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Prevalence of Hepatitis E Virus in the United States.
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Prevalence of Hepatitis E Virus in the United States.
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Prevalence of Hepatitis E Virus in the United States.

Hepatitis E is an inflammation of the liver and is caused by the hepatitis E virus (HEV). Mortality rates are generally low, because Hepatitis E is a “self-limiting” disease, in that it usually goes away by itself and the patient recovers. However, during the duration of the infection (usually several weeks), the disease severely impairs a person’s ability to work, care for family members, and obtain food. Hepatitis E occasionally develops into a severe liver disease, and is fatal in about 2% of all cases. Clinically, it is comparable to hepatitis A, but in pregnant women the disease is more often severe and is associated with a clinical syndrome called fulminant hepatic failure (severe impairment of liver function) which may cause death. Pregnant women, especially those in the third trimester, suffer an elevated mortality rate from the disease which tends to be about 20%.

Risk factors for Hepatitis E include exposure to contaminated food or water by consuming untreated water; consuming food prepared by an infected person; consuming raw produce or raw shellfish (oysters); traveling to other countries where hepatitis E is common. Another risk factor could be exposure to the blood or stool of an infected person. Those at greatest risk for transmission of HEV are health care workers and students, dentists, dental hygienists, and anyone regularly exposed to infectious diseases. Symptoms of hepatitis E could be diarrhea, nausea, vomiting, tiredness, stomach pain, fever, dark urine, pale colored stool, loss of appetite and yellowing skin and eyeballs (jaundice).

According to a study conducted at the Johns Hopkins Bloomberg School of Public Health, exposure to Hepatitis E Virus (HEV) appears to be common in the United States. The data used in the study came from the third National Health and Nutrition Examination Survey (NHANES III) conducted by the National Center for Health Statistics between 1988 and 1994. Blood samples from over 18,000 participants representing a cross section of the U.S. population were tested for antibodies for HEV. The results revealed antibodies were present indicating exposure to HEV in 21 percent of the U.S. population. It was found that HEV exposure was less common in children than in adults and generally increased with age. The results also revealed that males had higher prevalence of HEV antibodies compared to women. Although how HEV is spread is not fully known, it appears that having a dog or pet in the home or consuming meats like liver and other organs were significantly associated with increased odds of exposure to HEV, therefore, animals could play an important role in the transmission of HEV to humans. “The very high prevalence of antibodies to the HEV among residents of the U.S. was quite surprising; however HEV-associated acute hepatitis has been increasingly reported among residents of Western European countries. In addition, HEV infections are an important cause of illness and even death among populations in developing countries—especially among women who are infected during pregnancy,” said Kenrad E. Nelson, MD, senior author of the study and professor in the Bloomberg School’s Department of Epidemiology.1

1 Kuniholm MH, Purcell RH, McQuillan GM, et al. Epidemiology of Hepatitis E Virus in the United States: Results from the Third National Health and Nutrition Examination Survey, 1988-1994. J Infect Dis. Jul2009.

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06-19-2012 02:26 PM
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