Hepatitis E primary prevention
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: João André Alves Silva, M.D. [2]
Overview
Prevention
Hepatitis E may be prevented by two ways:[1]
- Limiting exposure to the virus
- Immunization through vaccine
Hepatitis E is a zoonosis, therefore prevention of the disease should start by avoiding transmission of the virus from animals to humans. As almost all HEV infections are spread by the faecal - oral route, improving sanitation is the most important measure, along with good personal hygiene. High quality standards for public water supplies and proper disposal of sanitary waste have resulted in a low prevalence of HEV infections in many well developed societies.[2]
For travellers to high endemic areas, the usual elementary food hygiene precautions are recommended. These include:[3]
- Avoiding drinking water and/or ice of unknown purity
- Eating uncooked shellfish, uncooked fruits or vegetables that are not peeled or prepared by the traveller
- Cook pork thoroughly
- Avoid eating shellfish
Although rare, transmission has been reported through blood transfusions. Because infection is often asymptomatic, and most blood products are not tested for the presence of the virus, transmission of hepatitis E may be occurring unnoticed. This represents a concern for immunosuppressed patients, and for those with chronic liver disease, who are at risk of developing chronic hepatitis E. Therefore screening of blood products is considered a preventive measure.[1][4]
Guidelines for Epidemic Measures
The following measures should be observed in an epidemic situation:[3]
- Determination of the mode of transmission
- Identification of the population with an increased risk of infection
- Elimination of a common source of infection
- Improvement of sanitary and hygienic practices to eliminate faecal contamination of food and water
Vaccination
Patients who have recovered from HEV infection show immunity against HEV, which seems to offer life-long protection against the development of symptomatic hepatitis E. Vaccination can also induce protective immunity
References
- ↑ 1.0 1.1 Kamar N, Bendall R, Legrand-Abravanel F, Xia NS, Ijaz S, Izopet J; et al. (2012). "Hepatitis E." Lancet. 379 (9835): 2477–88. doi:10.1016/S0140-6736(11)61849-7. PMID 22549046.
- ↑ Mandell, Gerald (2010). Mandell, Douglas, and Bennett's principles and practice of infectious diseases. Philadelphia, PA: Churchill Livingstone/Elsevier. ISBN 0443068399.
- ↑ 3.0 3.1 "Hepatitis E".
- ↑ Hoofnagle JH, Nelson KE, Purcell RH (2012). "Hepatitis E." N Engl J Med. 367 (13): 1237–44. doi:10.1056/NEJMra1204512. PMID 23013075.