Hepatitis E is a viral disease of the liver caused by the hepatitis E virus. More than 20 million people get infected each year. Although hepatitis E is a global problem, affecting people worldwide, some regions are more impacted than others. Since the disease is usually spread via fecal contamination of food or water, the areas of the world with poor hygiene and/or bad sanitation fall victim to a higher incidence of the disease.
So, how is hepatitis E actually spread?
There are a few ways a person can contract this disease. The most common way is through the "fecal-oral route", which basically means that a person can get infected if he or she ingests particles of fecal matter containing the virus. This usually happens by drinking unsafe water, or using unsafe water to wash food. Although this type of hepatitis is common in areas with poor sanitation, several outbreaks of hepatitis E have struck western countries, mainly connected to imported food. In countries such as India, China and Burma, outbreaks usually happen after heavy rains or monsoons.
The other way of getting infected is by eating raw or undercooked food coming from infected animals. Some animals can get infected, or act as a reservoir for the disease, most notably pigs. A temperature of 70 °C kills the virus in 20 minutes. It is important to note that veterinarians discovered that almost half of pigs tested positive for hepatitis E in Scotland, meaning that one should be careful when preparing food as the liver from an infected animal can be a possible source of infection. Aside from eating undercooked pig meat or liver, eating raw shellfish can also be a source of infection.
Other, less common ways of getting an infection include blood transfusions and from an infected mother to her child.
What are the symptoms of hepatitis E?
The liver has many different functions, from processing the food and toxins in our organism, through producing different types of proteins and hormones, to producing blood clotting factors, to name a few. Any loss of liver function, due to the infection, shows through one or more symptoms. The symptoms include:
- Vomiting
- Loss of appetite
- Weight loss
- Dark urine
- Light stool
- Jaundice
- Mild fever
- Abdominal pain
- Skin rash
- Itching
- Joint pain
How can I know if I contracted hepatitis E?
There are several diagnostic procedures which can help diagnose the disease. Judging by the symptoms alone, hepatitis E is indistinguishable from other types of hepatitis, both infectious and non-infectious. If the symptoms presented and your history of traveling or eating certain types of food are taken into consideration, your doctor can suspect that you've been infected with this type of hepatitis.
The more accurate way of getting diagnosed is by detecting IgM molecules in your blood. Whenever our body encounters a foreign "object", be it a virus, bacterium, parasite, poison, or a red blood cell of a different type than yours, our immune system produces defensive molecules called immunoglobulins. These are highly specific for each disease, and we have ways of detecting specific molecules our immune system produces to fight hepatitis E. If those are detected, it means that your body has come in contact with hepatitis E virus at some point.
PCR can also be used to detect the nucleic acid in blood or stool of the infected person.
How is hepatitis E treated?
Usually, specific treatment is not needed, since the virus gets cleared out of the organism in a few weeks. Some therapy against vomiting and nausea should be administered. Hospitalization is rarely needed, usually in the case of acute liver failure. On the other hand, it is highly recommended for pregnant women to be hospitalized. If a person is, for what ever reason, immunosupressed, antivirals and interferons should be used.