An outbreak of hepatitis in New Delhi was characterized by high incidence of fulminant hepatitis in pregnant women, who experienced a mortality rate of 20%. The virus responsible for the outbreak:

Question

An outbreak of hepatitis in New Delhi was characterized by high incidence of fulminant hepatitis in pregnant women, who experienced a mortality rate of 20%.  The virus responsible for the outbreak:

Quizplus · Accepted Answer

Hepatitis E virus is an unenveloped, single-stranded RNA virus spread through the fecal-oral route. Infection with HEV occurs primarily in young and middle-aged adults living in Asia, sub-Saharan Africa, and Mexico, with an average incubation period of 6 weeks. While the virus is shed in the stool during the acute illness, the disease is typically self-limited and not associated with either chronic liver disease or a carrier state. HEV antigen or HEV RNA can be detected in the stool or liver in the earliest stages of infection (when the patient is asymptomatic). Later, serum transaminases and IgM anti-HEV titers rise in association with clinical illness. The most concerning feature of hepatitis E is the high mortality rate observed in infected pregnant women. (Choice B) Although hepatitis B, C, and D can be transmitted parenterally (with patients with intravenous drug use and hemophilia at particularly high risk), hepatitis A and E are primarily transmitted via the fecal-oral route. (Choice C) Hepatitis E causes an acute illness and is not associated with chronic infection. (Choice D) Unlike hepatitis D virus, hepatitis E is not dependent on HBsAg for infection and multiplication. (Choice E) Because of their association with hepatocellular carcinoma, hepatitis B and C have been suggested to have oncogenic properties. Hepatitis E is not associated with an increased risk of hepatocellular carcinoma, however. Educational objective: Hepatitis E virus is an unenveloped, single-stranded RNA virus spread through the fecal-oral route. The most concerning feature of hepatitis E infection is the high mortality rate observed in infected pregnant women.

An Outbreak of Hepatitis in New Delhi Was Characterized by High