Hepatitis E (patient information): Difference between revisions
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==Overview== | ==Overview== | ||
Hepatitis E is a [[liver disease]] caused by the [[hepatitis E virus]]. The [[hepatitis E virus]] is transmitted mainly through contaminated drinking water. It is usually a self-limiting [[infection]] and resolves within 4–6 weeks. Occasionally, a fulminant form of [[hepatitis]] develops ([[acute liver failure]]), which can lead to death. | Hepatitis E is a [[liver disease]] caused by the [[hepatitis E virus]]. The [[hepatitis E virus]] is transmitted mainly through contaminated drinking water. Common symptoms include: [[fever]], [[jaundice]], [[loss of appetite]], [[nausea]] and [[vomiting]]. [[Diagnosis]] is based on [[antibody]] detection and detection of the viral [[RNA]]. It is usually a self-limiting [[infection]] and resolves within 4–6 weeks. Occasionally, a fulminant form of [[hepatitis]] develops ([[acute liver failure]]), which can lead to death. There is no available treatment capable of altering the course of acute hepatitis. [[Prevention]] is the most effective approach against the disease. Possible [[complications]] include: [[chronic hepatitis]] and [[liver failure]]. | ||
==What are the symptoms?== | ==What are the symptoms?== | ||
The incidence of hepatitis E is highest in adults between the ages of 15 and 40. Though children often contract this infection as well, they less frequently become | The [[incubation period]] following exposure to the [[hepatitis E virus]] ranges from three to eight weeks, with a mean of 40 days. | ||
*[[Jaundice]] | |||
The [[incidence]] of [[hepatitis E]] is highest in adults between the ages of 15 and 40. Though children often contract this infection as well, they less frequently become [[symptomatic]]. | |||
Typical [[signs]] and [[symptoms]] of hepatitis include: | |||
*[[Fever]] | |||
*[[Jaundice]] (yellow discolouration of the skin and sclera of the eyes, dark urine and pale stools) | |||
*[[Malaise]] | *[[Malaise]] | ||
*[[ | *[[Loss of appetite]] | ||
*[[Nausea]] | *[[Nausea]] | ||
*Vomiting | *[[Vomiting]] | ||
*Abdominal pain | *[[Abdominal pain]] | ||
*[[Fever]] | *[[Fever]] | ||
*[[Hepatomegaly]] | *[[Hepatomegaly]] | ||
*Other less common features include [[diarrhea]], arthralgia, [[pruritus]], and urticarial rash | *Other less common features include [[diarrhea]], arthralgia, [[pruritus]], and urticarial [[rash]] | ||
Some patients have [[asymptomatic]] [[infection]]. | |||
==Diagnosis== | ==Diagnosis== | ||
Cases of [[hepatitis E]] are not clinically distinguishable from other types of acute viral hepatitis. | |||
[[Diagnosis]] of [[hepatitis E]] [[infection]] is, therefore, usually based on: | |||
* Detection of specific [[IgM]] and [[IgG]] [[antibodies]] to the [[virus]] in the [[blood]] | |||
* [[Reverse transcriptase polymerase chain reaction]] ([[RT-PCR]]) to detect the [[hepatitis E virus]] [[RNA]] in [[blood]] and/or stool, but this assay may require specialized laboratory facilities. | |||
Hepatitis E should be suspected in [[outbreaks]] of waterborne [[hepatitis]] occurring in developing countries, especially if the disease is more severe in pregnant women, or if [[hepatitis A]] has been excluded. | |||
The following tests are done to identify and monitor liver damage from hepatitis B: | The following tests are done to identify and monitor liver damage from hepatitis B: | ||
* Albumin level | * [[Albumin]] level | ||
* Liver function tests | * [[Liver function tests]] | ||
* Prothrombin time | * [[Prothrombin time]] | ||
==Transmission== | ==Transmission== | ||
The [[hepatitis E virus]] is | The [[hepatitis E virus]] is transmitted mainly through the fecal-oral route due to fecal contamination of drinking water. | ||
Other transmission routes have been identified, including: | Other transmission routes have been identified, including: | ||
| Line 44: | Line 58: | ||
==Treatment options== | ==Treatment options== | ||
