Hepatitis E HEV

Organism An enteric (E) virus provisionally classified as a calicivirus.

Clinical features Hepatitis E is very similar to hepatitis A except that it nearly always occurs in large epidemics. The main difference is that hepatitis E results in a high mortality in pregnant women (up to 20%).

Transmission Similar to hepatitis A, although the main means of transmission is via water. A reservoir has been found in wild and domestic pigs, suggesting a zoono-tic pattern of transmission.

Diagnosis is by the detection of IgM and IgG anti-hepatitis E virus (anti-HEV) in serum.

Incubation period 3-9 weeks.

Period of communicability From 14 days after the appearance of jaundice for a further 2 weeks.

Occurrence and distribution Hepatitis E has been responsible for large epidemics in South and Southeast Asia, especially Myanmar and Vietnam, where it appears to be endemic. Epidemics have also occurred in North Africa, Ethiopia, China and Mexico.

Control and prevention The same as hepatitis A, but extra precautions should be taken to protect pregnant women. There is no specific vaccine.

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