Prevention and treatment
As almost all HEV infections are spread by the faecal - oral route, good personal hygiene, high quality standards for public water supplies and proper disposal of sanitary waste have resulted in a low prevalence of HEV infections in many well developed societies.29
For travellers to high endemic areas, the usual elementary food hygiene precautions are recommended. These include avoiding drinking water and/or ice of unknown purity and eating uncooked shellfish, uncooked fruits or vegetables that are not peeled or prepared by the traveller.
As with hepatitis A, hepatitis E patients generally do not require hospitalization.48
Admission is required for fulminant hepatitis and should be considered for infected pregnant women.48
Guidelines for epidemic measures
The manufacture of hyperimmune E globulin and the production of a vaccine are essential for the control of the disease.
There is a need for determining the durability of anti-HEV neutralizing antibody after natural infection or vaccination.
The development of differential diagnostic tests to distinguish between infections with swine HEV and human HEV is necessary.33
The pathogenesis of the disease, especially in infected pregnant women, needs to be elucidated.
International measures should be established.