Hepatitis E

It was in 1980 that hepatitis E was discovered to be distinct from other types of hepatitis. This type of hepatitis is caused by Hepatitis E virus.

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.

The mode of transmission of this virus is through fecal-oral route. Water contaminated by feces are the major source of outbreaks in the communities. This case is rampant to communities with poor sanitation.

Hepatitis E incidence is common in areas of Central and South-East Asia, North and West Africa as well as in Mexico.

The virus’ incubation period may last between 3 to 8 weeks.

Signs and Symptoms:

  1. Jaundice (yellow discoloration of the skin and sclera of the eyes dark urine and pale stools)
  2. Anorexia (loss of appetite)
  3. An enlarged, tender liver (hepatomegaly)
  4. Abdominal pain and tenderness
  5. Nausea and vomiting
  6. Fever

Diagnostic Evaluation:

  1. Blood tests are obtained in order to detect elevation of antibody levels of specific antibodies
  2. Areas are of suspected Hepatitis E incidence when Hepatitis A was ruled out. If laboratory tests are not available, epidemiologic investigation is the source of the diagnosis.

Medical Management:

  1. The goal of management is to prevent the spread through fecal-oral route.
  2. Always observe good hygiene.
  3. Proper and regular water analysis must be made for public water supplies.
  4. 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.

Photo credits: http://www.712designs.com/illustrations.htm

Daisy Jane Antipuesto RN MN

Currently a Nursing Local Board Examination Reviewer. Subjects handled are Pediatric, Obstetric and Psychiatric Nursing. Previous work experiences include: Clinical instructor/lecturer, clinical coordinator (Level II), caregiver instructor/lecturer, NC2 examination reviewer and staff/clinic nurse. Areas of specialization: Emergency room, Orthopedic Ward and Delivery Room. Also an IELTS passer.

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