How the virus is transmitted
The main route is water: the virus enters drinking water sources with wastewater, so outbreaks are associated with water supply failures, floods and the use of water from open reservoirs. The second route is food, through the meat of pigs, wild boar and deer, as well as by-products that have not undergone sufficient heat treatment: these animals are a natural reservoir of the virus. Transmission from person to person through household contacts is rare, unlike hepatitis A. Transmission from mother to fetus is possible and, much less frequently, through blood transfusion.
- Contaminated drinking water is the main route
- Undercooked pork and game meat
- Raw shellfish from polluted waters
- Unwashed vegetables and fruits washed with contaminated water
- Transmission from mother to fetus
- Rarely - through blood products
Symptoms
The incubation period lasts on average from two to six weeks. The disease begins with malaise, weakness, loss of appetite, nausea, heaviness in the right hypochondrium, sometimes with low fever and joint pain. After a few days, the urine darkens, the stool becomes lighter, and yellowness of the sclera and skin appears; With the appearance of jaundice, health usually improves. Itchy skin often bothers me. In many people, especially children, the infection occurs without jaundice and remains unrecognized. Recovery occurs in four to six weeks.
- Weakness, fatigue, loss of appetite
- Nausea, sometimes vomiting, heaviness in the right hypochondrium
- Darkening of urine and lightening of stool
- Yellowness of the sclera and skin
- Itchy skin
- Joint pain and low temperature at the beginning
Why is hepatitis E dangerous during pregnancy?
In pregnant women, especially in the third trimester, hepatitis E is much more severe than in other people and can lead to acute liver failure, bleeding disorders, premature birth and pregnancy loss. The reasons for this severity are associated with changes in immune and hormonal regulation during pregnancy. Therefore, any jaundice in a pregnant woman requires immediate consultation with a doctor and joint management by an infectious disease specialist and an obstetrician-gynecologist, most often in a hospital setting. Self-medication and waiting in this situation are unacceptable.
- Severe course in the third trimester
- Risk of acute liver failure
- Clotting and bleeding disorders
- Premature birth and pregnancy loss
- Mandatory hospital observation
- Joint management by an infectious disease specialist and an obstetrician-gynecologist
Diagnostics
Jaundice and characteristic complaints help to suspect hepatitis; tests confirm this. ALT and AST increase significantly in the blood, bilirubin increases, mainly direct. A specific diagnosis is made by antibodies: the presence of anti-HEV IgM indicates a fresh infection, IgG indicates an advanced or late stage. Be sure to exclude hepatitis A, B and C, as well as drug and toxic liver damage, cholelithiasis and other causes of jaundice. Ultrasound of the liver and gallbladder helps to assess the condition of the organ and exclude a mechanical cause of jaundice.
- Anti-HEV IgM and IgG antibodies
- ALT and AST, total and direct bilirubin
- General blood test
- Rule out hepatitis A, B and C
- Ultrasound of the liver and gallbladder
- Coagulogram in severe cases
Treatment and prevention
Specific antiviral treatment for ordinary acute hepatitis E is not required: the body copes on its own. Prescribe rest, sufficient drinking, gentle nutrition with a limit on fatty and fried foods, avoidance of alcohol and drugs that burden the liver, including many painkillers and herbal remedies. Any medications during this period should be agreed with your doctor. Hospitalization is needed in severe cases, in pregnant women, people with chronic liver diseases and reduced immunity. Prevention comes down to safe water and food: boiling water, thoroughly frying meat, washing hands and food.
- Rest and adequate drinking
- Gentle nutrition, avoidance of alcohol
- Coordinating any medications with your doctor
- Hospitalization for severe cases and pregnancy
- Boiling drinking water
- Thorough heat treatment of meat
- Washing hands, vegetables and fruits