prevention of hepatitis E

Rejekine. Hepatitis E is a viral hepatitis (liver inflammation) caused by infection with the hepatitis E virus (HEV). HEV has a fecal-oral transmission route (feces to the mouth). Infection with this virus was first documented in 1955 during an outbreak in New Delhi, India.

Epidemiology
The incidence of hepatitis E are highest in adolescents and adults aged between 15-40 years. Although children are often exposed to these infections as well, but they rarely show symptoms. The death rate is generally low, Hepatitis E usually goes away by itself and the patient recovered. However, during the duration of infection (usually several weeks), the disease is very disturbing daily activities. Hepatitis E is sometimes develop into a severe acute liver disease, and fatal in about 2% of all cases. Clinically, the disease is proportional to the hepatitis A, but in pregnant women the disease is more often severe and associated with the clinical syndrome called fulminant liver failure. Pregnant women, especially in the third trimester, experienced higher mortality rate from this disease (around 20%).

Although there is a single serotype of this virus, four different genotypes have been reported. Genotypes 1 and 2 is only limited to humans and often associated with large outbreaks and epidemics in developing countries with poor sanitary conditions. Genotype 3 and 4 infect humans, pigs and other animal species and has been responsible for sporadic cases of hepatitis E in developing countries and industries.

Deployment
Hepatitis E is prevalent in most developing countries, and the public in any country with hot climate. It is widespread in Southeast Asia, northern and central Africa, India, and Central America. It spreads primarily through fecal contamination in water or food supplies; transmission person to person is rare, but can occur during oral-anal sex (eg licking the anus). Epidemic outbreak of Hepatitis E most often occurs after heavy rain and the wet season due to disruption of water supply.

Pets have been reported as a reservoir for hepatitis E virus, with some surveys showing infection rates exceeding 95% of them come from pigs. This possibility applies also if someone eats meat boar and deer meat raw. However, the rate of transmission to humans via this route is still debated by experts.

A number of other small mammals have been identified as a potential reservoir: Bandicoot rats was lower (Bandicota bengalensis), black rat (Rattus rattus brunneusculus) and home cecurut Asia (Suncus murinus).

A bird flu virus has been described symptoms associated with hepatitis-splenomegaly in chickens. The virus is genetically and antigenically related to mammalian HEV and may constitute a new genus.

replication of the virus have been found in the small intestine, lymph nodes, colon and liver of infected pigs.

Prevention
Improving sanitation is the most important measure, which consists of maintenance of cleanliness on the disposal of human waste; also important higher standards for public water supplies, good personal hygiene procedures and sanitary food preparation.

A vaccine based on viral proteins that are re-combination, have been developed and recently tested in a high-risk population (military personnel from developing countries). The vaccine appears effective and safe, but more research is needed to assess long-term vaccine protection and cost effectiveness of vaccination with hepatitis E