Hepatitis E

[hep·a·ti·tis ]

HEV outbreak investigation

Here’s a type of hepatitis you probably haven’t heard of before. Like all types of viral hepatitis, hepatitis E is a disease that affects the liver. It is spread by ingesting fecal matter contaminated with hepatitis E virus, even in tiny amounts, and is often associated with contaminated water in countries with poor sanitation. For this reason, hepatitis E is more common in developing parts of the world; it is rare in the United States and other developed countries. In the United States, most cases of hepatitis E occur among travelers to countries with a high burden of this disease, but rarely cases can also be traced to consumption of raw or undercooked food that is contaminated with the virus.

For most people, infection with the hepatitis E virus (HEV) results in short-term illness. The infection usually improves with rest, proper hydration, and nutrition. Although many people don’t have any symptoms, hepatitis E can lead to liver disease and death in certain people (pregnant women and people who have received solid organ transplants). No FDA-approved vaccine is available to prevent hepatitis E.


Key Facts

  • Hepatitis E is a liver disease caused by the hepatitis E virus.
  • People living in countries with poor sanitation and limited access to safe water are at highest risk for hepatitis E, along with travelers to these countries.
  • Hepatitis E may occur in high-income countries as a result of the consumption of raw or undercooked food.
  • Hepatitis E can cause serious liver disease and even lead to death in pregnant women and people with vulnerable immune systems.
  • Not everyone infected with hepatitis E has symptoms, but symptoms can include fever, fatigue, nausea, and jaundice.
  • Hepatitis E can only be diagnosed by your health-care provider with the assistance of laboratory tests.
  • No vaccine is available to prevent hepatitis E.


Hepatitis E Micrograph
Hepatitis E Micrograph

An electron micrograph photo of hepatitis E viruses.

Chlorine treatments
Drink Treated Water

Water purification packets are an effective way to purify water that might be contaminated with hepatitis E. Adding a packet or bottlecap of chlorine per 20 liters of water and waiting 30 minutes before drinking is proven to reduce most bacteria and viruses, including hepatitis E.

Refugee camp in South Sudan
Hepatitis E Around the World

While rare in the United States, hepatitis E is common in low-income countries with limited access to safe water.

Mother washing child's hand with chlorine-treated water
Preventing Hepatitis E

Hepatitis E can be prevented by following water, sanitation, and hygiene principles: wash your hands often with soap, use toilets, drink treated water, and avoid eating undercooked food.

Prevention Tips

  • Avoid drinking untreated water when traveling to areas with poor sanitation; HEV is inactivated when water is boiled and chlorinated.
  • Avoid eating raw or undercooked food, specifically pork and venison.
  • Visit your health-care provider immediately if you have signs and symptoms consistent with viral hepatitis.