Viral Hepatitis E –Myths and facts

What is Hepatitis E?
Hepatitis E is an acute liver disease caused by the hepatitis E virus. Since it is a viral infection most of the times it subsides on its own and does not require any special treatment.
How does Hepatitis E spreads?
The hepatitis E virus is transmitted primarily through the ingestion of contaminated drinking water containing the Hepatitis E virus. The other modes like person-to-person transmission and foodborne transmission from ingestion of products derived from infected animals are rare.
What are the symptoms of Hepatitis E?
The signs and symptoms following exposure to the hepatitis E virus usually develop within three to eight weeks, with a mean of 40 days. Symptomatic infection is most common in young adults aged 15–40 years. Typical signs and symptoms of hepatitis include decreased appetite, distaste for food, abdominal pain and tenderness, nausea, vomiting and fever followed by jaundice. This jaundice usually peaks in two to three weeks time and subsequently settles down over the next four to six weeks. A small proportion of patients can have a complicated course with development of rapidly progressive liver failure especially in pregnant females.
How to make a diagnosis of Hepatitis E?
The cases of hepatitis E are indistinguishable from other types of acute viral hepatitis. The diagnosis of acute infection is based on the detection of specific antibodies to the virus in the blood. Additional tests, which are rarely required, include reverse transcriptase polymerase chain reaction (RT-PCR) to detect the hepatitis E virus RNA in blood and/or stool.
How can we treat Hepatitis E?
There is no specific treatment capable of altering the course of acute hepatitis. As hepatitis E is usually self-limiting, hospitalization is generally not required. Treatment is symptomatic and is aimed at maintaining hydration and adequate calorie intake. There is no role of antibiotics and other over the counter drugs that are claimed to alter the course of the illness. However a small proportion of patients with fulminant hepatic failure and pregnant women require hospitalization. Nutritious diet plays an important role and hastens recovery, however there are certain myths about dietary intake, which need to be addressed.
Common Myths and explanations:
• Diet should be restricted and avoid non-vegetarian food in acute hepatitis-The restricted diet causes a delayed recovery. Even for a healthy individual, a prolonged zero-fat diet leads to delayed recovery. There is absolutely no taboo in eating non-vegetarian food too, provided it is cooked adequately and hygienically. Boiled vegetables and with the all time favorite radish juice is debilitating enough and should be avoided.
• Proteins in liver disease
: Proteins should be restricted in acute viral hepatitis- There is sufficient evidence to show that protein should not be restricted in acute viral hepatitis patients, as restriction leads to delayed recovery. A high protein diet is recommended in patients with acute viral hepatitis as it is a catabolic state and liver is not able to synthesize proteins.
• Turmeric in acute viral hepatitis
: Avoid Haldi, (turmeric) in patients who have jaundice-Anti-inflammatory substances are commonly available in turmeric, and they work for the liver also. The yellow color of turmeric should not be viewed as a potentially aggravating substance for the sufferers.
How can we prevent Hepatitis E?
At the level of the administration, improving sanitation and maintaining quality standards for public water supplies with proper disposal systems to eliminate sanitary waste can reduce the risk of infection and transmission.
For the general public, some measures during this outbreak, which can help prevent the infection, are using boiled/filtered water, avoid eating from outside especially street vendors, and avoid eating undercooked food and washing hands frequently.

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