Hepatitis E

Hepatitis E is an infectious disease that affects the liver. Its causative agent is a virus that contains an RNA molecule. The danger of this infection lies in the damage of the entire structure of the liver, which is accompanied by severe acute symptoms and puts the patient's health at risk. The disease is often diagnosed in people under 30 years old. The causative agent enters the body by fecal-oral contamination through feces of a sick person.

The structure of the virus is destroyed under the influence of low and high temperatures, disinfectants from the halogen group, but it has the ability to remain in fresh water for a long time. Outbreaks of the disease are observed in the warm season, when climatic factors are favorable for the vital activity of the virus. It is almost never found in winter seasons. Cases of epidemics are typical for hot areas with excess population and unfavorable sanitary and hygienic conditions, when contaminated feces enter the drinking water. The risk group includes residents of territories where hostilities are taking place, refugees, people in places of confinement and residents of settlements without water supply and sewerage. Mostly this disease affects people from 10 to 30 years.

Transmission of the disease

The main cause of infection is the use of raw water, in which there are feces of a sick person. Less commonly, there are cases when the virus enters the body through poorly processed animal meat or raw shellfish that live in freshwater. Their ability to carry the virus and serve as a source of the infection has been proven in numerous laboratory studies. Transfusion of infected donor blood to a healthy person will invariably cause the disease of the latter. Also, the virus is characterized by a transplacental method of transmission of the virus from a sick mother to the fetus. In isolated cases, the causative agent of hepatitis E enters the body through dirty hands, poorly washed vegetables and fruit.

The presence of non-enveloped RNA in the structure of the virus makes the pathogen vulnerable to any temperature effects - both hypothermia and heating. The conditions of stay in freshwater are relatively favorable for it. Such conditions contribute intensive reproduction. The risk of infection increases due to the asymptomatic course of the initial stages of hepatitis E. A person who does not feel signs of pathology leads a normal life, but his feces contain a significant amount of the pathogen and can cause infection of another person. Carriage of the virus can be detected only in 20% of infected individuals, while diagnosis due to pronounced symptoms increases this level to 50%.

Symptoms of viral Hepatitis E

The disease is characterized by a long incubation period, when the pathology does not reveal its presence in the body. In some cases, symptoms did not appear within 50-70 days after the fact of infection. In children the signs of the disease are ill-defined, in young and middle-aged patients they are more often obvious. Among the most characteristic symptoms of the so-called preicteric period are weakness, loss of appetite and nausea. During the next, icteric phase, patients complain of:

• body temperature increases up to 38 degrees;
• soreness of the stomach and right hypochondrium;
• staining of the mucous membrane and skin in an icteric tone;
• darkening of the urine and lightening of the feces.

There is an increase in size and softening of the structure of the liver in palpation. If the disease is severe, there may be signs of internal bleeding, traces of blood in the urine, symptoms of bleeding in the uterine cavity and organs of the gastrointestinal tract. All these factors disappear after a few weeks and normal laboratory tests are noted in a month or two after infection.

If the hepatitis E virus attacks the body of a person with a weakened immune system, among the characteristic symptoms there is a feeling of dry mouth, lethargy and an impermanent pain in the back of the head. During the so-called prodromal stage, which is coming between the incubation and the main stage, the patient may notice:

• problems with spatial orientation;
• tremor, constant freezing;
• feelings of aggression or depression;
• deterioration of mental activity;
• fluctuations in body temperature;
• sleep disorders, insomnia.

At the clinical stage of hepatitis E, all signs of liver damage are noted: an increase in the size of the organ, bowel disorders with a change in the color of feces, a feeling of heaviness and bloating and yellowness of the skin. The patient loses his appetite, there is pain in the right hypochondrium and darkening of the urine.

The co-called fulminant form of hepatitis E was identified in a separate category. Its main symptom is a sharp increase in blood pressure in the portal vein, which serves as a form of protection of the body from harmful substances penetrating the liver. This disease can appear in the form of such pathologies as:

• abdominal dropsy;
• intestinal hemorrhage;
• hepatic dystrophy;
• arrhythmia;
• severe limb edema;
• protrusion of a venous network on the skin.

The prognosis for this form of hepatitis E in most cases is unfavorable.

When should a patient see a doctor?

Self-medication of hepatitis E is a serious mistake, its consequences are unpredictable. Your best assistant in the fight against the symptoms of the disease will be a competent infectious disease specialist - a highly qualified doctor with extensive experience. With the help of his efforts, a treatment course will be developed. It will guarantee the elimination of unpleasant signs of the disease and the return of lost health.

Complications

Liver cells are fully restored, subject to timely diagnosis and treatment, the course of which is developed by competent specialists. Moreover, there were no cases of transition of this disease to the chronic stage. The only exception is women during pregnancy. Infection usually leads to spontaneous misbirth and serious health complications of the prospective mother.

Hepatitis E can cause serious complications in immunocompromised patients, e.g. such as:

• lack of liver enzymes;
• hypertension;
• cirrhosis;
• atrophy of the liver tissue;
• bleeding in the gastrointestinal tract.

Without timely medical attention, these complications can be fatal.

Diagnostics

Some forms of laboratory and instrumental researches can accurately determine the presence of the hepatitis E virus in the body, e.g. such as:

• blood test for specific immunoglobulins IgM and IgG;
• PCR test to detect signs of a viral infection RNA;
• coagulogram to clarify the parameters of blood coagulability;
• liver function tests;
• ultrasound investigation and MRI of the liver..

Treatment

The basis of treatment is nutrition according to the No. 5 diet for patients with acute form of the disease and No. 5a diet for ones with the chronic liver disease. It is recommended to eat five times a day in small portions using foods containing a significant amount of fiber.

The drug therapy implies symptomatic treatment designed to alleviate the patient's condition. In the case of a well-being deterioration, hospitalization with a stay in the intensive care unit is possible. An additional measure of treatment is detoxification of the body in the form of intravenous fluids to remove breakdown products from the body. Glucose or saline with calcium and magnesium are used as the substance of the dropper. 

Prevention

In the vast majority of cases, the likelihood of infection depends only on external conditions, so a person cannot foresee the risk of becoming a carrier of infection. However, he can do everything necessary to decrease the possible contact with pathogens to a minimum. If there is a threat of infection, you should:

• change living conditions;
• take care of high-quality purification of drinking water;
• handle food carefully;
• refuse from bad habits;
• do physical exercises.

If there is a risk of mass infection, the population is vaccinated. Vaccination is also recommended for pregnant women from areas with poor sanitary and hygienic conditions.

How to make an appointment with an infectious disease specialist at JSC "Medicina" (Academician Roitberg Clinic)?

You can make an appointment with an infectious disease specialist at JSC "Medicina" (Academician Roitberg Clinic) on the website: an interactive form allows you to select doctors from the general list of specialists and schedule your appointment.

Our clinic is located on the territory of the Central Administrative District of Moscow at the address: 2nd Tverskoy-Yamskoy lane, building 10. Convenient location allows patients to quickly get to the clinic from the metro stations "Mayakovskaya", "Novoslobodskaya", "Tverskaya", "Chekhovskaya" and "Belorusskaya". 

You can get detailed information about the order of appointments and the documents required to visit the clinic from the information desk at +7 (495) 775-73-60.