Viral hepatitis E HEV

Like HAV, HEV causes malaise, anorexia, jaundice and liver enzyme serum elevation. The first outbreak occurred in India in 1955 involving over 30 000 people and was associated with a breach in the city's water supply system. The incubation period is around 40 days, a case fatality rate of 20% occurred in pregnant women in India, while 60% of sporadic cases of fulminant hepatitis seen in the country are all due to HEV.

EPIDEMIOLOGY

Subsequent to the Indian epidemic, hepatitis E has been reported from a number of countries in the tropics ranging from China to Mexico. The source of infection has been contaminated drinking water. The peak age specific sero-prevalence in endemic countries is in the over-16 years group - unlike hepatitis A, which usually occurs before the age of 5 years. Clinical manifestations occur in persons 25A10 years of age. Autochthonous cases of hepatitis E are rare in Western Europe and the USA.

CONTROL

As for HAV, provision of safe drinking water and sanitary disposal of faeces is required to prevent the infection. No vaccine is as yet available.

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