There is no available treatment capable of altering the course of [[acute hepatitis]]. [[Prevention]] is the most effective approach against the disease. | |||
As hepatitis E is usually self-limiting, hospitalization is generally not required. However, hospitalization is required for people with fulminant [[hepatitis]] and should also be considered for [[symptomatic]] [[pregnant]] women. | |||
==Possible Complications== | ==Possible Complications== | ||
Chronic hepatitis | Possible [[complications]] include: | ||
* [[Chronic hepatitis]] | |||
* [[Liver failure]] | |||
==What to expect (Outlook/Prognosis)?== | ==What to expect (Outlook/Prognosis)?== | ||
Mortality rates are generally low, for Hepatitis E is a “self-limiting” disease, in that it usually goes away by itself and the patient recovers. In rare cases, acute hepatitis E can result in fulminant hepatitis ([[acute liver failure]]) and death. | |||
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. | |||
==Prevention== | ==Prevention== | ||
The risk of [[infection]] and [[transmission]] can be reduced by: | |||
* Maintaining quality standards for public water supplies | |||
* Establishing proper disposal systems to eliminate sanitary waste | |||
On an individual level, [[infection]] risk can be reduced by: | |||
* Maintaining hygienic practices such as hand washing with safe water, particularly before handling food | |||
* Avoiding drinking water and/or ice of unknown purity | |||
* Adhering to [[WHO]] safe food practices | |||
In 2011, the first vaccine to prevent hepatitis E infection was registered in China. Although it is not available globally, it could potentially become available in a number of other countries. | |||
===Guidelines for epidemic measures=== | |||
* In [[epidemics]], [[WHO]] recommends: | |||
:* Determining the mode of [[transmission]] | |||
:* Identifying the population specifically exposed to increased risk of [[infection]] | |||
:* Eliminating a common source of [[infection]] | |||
:* Improving sanitary and hygienic practices to eliminate fecal contamination of food and water. | |||
==Diseases with similar symptoms== | ==Diseases with similar symptoms== | ||
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==Sources== | ==Sources== | ||
http://digestive.niddk.nih.gov/ddiseases/pubs/viralhepatitis/#hepe | http://digestive.niddk.nih.gov/ddiseases/pubs/viralhepatitis/#hepe<br> | ||
[http://www.who.int/en/ World Health organization] | [http://www.who.int/en/ World Health organization] | ||
{{WH}} | {{WH}} | ||
{{WS}} | {{WS}} | ||
[[Category:Patient information]] | |||
[[Category:Medicine]] | |||
[[Category:Infectious disease patient information]] | |||
[[Category:Gastroenterology]] | |||
[[Category:Hepatology]] | |||
[[Category:Hepatitis]] | |||
[[Category:Viral diseases]] | |||
[[Category:Gastroenterology patient information]] | |||
[[Category:Disease]] | |||
[[Category:Dermatology]] | |||
[[Category:Emergency mdicine]] | |||
[[Category:Up-To-Date]] | |||
[[Category:Infectious disease]] | |||
Latest revision as of 22:07, 29 July 2020
For the WikiDoc page for this topic, click here
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Hepatitis E |
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Hepatitis E On the Web |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Priyamvada Singh, M.B.B.S; João André Alves Silva, M.D. [2]
Overview
Hepatitis E is a liver disease caused by the hepatitis E virus. The hepatitis E virus is transmitted mainly through contaminated drinking water. Common symptoms include: fever, jaundice, loss of appetite, nausea and vomiting. Diagnosis is based on antibody detection and detection of the viral RNA. It is usually a self-limiting infection and resolves within 4–6 weeks. Occasionally, a fulminant form of hepatitis develops (acute liver failure), which can lead to death. There is no available treatment capable of altering the course of acute hepatitis. Prevention is the most effective approach against the disease. Possible complications include: chronic hepatitis and liver failure.
