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Hepatitis E

What is Hepatitis E?

Hepatitis E is an infectious liver disease caused by the Hepatitis E virus (HEV).

How common is Hepatitis E?

While Hepatitis E is widespread in developing countries, it is uncommon in the United States. In California, 47 cases were reported in 2016. Areas with poor sanitation such as Mexico and certain countries within Africa, Asia, the Middle East, and Central America are places where Hepatitis E is most common; people in the United States infected with HEV usually contracted it while traveling to these areas.

How do people get Hepatitis E?

People get Hepatitis E by drinking water or eating food contaminated with feces from a person infected with the virus. HEV infection may also occur as a result of eating undercooked pork, wild boar, or deer.

What are the symptoms of Hepatitis E?

The most common symptoms of Hepatitis E are similar to those caused by other hepatitis viruses (A, B, & C):

  • ​Fever
  • ​Abdominal pain
  • ​Fatigue
  • ​Dark urine
  • ​Loss of appetite
  • ​Joint pain
  • ​Dizziness
  • ​Clay-colored stool
  • ​Vomiting
  • ​Yellowing of the skin or eyes (jaundice)

Symptoms can appear between two to six weeks after exposure to the virus and develop over several days or weeks. Some people do not have any symptoms. 

Are certain people at greater risk for Hepatitis E?

Certain groups, particularly persons who travel in areas with poor sanitation, are at increased risk for exposure to HEV.

In addition, some people are at greater risk for severe HEV infection and its complications, including liver failure and death. These include:

  • Pregnant women
  • Persons with health conditions that weaken their immune system such as: 
    • Cancer
    • HIV infection
    • Treatment with chemotherapy or steroids
    • Organ transplant 

How is Hepatitis E diagnosed and treated?

If you think you might have Hepatitis E, visit your healthcare provider. Since Hepatitis E symptoms are similar to those of other illnesses, your provider may order blood tests or other tests to confirm a Hepatitis E diagnosis.

For most healthy people, Hepatitis E usually gets better without treatment. Healthcare providers may recommend rest, drinking lots of fluids, and avoiding alcohol or acetaminophen consumption. However, people with weakened immune systems and pregnant women can experience severe illness and may need additional care. Severe illness may lead to pregnancy complications, acute liver failure, and death, so it is important to have a discussion with your healthcare provider as soon as possible. 

How can a person reduce their risk of getting Hepatitis E?

There is no vaccine currently available in the United States that protects against Hepatitis E. People who travel in areas with poor sanitation can reduce their risk of getting Hepatitis E by avoiding contaminated food or water, and practicing good hand hygiene. 

  • Avoid ice cubes, flavored ices, and popsicles unless you are sure those items were made with boiled or bottled water.
  • Drink bottled water or bring water to a rolling boil for 1 minute before you drink it.
  • Drink bottled carbonated water which is safer than noncarbonated water.
  • Eat foods that have been thoroughly cooked and that are still hot and steaming.
  • Do not eat raw vegetables and fruits that cannot be peeled.Do not consume undercooked pork, wild boar, or deer (venison). 
  • While traveling, be sure to wash your hands with soap and water after using the bathroom, after changing diapers, and before preparing food or eating.  

What is being done about HEV infections in California?

State and local health departments:

  • Monitor the number of people who get Hepatitis E in California to determine if there are increases in the number of cases or outbreaks of illness
  • Raise awareness of Hepatitis E among healthcare providers and the public, including prevention messages 

Where can I get more information about Hepatitis E?

For more information on Hepatitis E, contact your local health department or visit the U.S. Centers for Disease Control and Prevention Hepatitis E webpage (
August 2017​

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