Introduction
Hepatitis E virus infection is a disease primarily caused by poor hygiene. It is now emerging as a global health concern. Earlier, it was more common in developing countries, but now its outbreak is a global concern. It was known to be common where there were fewer resources and limited access. However, with the growing migration trend, the spread of infection has evolved, leading to the need for more awareness and the advent of effective strategies to manage and control its spread. This article explores the multifactorial nature of hepatitis E, along with management and the challenges faced due to it.
How Is Hepatitis E Spread?
Hepatitis E is spread through the fecal-oral route, which means that the virus is present in the feces of an infected person. The most common source of infection is unclean water, which is contaminated. It can be transmitted from animals to humans through the consumption of cooked or improperly cooked contaminated meat. It is generally considered common in developing countries because of poor hygiene and sanitation practices. In developed countries, it is more commonly caused by undercooked meat from infected animals consumed or from the migration of the infected individual. Pregnant women and patients with compromised immune systems stand at higher risk of developing untoward complications from hepatitis E infection.
Hepatitis E has 4 genotypes. Genotypes 3 and 4 are foodborne. Type 3 is common in developed countries, whereas others are common in developing countries.
What Are the Symptoms?
Many people do not have any symptoms. When symptoms do occur, they come after around 40 days of exposure. The disease is infectious from a week before jaundice occurs. It is a very serious disorder in pregnant women with a high mortality rate. Also, individuals with previous liver disease can have serious complications. Commonly seen symptoms are:
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Fever: One of the most early symptoms is fever. It could either be a mild fever or a severe one, which is persistent for weeks.
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Tiredness: It is common for hepatitis patients to experience a severe lack of energy and fatigue, thereby hampering their regular activities.
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Appetite Loss: The patients are unable to eat, making them prone to nutritional deficiencies.
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Nausea and Vomiting: These symptoms make the patient more tired and may lead to electrolyte imbalance.
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Pain in the Abdomen: It could manifest as a dull or cramping kind of pain in the area of the liver that is the upper right quadrant.
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Jaundice: Yellowish discoloration of the skin and eyes is jaundice and is a common manifestation seen in hepatitis E. When the liver is diseased, there is decreased metabolism of bilirubin and hence, it is seen as yellowish pigmentation.
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Dark-Colored Urine: Bilirubin present in urine results in a darker color.
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Clay-Colored Stool: Bilirubin excreted in stool leads to pale or clay-colored stool.
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Joint Pain: It is a less common symptom.
What Are the Emerging Challenges and Opportunities Available?
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Globalization: With the increase in international travel, it has become easier for hepatitis E infection to spread across borders, thereby making it a concern worldwide. Infected individuals may travel to regions where there were previously no cases of infection, thereby leading to the spread of infection.
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Transmission From Animals: Types 3 and 4 of hepatitis E have a zoonotic source, and they can spread from interaction between animals and humans. This makes it challenging to control and prevent the spread of the disease.
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Diagnostic Challenge: Since the disease is not very specific, it might be difficult to diagnose it. Hepatitis E is not considered in the routine examination, as there is less test access. All these pose a significant challenge to identify and manage these diseased individuals.
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Immunocompromised Individuals: Though the disease is generally self-limiting, individuals with compromised immune systems, such as patients with chronic diseases or organ transplant individuals. This can lead to progressive damage in the liver also along with other symptoms.
Intervention Opportunities Include:
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Vaccines: Safe and efficient vaccines are to be introduced against hepatitis E infection. There has been a lot of research and study in this regard. The hepatitis E vaccine will be a part of the routine immunization program.
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Food Safety Measures: Maintaining proper hygiene and sanitation while handling food production and supply cooking helps prevent contamination with the virus. This mandates collaboration between different departments and regulatory bodies to monitor food production.
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Screening Blood: Blood screening is incorporated into the routine to detect the disease in the early stage. To reduce the risk of blood transmission-related infection, healthcare authorities must enforce strict screening protocols by implementing tests that produce quicker results.
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Public Health Education: Educational campaigns must be conducted to raise awareness about the infection and various risk factors and ways to prevent it. Individuals with a higher risk of transmission must be instructed to undergo regular screening.
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Improved Diagnosis: Using enhanced surveillance systems helps in monitoring the emerging trend of transmission. This gives an idea to research targeted intervention to facilitate early outbreak detection and prepare the country to manage an adequate response.
Conclusion
To conclude, hepatitis E infection is a significant global health concern for both developing as well as developed countries. This increase in the spread of disease is alarming and necessitates a comprehensive and multifaceted approach to spread awareness of the disease, encouraging the prevention of its spread and control. Amidst all the challenges, there are numerous opportunities like developing safe and efficient vaccines, improving sanitation and hygiene, and having reforms that enforce hygienic food production and packaging. These help in preventing disease spread to some extent. Educating the general public and screening those at high risk helps in early disease diagnosis and timely intervention. Also, care has to be taken to give equal access to healthcare for the poor and vulnerable as they are considered more at risk. To end, the challenges of Hepatitis E are numerous, but they can be reduced with the help of collaborative efforts from researchers, clinicians, the general public, patients, and caregivers. This effort can help safeguard the health and overall well-being of individuals and communities across the globe.
