Mexico, Africa, the Middle East, India, and China.

How is hepatitis E spread?

Hepatitis E virus is passed in the stool, and people become infected by having contact with the stool of an infected person (fecal-oral route). Most outbreaks have been associated with contaminated drinking water. For this reason, the virus is more easily spread in areas where there are poor sanitary conditions or where good personal hygiene is not observed.

Persons are at risk for hepatitis E infection if they have:

  • Exposure to contaminated food or water:
    • Consuming untreated water.
    • Consuming food prepared by an infected person.
    • Consuming raw produce or raw shellfish (e.g., oysters).
    • Traveling to countries where hepatitis E is common and where there is little clean water or proper sewage disposal.
  • Exposure to the stool or blood of an infected person, who is a:
    • Household member or sexual partner (men who have sex with men are at higher risk).
    • Child or staff member of a daycare center (including centers for the disabled).
    • Resident or staff member of a health care center.

Casual contact, as in the usual workplace or school setting, does not spread the virus. However, most cases of hepatitis E have an unknown exposure, because the time from exposure to the time symptoms begin can be long (range of 15-64 days).

What are the symptoms of hepatitis E?

  • Diarrhea
  • Nausea
  • Vomiting
  • Tiredness
  • Stomach pain
  • Fever
  • Dark urine
  • Pale, clay-colored stool
  • Loss of appetite
  • Yellowing of skin and eyeballs (jaundice)

Symptoms usually occur suddenly. Some people, especially children, may have no symptoms but can still spread the virus to others.

Symptoms usually begin 26-42 days (range of 15-64 days) after exposure. Death from hepatitis E is rare but may be as high as 20 percent among pregnant women in their third trimester. Premature deliveries due to infection have a 33 percent infant mortality rate. People are most contagious from about 2 weeks before symptoms begin until 2 weeks after.

How do I know if I have hepatitis E?

A person having diarrhea lasting more than 24 hours or having jaundice should consult a health care provider immediately. The health care provider may collect a blood sample to test for hepatitis E.

How is hepatitis E treated?

There is no cure for hepatitis E. However, people who have had hepatitis E develop lifelong immunity to the virus. Unlike hepatitis A, there is no vaccine or immune globulin (Ig) to prevent infection.

How can hepatitis E be prevented?

  • Practice good hygiene:
    • Thoroughly wash hands with soap and water after using the restroom; after assisting someone with diarrhea and/or vomiting; after swimming; and before, during, and after food preparation (please refer to Quick Facts about Hand Washing).
    • Clean food preparation work surfaces, equipment, and utensils with soap and water before, during, and after food preparation.
  • Eat safe foods and drink safe water (Remember: Contaminated foods may look and smell normal):
    • Wash all produce before eating raw or cooking.
    • Use treated water for washing, cooking, and drinking.
    • Avoid swallowing untreated water.
  • Protect others:
    • Persons with diarrhea and/or vomiting should not prepare food or provide health care for others and should limit direct contact with others as much as possible.
    • Persons with diarrhea and/or vomiting should not attend a daycare facility or school.
    • Persons with diarrhea, vomiting, and/or jaundice shall be excluded from employment involving food handling (Indiana Retail Food Establishment Sanitation Requirements, 410 IAC 7-24-122).
    • Do not change diapers near recreational water.
    • Do not go swimming or use hot tubs if you have diarrhea and for at least two weeks after diarrhea stops.
  • Safe travel outside of the United States:
    • Drink bottled beverages and water, even when brushing teeth.
    • Do not eat uncooked fruits or vegetables unless you peel them yourself.
    • Do not eat foods or beverages from street vendors.
    • Do not consume local water or ice.

Where can I learn more about hepatitis E?

To search Indiana data and statistics:
www.in.gov/isdh/dataandstats/disease/diseases_index.htm

To search the Indiana Food Protection Program:
http://www.in.gov/isdh/regsvcs/foodprot/index.htm

To search disease information:
http://www.cdc.gov/ncidod/diseases/hepatitis/e/index.htm
http://www.cfsan.fda.gov/~mow/chap32.html

To search for national data, statistics, and outbreaks:
www.cdc.gov/mmwr/

Updated on January 9, 2009

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