Infectious Disease Compendium

Hepatitis E


Virus. NEJM Review.

Epidemiologic Risks

Fecal oral, there is evidence of human to human spread. Mostly its eating pig meat, innards, home-prepared pork products, or tasting raw pig meat. One guy got it from his pet pig. Really. In Denmark (PubMed) and Germany (PubMed) it is mostly an asymptomatic zoonoses from eating swine and wild boars. Especially common after flooding.

About 21% of Americans are seropositive ( PubMed) although other studies have put it at 6% (PubMed); pets and eating liver are the risks; I assume these risks are rarely combined. I bet Hannibal Lecter is seropositive.

It is in the Red Deer in Spain (PubMed). I thought Franco got rid of all the Reds. In Rabbits in West Virginia and France. And rats in LA (PubMed). And ferrets.  And eating camel meat and milk (PubMed). There goes my diet.

It has been passed on by transfusions.


Acute hepatitis.

Can be chronic in them what have bad immune systems (PubMed)(PubMed).

In HIV patients with unexplained increased ALT, chronic hepatitis E was found in 2.6%, so it wasn't so unexplained, was it?

Pregnant women in Asia die and use of acetaminophen is a risk for death (PubMed).

There are a smattering of cases of encephalitis and other neurologic diseases (PubMed).


Supportive. Highly effective (95%) vaccine is in the works (PubMed).

Chronic infection responds to ribavirin (PubMed) for at least 3 months (PubMed). Oh. My. God. A disease that responds to ribavirin.


Kills pregnant women in Africa that may be genotype dependent, the genotypes in the US and Europe are not so virulent in the pregnant. (All pregnant men are spared, an issue here in Oregon).

Curious Cases

Relevant links to my Medscape blog

Neither A nor B nor C nor D.

Last Update: 04/28/18.