Hepatitis E Virus (HEV) Fact Sheet

(adapted from materials developed by the Centers for Disease Control and Prevention)

On this page:
Report to Minnesota Department of Health
Etiology
Signs and Symptoms
Long-term Effects 
Transmission
Communicability
Risk Groups
Prevention
Treatment and Medical Management
Postexposure Management
Trends and Statistics
References

Report to Minnesota Department of Health

• Tests for the hepatitis E virus (HEV) are not yet FDA approved; however, these tests can be accessed through referral for patients with clinical symptoms of viral hepatitis when other viral etiologies (HAV, HBV, HCV, HDV, CMV, EBV) have been ruled out.
• Diagnosis of HEV would be more likely in persons with a history of travel to endemic regions outside the U.S.
• Contact the Minnesota Department of Health if you suspect a case of HEV by any of the following methods:
  • Phone: 651-201-5414 or 1-877-676-5414 (toll free)
  • Fax: 1-800-334-4931
  • Mail: Minnesota Department of Health Disease Report Card, P.O. Box 64975, St. Paul, MN 55164-0975

Etiology

• HEV is a spherical, non-enveloped, positive-strand RNA virus.

Signs and Symptoms

• Persons with HEV infection may be asymptomatic.
• Symptoms are those associated with other types of viral hepatitis: jaundice, malaise, anorexia, fever, diarrhea, abdominal pain, and arthralgia.
• Symptom severity increases with age.
• High case-fatality rate among pregnant women
• Incubation period is typically 40 days (range: 15 to 60 days)

Long-Term Effects

• There is no known chronic (long-term) infection.

Transmission

• Fecal-oral route by either:
  • ingestion of contaminated food or water, or
  • person-to-person contact (less common)

Communicability

• The period of communicability after acute infection is unknown, but fecal shedding of the virus and viremia commonly occur for at least two weeks.

Risk Groups

• Travelers to parts of Asia, Africa, and Mexico (not endemic in the U.S.)
• More common among adults than children

Prevention

• Travelers to HEV-endemic regions should avoid drinking water (and beverages with ice) of unknown purity, uncooked shellfish, and unpeeled fruit and vegetables not prepared by traveler.
• Vaccine is not yet available.

Treatment & Medical Management

• Supportive care

Postexposure Management

• None; immune globulin (IG) prepared in the United States does not prevent HEV infection.

Trends & Statistics

• HEV is rarely reported in the United States and most reported cases have occurred among travelers to endemic regions.
• Rarely, a "U.S. strain" of HEV has been reported among persons with no recent history of travel outside of the United States.

References

• CDC website on HEV
• Pickering L, eds. "Red Book 2000 Report of the Committee on Infectious Diseases, 25th ed." 2000, American Academy of Pediatrics.