Hepatitis E is a form of liver inflammation caused by a virus. It is atypical for Europe and occurs primarily in Asia, Central and South America, and Northeast and North Africa.
What is hepatitis E?
According to Abbreviationfinder, Hepatitis E is an acute inflammation of the liver. The cause is the hepatitis E virus. It attacks the liver cells and is responsible for organ dysfunction.
While hepatitis E is almost unknown in Europe and is largely considered a travel sickness, hepatitis E epidemics occur again and again in North Africa, Central and South America, India, Sudan and Iraq.
Apparently, younger people (under 20 years of age) rarely or very rarely contract hepatitis E. Hepatitis E was first detected in 1980.
Causes
Hepatitis E occurs primarily where food is contaminated or drinking water is contaminated with faeces. The virus enters the body mainly through food intake.
Smear infections are also a possible type of infection, while infection by droplet infection has not been proven. It is also suspected that the virus can also be transmitted to the unborn child.
People in the flood areas of the corresponding regions become ill particularly frequently during the monsoon, since the pathogen is transmitted to both humans and animals through water. Mammals such as mice, rats, pigs, sheep or monkeys are among the natural hosts of the virus. Therefore, eating the meat of an infected animal can also lead to the disease.
Symptoms, Ailments & Signs
Hepatitis E is a viral disease of the liver that is very similar to hepatitis A in its course. As with this, non-specific symptoms initially appear, which can also indicate other diseases. These symptoms include, but are not limited to, nausea, vomiting, fever, and flu-like symptoms. Jaundice can also develop as the disease progresses.
This is indicated by yellowing of the skin and eyes and by unbearable itching. In addition, the stool often becomes discolored, which then takes on a light color. At the same time, the urine turns dark. However, not all those affected develop jaundice. A completely asymptomatic course of the disease is often possible. Hepatitis E usually heals on its own without any consequences.
However, there are also more complicated processes. Hepatitis E is particularly dangerous for pregnant women. If the disease occurs in the last third of pregnancy, the course of the disease can be fulminant with liver failure and acute pancreatitis, which ends fatally in up to 20 percent of cases.
Severe and sometimes fatal complications can also occur in people with liver damage or immunocompromised people. However, apart from pregnant women, complications and deaths from hepatitis E are very rare overall. As a rule, there are also no chronic courses, with the exception of people who have had organ transplants, in whom chronic cases have also been observed in very rare cases.
Course
The incubation period for hepatitis E is 30 to 40 days. The disease usually begins with non-specific symptoms that do not differ from those of hepatitis A. These include exhaustion, tiredness, loss of appetite, fever, nausea, weight loss, headaches, a feeling of pressure in the upper abdomen and muscle and joint problems.
After that, the usual symptoms of jaundice appear. The urine turns dark, the stools are discolored, the skin or eyes turn yellowish, and in some cases itching is severe.
After about six weeks, these symptoms subside on their own. In children, hepatitis E is very often symptom-free. Because the clinical course is the same as hepatitis A, hepatitis E can only be reliably detected by a blood test and the presence of antibodies.
Complications
Hepatitis E is a rather harmless form of hepatitis. Once infected, it heals again after a few weeks without any consequences. This is especially the case in people with an intact immune system. If the immune system is not adequate, it can happen that the patient slides down into liver failure.
The liver can no longer perform its important tasks and the consequences are serious. On the one hand, not enough required proteins are produced. This leads to strong water retention in the body, the edema. Less proteins for clotting are also synthesized, the bleeding time is thereby increased and there is a risk of bleeding in the event of serious injuries.
The detoxification function of the liver is also disturbed. Ammonia builds up in the body, which can lead to hepatic encephalopathy in the brain. Furthermore, the blood is no longer transported properly through the liver. More is derived in bypass circuits. These are located in the stomach, esophagus and rectum.
Varicose veins in the stomach or esophagus and hemorrhoids are the consequences. Death due to hepatitis E infection has been observed particularly in pregnant women. About 20 percent of pregnant women with hepatitis E die from the disease.
When should you go to the doctor?
Hepatitis E does not heal itself and, in the worst case, the disease can lead to the death of the person affected. A doctor should be consulted at the first sign of the disease. It should also be noted whether the person concerned has been in an affected area in the past few weeks. A doctor should be consulted if the patient suffers from jaundice. As a rule, this is easy to recognize from the outside. It is accompanied by weakness and fatigue.
Weight loss or loss of appetite are also signs of hepatitis E and should be investigated. Many patients also experience severe pain in the abdomen and head, although these are not particularly specific symptoms. The onset of hepatitis E is very similar to a common cold. At the latest when jaundice occurs, a doctor should be consulted.
Since hepatitis E must be reported, the disease should be treated in a hospital. Alternatively, the person concerned can also consult a general practitioner. Early diagnosis has a positive effect on the further course of the disease.
