HEPATITIS E

Hepatitis E is a viral hepatitis (liver inflammation) caused by infection with a virus called hepatitis E virus (HEV). It is one of five known hepatitis viruses: A, B, C, D, and E. Infection with this virus was first documented in 1955 during an outbreak in New Delhi, India. Pathophysiology The HEV genome contains 3 open reading frames (ORFs). The largest, ORF-1, codes for the nonstructural proteins responsible for viral replication. ORF-2 contains genes encoding the capsid. The function of ORF-3 is unknown, but the antibodies directed against ORF-3 epitopes have been identified. Causative agent Hepatitis E is a viral hepatitis (liver inflammation) caused by infection with a virus called hepatitis E virus (HEV). HEV is a positive-sense single-stranded RNA icosahedral virus with a 7.5 kilobase genome. HEV has a fecal-oral transmission route. The Hepatitis E virus is described to be a non-enveloped, single-stranded RNA virus. The natural reservoir of this virus is primarily humans but primates could also carry such virus. Hepatitis is a general term meaning inflammation of the liver. Hepatitis is a disease that can be caused by a variety of different viruses such as hepatitis A, B, C, D and E. Since the development of jaundice is a characteristic feature of liver disease, a correct diagnosis can only be made by testing patients' sera for the presence of specific viral antigens and/or antiviral antibodies. Hepatitis E (HEV) was not recognized as a distinct human disease until 1980. Hepatitis E is caused by infection with the hepatitis E virus, a non-enveloped, positive-sense, singlestranded RNA virus. Although man is considered the natural host for HEV, antibodies to HEV or closely related viruses have been detected in primates and several other animal species.

Incubation Period The average incubation period for the hepatitis viruses is different for each one. The range represents the shortest known time and the longest known time for symptoms to develop after exposure to the virus. Hepatitis E: 40 days (range: 14-60 days) After the incubation period is when the signs and symptoms of the disease begin to show (unless the person is asymptomatic and doesn't show any symptoms, which is very common for viral hepatitis). Medical Management: 1. 2. 3. 4. The goal of management is to prevent the spread through fecal-oral route. Always observe good hygiene. Proper and regular water analysis must be made for public water supplies. HEV infections is limiting and hospitalization is not done. Vaccines are not yet developed so focus in management is more on preventive measures.

Nursing Management: 1. Proper surveillance of the community and the source of water should be emphasized to the community leaders. 2. Teach the children as well as the adults of proper hand washing and good hygiene. 3. Evaluate the source of water supply in the community and refer to the leaders of the community if the source of drinking water is at danger of making the transmission of Hepatits E possible. 4. Emphasize to the leaders of the community the political will to provide hygienic sanitation to each of the houses in the community.