In children, Hepatitis E infection does not produce symptoms. It mostly affects adults as this disease mimics hepatic illness with features such as fatigue, jaundice, nausea, emesis, fever, anorexia, hepatomegaly, and abdominal pain. The duration is 1 to 2 weeks. Rarely does this infection cause acute liver failure.
The clinical assessment consists of the patient's history including recent travel, a physical exam, and the appropriate laboratory studies.
Severe presentations warrant comprehensive laboratory studies such as a complete blood count (CBC), blood cultures, and a complete metabolic panel (CMP) which includes liver function tests (LFTs). Measurements of the latter reveal that levels of serum alanine aminotransferase (ALT) are higher than the serum aspartate aminotransferase (AST), with both measuring at least 10 times the upper limit of normal. These distinct findings are indicative of acute viral hepatitis.
Diagnosis of this infection is confirmed by the presence of anti-HEV immunoglobulin M (IgM), which increases about a month post-infection . Another test, reverse transcriptase polymerase chain reaction (RT-PCR), detects the HEV RNA in blood and stool .
Abdominal ultrasonography may be performed to exclude extra hepatic pathologies.
In patients with no underlying disease, the treatment of acute infection is symptomatic with adequate hydration and electrolyte replacement. However, severe cases may be treated with ribavirin, which causes improvement in LFTs .
Furthermore, ribavirin is also used in patients with chronic hepatitis E infection that persists after the reduction of immunosuppression . Additionally, therapy with pegylated interferon alpha-2b in liver transplant recipients can successfully clear the viral RNA  . However, this drug is associated with serious side effects such as organ rejection in transplant patients.
The HEV is a member of the Hepeviridae family. Transmission of this virus occurs through the feco-oral route as contaminated water supplies are responsible for the majority of all infections. In industrialized countries, undercooked pork is a source of infection . This virus is not spread through sexual or casual contact.
Hepatitis E is prevalent worldwide especially in regions with poor sanitation. Specifically, developing areas surrounding the equator exhibit higher rates of this infection. Factors that lead to outbreaks include rainy weather, floods, and overpopulation. Additionally, in endemic areas the disease affects mostly adults in the 15 to 40 years age group .
HEV is a small, non-enveloped, single-stranded RNA virus  that is transmitted as a water-borne pathogen in endemic regions whereas it is spread as a foodborne organism in developed countries  .
Preventive strategies such as good personal hygiene should be practiced. All individuals should wash their hands properly especially after using the restroom and prior to handling food. Additionally, meat should be cooked thoroughly. Very importantly, endemic areas should enforce sanitary standards for public water.
China has approved a vaccine  for prevention of Hepatitis E.
Hepatitis E is a self-limiting, acute infection that is usually benign in healthy and non-pregnant individuals. It is caused by the hepatitis E virus (HEV), which is transmitted mainly through the fecal-oral route. The diagnosis is achieved through a detailed evaluation of the history, physical exam, and laboratory studies. Most patients are treated symptomatically while certain individuals will require treatment.
What is Hepatitis E?
This is an infection caused by the Hepatitis E a virus. This is spread through the fecal-oral route, especially in underdeveloped areas with poor sanitation.
What are the symptoms?
How is it diagnosed?
There is a blood test that looks for antibodies to the virus and another test that measures the virus,
How is it treated?
How can it be prevented?