• Hepatitis E is one form of viral hepatitis caused by hepatitis E virus.

• It is transmitted by faecal-oral route, mainly via contaminated food (e.g. shellfish) or water. Foodborne transmission through consumption of raw or undercooked meat has been documented and HEV has also been detected in pig livers. However, the significance of this transmission route is uncertain. Person-to-person transmission appears to be less efficient than hepatitis A virus. „X

• The period of communicability is unknown but virus excretion in stools has been demonstrated up to 14 days after onset of jaundice. „X

• The incubation period range from 15 to 60 days with an average of 40 days.

• Signs and symptoms of acute hepatitis E resemble to other types of viral hepatitis, including jaundice, fatigue, abdominal pain and dark (tea colored) urine. „X

• The disease is more common among adults than children and is more severe in pregnant women.

Epidemiology

In Hong Kong, the number of reported cases was on a rising trend in recent years.

Prevention

At present, no vaccine is available for the prevention of hepatitis E. To prevent hepatitis E infection, adopt good hygiene practice at all stages of food preparation:

1. Personal hygiene ¡V wash hands with soap before preparing or eating food and after going to the toilet.
2. Food hygiene ¡V drink only boiled water. All food, especially seafood (e.g. shellfish), pork and pig offal should be carefully cleaned and thoroughly cooked. Avoid raw and undercooked food. Handle and store raw and cooked food separately to prevent cross-contamination.
3. Environmental hygiene ¡V always keep the environment clean. Particular attention should be paid to the kitchen and toilet.

Management

Most patients recover in 3 to 6 weeks with supportive treatment and bed rest. Chronic infection does not occur. The case fatality rate is generally low at less than 1% but may reach 20% for those pregnant women in the third trimester.