Treatment & Therapy
In the case of hepatitis E, only the symptoms accompanying the disease can be treated. There is no vaccine against the disease. Since it is a viral disease, the use of antibiotics does not make sense either.
Bed rest and, if necessary, painkillers are usually prescribed. Alcohol should be avoided so as not to put additional strain on the liver. In most cases, hepatitis E heals on its own and progresses without complications. Serious courses of the disease, including death, are extremely rare, but can occur in pregnant women in the last third of their pregnancy.
In these cases, hepatitis E can lead to acute liver failure and acute inflammation of the lungs, heart or pancreas. Hepatitis E always takes an acute course, and no chronic diseases are known to date.
If hepatitis E is suspected, an existing illness or a death has occurred, the doctor treating you must report this in accordance with the Infection Protection Act, as this is a notifiable illness.
Outlook & Forecast
The prognosis of hepatitis E can be classified as favorable. In contrast to the other forms of hepatitis, the course of the disease is not chronic. The symptoms that occur are minor in direct comparison to the other courses of the viral disease.
In almost all documented cases, the patient makes a full recovery after a few weeks of infection. The slight symptoms usually heal on their own and without medical help. Treatment is therefore usually not required. In addition, no consequential damage or permanent impairments are to be expected in the event of hepatitis E disease. This also applies if the disease breaks out again.
In rare cases, the disease can become severe with a fatal outcome. The dramatic developments only affect patients who belong to a risk group. Pregnant women who are in the last trimester of their pregnancy are given a very unfavorable prognosis. They may have a sudden and unexpected preterm birth.
This is associated with the usual dangers for the newborn and, in addition to lifelong health impairments, can also lead to the death of the child. In addition, pregnant women can suffer a miscarriage. In the case of particularly severe developments, the expectant mother dies. In 1/5 of all known cases, the pregnant woman does not survive the consequences of hepatitis E.
Prevention
A preventive vaccination against hepatitis E is not possible because research is still being carried out into a vaccine. When traveling to countries where there is a possibility of infection, hygienic measures in particular can help to protect against hepatitis E.
In principle, only boiled water or packaged mineral water should be drunk and used. It is also advised to rinse and brush fruit and vegetables thoroughly with boiled water. If this is not possible, it should only be used peeled.
The consumption of food from snack stands is classified as questionable. Appropriate information about endangered areas can be obtained from the Foreign Office or from any tropical institute. If you suspect an illness, you should definitely consult a doctor.
Aftercare
In order to allow the disease to heal as completely as possible and to prevent further incidents, a gentle lifestyle should be striven for. Alcohol consumption should be curbed if possible. Smoking also damages the liver, which is already overstrained by the disease.
Medicines that affect the liver, such as paracetamol, should only be taken sparingly, rarely and only after medical clarification. Hormonal contraceptive medication can also put additional strain on the liver. Therefore, before taking it, it should be pointed out that it was previously infected with hepatitis E. In addition, sports and strenuous activities should be avoided until the disease has completely healed.
Bed rest is not mandatory, but it makes sense depending on your needs and condition. With regard to nutrition, a liver-friendly diet should be aimed for. This means that you should rather avoid high-fat food and switch to high-carbohydrate foods. Fatty sausages and fatty meat are particularly sensitive and should therefore not be consumed.
In addition, to avoid further outbreaks of hepatitis E, meat intended for consumption should always be sufficiently cooked. Limiting sugar consumption has been shown to promote healing. Because too much sugar is converted into fat in the body, which damages the liver. Omega-3 fats such as linseed oil are particularly good for the liver. A regular blood count to clarify the liver values is also part of careful aftercare.
You can do that yourself
Hepatitis E is extremely rare in Europe and is considered a travel sickness. This form of hepatitis is particularly widespread in Southeast Asia, Iraq and Sudan. In Asia, most cases of the disease occur during the monsoon. Private trips to Southeast Asia should therefore be undertaken at a different time of the year.
Anyone traveling to high-risk areas for work can take a number of precautionary measures. Hepatitis E pathogens primarily enter the body through food intake. Drinking water contaminated with faeces and contaminated food are particularly dangerous. Since the disease can be transmitted not only from human to human, but also from mammals, especially rodents, pigs, sheep and monkeys, the meat of these animals should not be eaten.
In addition to infection through contaminated food, there is also a risk of smear infection. Regular, thorough washing of hands can have a preventive effect here. In addition, no commodities such as pens, cell phones or computer keyboards should be shared.
If you have to use an internet café, you should disinfect the keyboard and mouse, never touch your face or mouth while you work, and wash your hands very thoroughly afterwards.
Since a hepatitis E infection rarely leads to an acute illness in people with an intact immune system and this usually heals quickly and without problems, a healthy lifestyle also contributes to self-help.
