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What is Hepatitis E
Hepatitis E (aka HEV) is a liver disease caused by the hepatitis E virus. The disease is most often mild. The chronic form (more than 6 months) of this disease is very rare and is usually recorded in patients with a suppressed immune system, for example, taking medication to prevent rejection after an organ transplant.
But there are two categories of people in whom hepatitis E can be severe:
- pregnant women;
- patients with liver disease.
“According to WHO, 20 million people are infected with hepatitis E every year in the world,” cites statistics Gastroenterologist Marat Zinnatulin. – In Russia, the incidence rate annually is 0,7 – 0,8 per 100 thousand of the population.
Routes of transmission of hepatitis E in adults
The hepatitis E virus is spread by the fecal-oral route. It is excreted through the intestines and enters the mouth, usually through contaminated food or water. The virus is widespread in countries where the water supply is polluted by sewage, often plowing occurs after monsoons and floods.
In European countries, the disease can also be caused by the so-called “zoonosis”. That is, the virus can be transmitted to humans by animals – pigs, wild boars, deer, rabbits and rats. Especially if there is raw or undercooked meat.
There is no evidence that this virus is transmitted through needles, body fluids, or sexual contact. However, there is a risk of transmission of infection through contact of the mouth with the anal area. A number of cases of transmission of hepatitis E through blood transfusion and organ transplantation have also been reported.
The disease does not usually spread within a family unless all family members have been drinking the same contaminated drinking water or eating contaminated food.
Symptoms of Hepatitis E in Adults
The incubation period for hepatitis E virus can be from 2 to 9 weeks. And only then the first symptoms appear. Among them:
- mild flu-like symptoms;
- fatigue (severe fatigue), which may continue for some time after the disease has been cured;
- change in the color of urine – it is dark or brown;
- abdominal pain;
- jaundice;
- fever (high temperature);
- loss of appetite;
- itching;
- nausea and vomiting;
- aching joints and muscles;
- tingling, numbness, and weakness in the arms and legs.
Direct person-to-person transmission of the virus is rare, but carriers can be contagious for up to 2 weeks after the onset of symptoms. During this period, patients should not prepare food for others and, if possible, should limit contact with loved ones, especially those who are pregnant or already have chronic liver disease.
Most people with hepatitis E recover within a month. However, some patients with suppressed immune systems may not clear the virus and may develop a chronic form of the disease that can lead to cirrhosis of the liver.
In some people, hepatitis E can affect the nervous system, which can lead to severe pain in the arms and legs.
Treatment of hepatitis E in adults
If a person has liver disease or is pregnant, hepatitis E can cause severe consequences, often leading to hospitalization.
Diagnostics
The diagnosis is made on the basis of anamnesis and laboratory data.
Modern treatments
There is no specific treatment for hepatitis E; doctors usually prescribe maintenance therapy to reduce symptoms.
– In case of mild and moderate course of the disease, a diet, regimen, detoxification therapy is recommended, – says Gastroenterologist Marat Zinnatulin. – Patients with a severe form are observed in the intensive care unit. Obstetricians are involved in the treatment of pregnant women.
Patients who have other liver problems besides hepatitis E are prescribed the antiviral drug Ribavirin.
Most people with hepatitis E recover completely within 4 weeks of the onset of symptoms.
Prevention of hepatitis E in adults at home
There is currently no vaccine for hepatitis E and therefore it is wise to take precautions when you travel to endemic areas. It is important to follow the rules of hygiene – wash your hands thoroughly after using the toilet, as well as before preparing or eating food. Use alcohol-based hand gel or “baby wipes” to wash your hands if soap and water are not available.
When traveling to an area where hepatitis E is common, it is recommended to avoid:
- drinking water from the tap (drink bottled water if possible);
- ice cubes in drinks;
- brush your teeth with tap water;
- drink unpasteurized milk;
- eat raw meat and shellfish;
- eat unpeeled fruits and raw vegetables, including in salads not prepared by you.
To reduce the risk of contracting the virus in European countries, you need to carefully cook meat, especially pork. You should also wash your hands after touching raw meat or meat products. Pregnant women, as well as people with a diseased liver or suppressed immunity, should be especially careful with cheese, meat, shellfish and pork products.
Popular questions and answers
We asked questions about hepatitis E Gastroenterologist Marata Zinnatullina.