Hepatitis E – The Other Waterborne Hepatitis Virus

Also known as enterically transmitted non-A non-B hepatitis has been the cause of several outbreaks and sporadic cases over a large geographical region.

The latest outbreak is currently underway in the African nation of Uganda. There have been 210 people admitted to hospitals due to this disease with 12 deaths reported.

The clinical course of hepatitis E is similar to that of hepatitis A with no chronic form of the disease. Jaundice, fever, loss of appetite and lethargy are common symptoms.

People get infected primarily through the fecal-oral route, usually through contaminated water or food. There have been several cases of hepatitis E infection in France due to eating raw figatellu, which is made with pig liver.

Transmission through blood transfusion has been documented albeit rare. Mother to baby transmission is possible.

Much like hepatitis A, the fatality rate is low with the exception of pregnant women where it can reach 20% among those infected in the third trimester. Liver failure is a frequent exit with pregnant women.

In the current outbreak in Uganda is attributed to a local cultural belief which discourages the use of latrines. The practice of defecating in river beds is common among the region of the country affected; although it is also the places where people get their drinking water and water for other domestic uses.

Hepatitis E is endemically found in countries that have adequate environmental sanitation. It is most frequently seen in Asia, Africa, Central America and the Middle East.

Laboratory diagnosis of hepatitis E is based on detecting antibodies in serum. There is no vaccine or drugs available for prevention or treatment. Any treatment available is supportive.