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Semin Liver Dis. 2013 Feb;33(1):15-29. doi: 10.1055/s-0033-1338111. Epub 2013 Apr 5.

Epidemiology of hepatitis E in low- and middle-income countries of Asia and Africa.

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Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.


Hepatitis E is an acute, viral hepatitis primarily transmitted through the fecal-oral route. The first major epidemic of hepatitis E virus (HEV) was reported in 1955 in Delhi, India. Since that time, numerous epidemics have been reported across the low- and middle-income countries in Asia and Africa. Even in the absence of large-scale outbreaks, hepatitis E is an important cause of clinical hepatitis. Serologic studies across Asia and Africa show a high prevalence of anti-HEV antibodies. Interest in hepatitis E has increased over the last two decades. However, there are many unanswered questions about the epidemiology of hepatitis E, including a low clinical illness rate in children and the high case fatality rate in pregnant women. Widespread usage of a hepatitis E vaccine may serve to relieve the burden of HEV disease in low- and middle-income countries in Africa and Asia.

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