Professional Documents
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“Infectious” A Enterically
E
transmitted
Viral NANB
hepatitis
Parenterally
“Serum” B D C transmitted
F, G,
? other
Hepatitis A Virus
Titre ALT
Fecal
HAV
IgM anti-HAV
0 1 2 3 4 5 6 1 2
2 4
Months after exposure
Transmission
Hepeviridae Hepevirus
Hepatitis E Virus
• unenveloped RNA virus, 32-34nm in
diameter
• +ve stranded RNA genome, 7.6 kb in size.
• very labile and sensitive
• Can only be cultured recently
Hepatitis E - Clinical Features
Virus in stool
0 1 2 3 4 5 6 7 8 9 1 1 1 1
0 1 2 3
Weeks after Exposure
Hepatitis E -
Epidemiologic Features
Most outbreaks associated with faecally contaminated drinking
water.
Several other large epidemics have occurred since in the Indian
subcontinent and the USSR, China, Africa and Mexico.
In the United States and other nonendemic areas, where
outbreaks of hepatitis E have not been documented to occur, a
low prevalence of anti-HEV (<2%) has been found in healthy
populations. The source of infection for these persons is
unknown.
Minimal person-to-person transmission.
Risk groups for severe course: Pregnancy, DM, obesity,
hypertension, ischemic heart disease
Genotype 1 Genotype 2 Genoytpe 3 Genotype 4
(Burma) (Mexico) (USA-swine) (China)
-causes epidemies -Sporadic cases
- subtropical regions - worldwide distributed (except
-Transmitted with contaminated Africa)
water -Zoonotic
- ın Europe travel associated -In Europe: autochton
-Reservoir: Human -Reservoir: wild boar
Epidemiological features of hepatitis E in
disease-endemic areas
• Highest attack rate among young adults aged 15–40 years, with
• relative sparing of children