Hepatitis E: danger in pregnancy

Hepatitis E is a form of hepatitis caused by contaminated water or certain foods, such as meat from infected animals. It usually heals by itself. Infection during pregnancy can lead to dangerous complications. There are no medicines for the hepatitis E virus, so only the symptoms can be treated. An infection can cause the typical symptoms of liver inflammation, such as fever, nausea and jaundice, but in many cases, symptoms do not appear and the infection goes unnoticed. As a vaccine is still being developed, hygiene is the only preventative measure.

Transmission and dissemination

The hepatitis E virus primarily affects animals such as pigs, sheep and rats and is transmitted to humans through a so-called fecal-oral smear infection. This means that the pathogen is absorbed by humans via water contaminated with animal faeces. Possible sources of infection are unclean drinking water or meat from infected animals. Even with floods there is an increased risk of infection with the virus. In contrast to hepatitis B and C, the disease is therefore not transmitted by blood or body fluids. Thus, no direct infection from person to person is known.

Due to the poor hygiene conditions, the hepatitis E virus is mainly distributed in Africa and Asia. The disease is therefore considered to be a typical travel sickness, but occasionally there are also infections in Germany.

Hepatitis E: symptoms

Infection with the hepatitis E virus is similar to a hepatitis A disease. Two to eight weeks after the infection with the pathogen, flu-like symptoms such as fever, nausea, abdominal pain and vomiting may occur. Occasionally, muscle or joint pain occurs. This is followed by the typical symptoms of liver disease:

  • Yellowing of the skin and the whites (jaundice)
  • Pressure pain in the right upper abdomen
  • Enlargement of the liver
  • discolored stool and beer brown urine
  • Itching of the skin

However, these symptoms do not always show the same degree. In about half of all cases of this disease symptoms are completely absent (asymptomatic course) and the infection goes unnoticed by those affected.

Diagnosis of hepatitis E infection

If the symptoms indicate hepatitis, the diagnosis is made by a blood test. First, the liver values ​​are determined in order to determine an existing damage to the liver. If the suspicion of liver inflammation is confirmed, the demarcation of other forms of hepatitis by the detection of specific antibodies to the hepatitis E virus in the blood. In case of infection, the diagnosis can also be confirmed by constituents of the virus in the stool and in the blood.

Course and therapy

In most cases, hepatitis E infection heals on its own within a few weeks. Since there are no active ingredients against the virus, the therapy is limited to a treatment of the symptoms with analgesics as well as antipyretic and nausea-relieving medicines. To protect the damaged liver, sufferers should abstain from alcohol for a few months.

Unlike hepatitis B and C, chronic hepatitis E infections are not known. Rarely, there is a severe (fulminant) course with acute liver failure, which can lead to brain swelling and disorders of consciousness to coma. In about 0.5 percent of cases, the disease is fatal.

Pregnancy and hepatitis E

For unknown reasons, the risk of a serious course of pregnancy is significantly increased during pregnancy, so that the death rate in pregnant women with hepatitis E infection is 15 to 20 percent. Therefore, travel to the risk areas during pregnancy should be avoided if possible. In addition, pregnant women should only eat meat thoroughly cooked and refrain from consuming pork liver.

Vaccination still in development

A vaccine against the hepatitis E virus has been researched for several years, but vaccination is currently not possible. However, hygiene measures when traveling to a high-risk area can reduce the risk of illness:

  • Before use, boil tap water for brushing and drink only bottled water from the store.
  • Avoid ice cubes in drinks.
  • Eat fruits and vegetables just peeled or cooked.
  • Consume meat only from hygienic preparation.
  • Pay attention to general hygiene measures such as frequent hand washing.
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