Infection
Infection with the hepatitis E virus is fecal-oral. This means that pathogens that are excreted with the stool (faecal) are later absorbed through the mouth (oral). This transmission from person to person is rather rare, although it is quite possible that an acutely ill person infects other people directly in this way.
Much more frequently, infection occurs indirectly via contaminated water or insufficiently cooked or boiled meat products. A type of the hepatitis E virus (genotype 3) that occurs in this country can be transmitted via wild boar, pigs and deer. The best way to protect yourself from hepatitis E infection is to heat meat products at over 70°C.
Contact with infected animals should also be avoided. Besides pigs, wild boar and deer, monkeys, sheep, mice and rats are the reservoir of the pathogen. Especially when hygienic standards are poor, e.g.
in third world countries, during environmental disasters (e.g. floods or monsoons), in war zones or in refugee accommodation, hepatitis E infection is common. In these cases contaminated drinking water is the main source of transmission. To protect against infection via contaminated drinking water, water should therefore only be consumed from water bottles sealed by the manufacturer.
Infection through a liver transplantation (in case of hepatitis E disease of the donor) is also possible. In very rare cases, infection with hepatitis E can also occur via contaminated blood products and blood transfusions, although this transmission value is rather untypical. Infection via coughing, sneezing, kissing, etc.
(droplet infection) and sexual intercourse is not known. Most hepatitis E infections that occur in the western world are recorded as travel diseases, which the ill persons bring along mainly from travel in the above-mentioned risk areas. How contagious hepatitis E is is not yet fully understood.
The duration of the infection is between one week before and 4 weeks after the first symptoms appear. The virus is excreted via the stool. The hepatitis E virus can then be transmitted by smear infection if hygiene is inadequate.
If a permanent infection by the virus occurs, it must be assumed that during this time the virus can also be transmitted to other people and the environment. However, fecal-oral transmission from human to human is rare. In Germany, the hepatitis E virus is mainly transmitted via insufficiently cooked food such as wild or domestic pigs.
The HEV genotype 3, which mainly occurs in Germany, is only very, very rarely transmitted from person to person via smear infection. The virus has a fecal-oral effect (i.e. pathogens excreted in the stool are absorbed through the mouth). Hepatitis E viruses (HEV-1 and -2), which are acquired during travel, are more likely to be transmitted through human contact. These are countries with a low standard of hygiene, although people can also become infected with hepatitis E through contaminated water or other food. These include mainly seafood such as mussels.
