Hepatitis E

The term 'hepatitis' simply means inflammation or swelling of the liver, and can be caused by chemicals or drugs, or by infection...


The term 'hepatitis' is the Greek term for inflammation or swelling of the liver.

It can be caused by chemicals or drugs, or by infection with different kinds of pathogens, including viruses.

Hepatitis E is caused by the hepatitis E virus. Most people recover from it within four to six weeks, but it can be serious in pregnant women, especially during the third trimester and in people who have pre-existing chronic liver disease.


Fortunately, it is uncommon in the UK.

How common is hepatitis E?

People who live in or travel to countries with poor sanitation are at most risk.

The virus is common in many parts of central and south-east Asia, the Middle East and North Africa, the Mediterranean region, Mexico and South America.

Over 60 per cent of all hepatitis E infections occur in European countries.

In Europe and the UK, the illness can also be caused by what is known as 'zoonosis'. This means the virus can be found in animals such as pigs, wild boar, deer, rabbits and rats.


It does not cause any illness in the animals, however, the virus can sometimes be passed from animals to humans.

One way this can happen is by eating raw or undercooked meat, but it is mainly transmitted through contaminated drinking water.

What are the symptoms of hepatitis E?

The usual symptoms of hepatitis E include:

  • loss of appetite
  • nausea
  • vomiting
  • tiredness
  • abdominal/gut pain
  • fever
  • dark urine and pale stools
  • joint pain
  • yellowing of skin and eyeballs (jaundice).

On average, symptoms develop about three to six weeks after the infection, although this differs between people and can be anywhere from 15 to 64 days after infection.

Some people, especially children, have no symptoms, but can still spread the virus to others.

Hepatitis E can worsen existing chronic liver disease and occasionally cause acute liver failure, which can lead to death.

People with hepatitis E are thought to be infectious for around two weeks after the onset of symptoms, but the virus has been detected in stools of an infected individual up to six weeks after the onset of symptoms.

How is it spread?

Hepatitis E can be spread through eating food or drinking water in countries with poor sanitation, eating insufficiently cooked meat, especially pork liver, venison (deer) and wild boar and eating raw shellfish that has been contaminated by sewage.

It can also be spread by:

  • eating food prepared by an infectious person
  • direct contact with infectious animals
  • transmission from a pregnant woman to her baby
  • direct contact with an infected person such as a household member or sexual partner
  • childcare or healthcare settings (although direct person-to-person transmission of hepatitis E is uncommon).

How is it prevented?

In countries with poor sanitation always use bottled or boiled water (for drinking and for brushing your teeth), and never consume untreated water or ice.

Eat only fruit or vegetables that you peel yourself and food that is freshly cooked and piping hot.

Wash your hands thoroughly using soap for at least 10 seconds and dry them with a clean towel after the toilet, when caring for someone with diarrhoea and/or vomiting; and before preparing food.

If eating pork it is important that any pork products are cooked to 75°C at the centre of the thickest part for at least two minutes before removing meat from the heat source.

How is it treated?

There is currently no specific treatment for hepatitis E – it is self-limiting and usually the affected individual gets better after four to six weeks.

Prevention is the most effective approach against the disease.

The diagnosis is based on the patient's symptoms and confirmed by a blood test showing antibodies to hepatitis E.

Other people also read:

Hepatitis A: Viral hepatitis can be caused by many other viruses – including hepatitis B, C, D and A .

Hepatitis B: The incubation period, from the time of exposure to the virus until the onset of the disease, is two to six months.

Hepatitis C: Hepatitis C is mainly spread via contaminated blood.

Last updated

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