Epidemic hepatitis, which resembles hepatitis A but is caused by a distinct and different virus, has been reported in the Indian subcontinent, Central and Southeast Asia, the Middle East, North and East Africa and Central America. Outbreaks involving tens of thousands of cases have been reported, and Hepatitis E virus (HEV) is also a common cause of sporadic acute hepatitis in these countries. Sporadic cases have been seen in other countries and in the highly developed (industrialised) countries in returning travellers from the areas listed above and among migrant labourers. The infection is acute and self-limiting but it is associated with high mortality (10-20%) in pregnant women during the third trimester of pregnancy.
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