What are the symptoms?
The incubation period following exposure to the hepatitis E virus ranges from three to eight weeks, with a mean of 40 days.
The incidence of hepatitis E is highest in adults between the ages of 15 and 40. Though children often contract this infection as well, they less frequently become symptomatic.
Typical signs and symptoms of hepatitis include:
- Fever
- Jaundice (yellow discolouration of the skin and sclera of the eyes, dark urine and pale stools)
- Malaise
- Loss of appetite
- Nausea
- Vomiting
- Abdominal pain
- Fever
- Hepatomegaly
- Other less common features include diarrhea, arthralgia, pruritus, and urticarial rash
Some patients have asymptomatic infection.
Diagnosis
Cases of hepatitis E are not clinically distinguishable from other types of acute viral hepatitis.
Diagnosis of hepatitis E infection is, therefore, usually based on:
- Detection of specific IgM and IgG antibodies to the virus in the blood
- Reverse transcriptase polymerase chain reaction (RT-PCR) to detect the hepatitis E virus RNA in blood and/or stool, but this assay may require specialized laboratory facilities.
Hepatitis E should be suspected in outbreaks of waterborne hepatitis occurring in developing countries, especially if the disease is more severe in pregnant women, or if hepatitis A has been excluded.
The following tests are done to identify and monitor liver damage from hepatitis B:
Transmission
The hepatitis E virus is transmitted mainly through the fecal-oral route due to fecal contamination of drinking water.
Other transmission routes have been identified, including:
- Foodborne transmission from ingestion of products derived from infected animals
- Transfusion of infected blood products
- Vertical transmission from a pregnant woman to her fetus
- Ingestion of raw or uncooked shellfish has also been identified as the source of sporadic cases in endemic areas.
Although humans are considered the natural host for the hepatitis E virus, antibodies to the hepatitis E virus or closely related viruses have been detected in primates and several other animal species.
Hepatitis E is a waterborne disease, and contaminated water or food supplies have been implicated in major outbreaks.
The risk factors for hepatitis E are related to poor sanitation in large areas of the world and shedding of the hepatitis E virus in faeces.
Treatment options
There is no available treatment capable of altering the course of acute hepatitis. Prevention is the most effective approach against the disease.
As hepatitis E is usually self-limiting, hospitalization is generally not required. However, hospitalization is required for people with fulminant hepatitis and should also be considered for symptomatic pregnant women.
Possible Complications
Possible complications include:
What to expect (Outlook/Prognosis)?
Mortality rates are generally low, for Hepatitis E is a “self-limiting” disease, in that it usually goes away by itself and the patient recovers. In rare cases, acute hepatitis E can result in fulminant hepatitis (acute liver failure) and death.
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.
Prevention
The risk of infection and transmission can be reduced by:
- Maintaining quality standards for public water supplies
- Establishing proper disposal systems to eliminate sanitary waste
On an individual level, infection risk can be reduced by:
- Maintaining hygienic practices such as hand washing with safe water, particularly before handling food
- Avoiding drinking water and/or ice of unknown purity
- Adhering to WHO safe food practices
In 2011, the first vaccine to prevent hepatitis E infection was registered in China. Although it is not available globally, it could potentially become available in a number of other countries.
Guidelines for epidemic measures
- Determining the mode of transmission
- Identifying the population specifically exposed to increased risk of infection
- Eliminating a common source of infection
- Improving sanitary and hygienic practices to eliminate fecal contamination of food and water.
Diseases with similar symptoms
Sources
http://digestive.niddk.nih.gov/ddiseases/pubs/viralhepatitis/#hepe
World Health organization