Overview Hepatitis E is widely spread across the globe and is self - limiting, acute liver disease caused by Hepatitis E virus. This virus is a non -enveloped, positive - sense, single - stranded ribonucleic acid (RNA) virus with four genotypes (Type 1, 2, 3, and 4). Globally, 57 000 deaths and 3.4 million cases of acute hepatitis E are attributable to infection with hepatitis E virus genotypes 1 and 2. Hepatitis E is found worldwide, but the prevalence is highest in East and South Asia with genotype 1 most commonly found in India. Route of transmission Hepatitis E virus is usually spread by the fecal - oral route. Other transmission routes identified include Foodborne transmission from ingestion of uncooked/cut vegetables and fruits Transfusion of infected blood products Vertical transmission from a pregnant woman to her foetus. Symptoms The incubation period following exposure to the hepatitis E virus ranges from three to eight weeks, with a mean of 40 days. The period of communicability is unknown. Symptoms include: Jaundice (yellow discoloration of the skin and sclera of the eyes, dark urine and pale stools) Anorexia (loss of appetite) An enlarged, tender liver (hepatomegaly) Abdominal pain and tenderness Nausea and vomiting Fever Fulminant hepatitis occurs more frequently during pregnancy. Pregnant women are at greater risk of obstetrical complications and mortality from hepatitis E, which can induce a mortality rate of 20% among pregnant women in their third trimester. Cases of chronic hepatitis E infection have been reported in immunosuppressed people. Reactivation of hepatitis E infection has also been reported in immunocompromised people. Diagnosis & Treatment Blood (2 -6ml) collected in plain vial for antibody detection and serum, stool for RT - PCR. Diagnosis can be confirmed only by testing for the presence of antibody to Hepatitis E or HEV RNA by RT - PCR. Hepatitis E usually resolves on its own without treatment. There is no available treatment capable of altering the course of acute hepatitis. Prevention is the most effective approach against the disease. Prevention Prevention and control can be achieved through safe and effective HBV vaccines. World Health Orgnisation recommends routine infant vaccination along with catch-up immunization for adolescents and high risk populations.India introduced universal immunization against hepatitis B in 10 states in the year 2002, and in 2011, scaled up this operation countrywide. On an individual/community level, infection risk can be reduced by: Maintaining quality standards for water supplies; Establishing proper disposal systems to eliminate sanitary waste; Raising awareness about the risk of HEV among common public through various channels by Maintaining hygienic practices such as hand washing with safe water, particularly before handling food; Use of boiled water for drinking Avoiding drinking water and/or ice of unknown purity; Avoiding eating uncooked and cut food, fruits or vegetables Increasing awareness of HEV infection among physicians to enhance its diagnosis and reporting for early epidemiological investigation and outbreak detection. Screening and immunization of high-risk groups, such as those with history of exposure, risky practices, and occupational risk. Specific measures for prevention of mother-to-child transmission. Promoting safe blood supply, safe injections and safe sex are other recommended preventive measures. Source: National Centre for Disease Control (NCDC) Related resources WHO Fact sheet on Hepatitis E WHO Infographic on Hepatitis A and E Viral Hepatitis - Prevention, Control and Treatment guidelines by NCDC