Hepatitis E

What is hepatitis E?

Hepatitis E is a liver disease spread by contaminated food and water. Usually, hepatitis E is spread by contaminated water; however, in developed countries eating uncooked or undercooked animal products can also cause hepatitis E.

Some people who get hepatitis E do not ever feel sick. Others have symptoms that include a sudden onset of fever, tiredness, loss of appetite, nausea, vomiting, stomach pain, and yellowing of the skin and eyes (jaundice). Symptoms usually last less than 2 months but can last for up to 6 months. Pregnant women are most at risk of serious illness if they get hepatitis E. Most people recover with no lasting liver damage.

Who is at risk?

Hepatitis E is seen worldwide except for a few countries. Travelers to the developing world are especially at risk for hepatitis E. Hepatitis E is common in developing countries because many developing countries do not have the same food and water safety standards that the United States does. Large outbreaks of hepatitis E have occurred in south and central Asia, tropical east Asia, Africa, and Central America (Map 3-06).

What can travelers do to prevent hepatitis E?

There is no vaccine or medicine to prevent hepatitis E. Travelers should follow safe food and water guidelines and practice cleanliness and hygiene.

Drink safe beverages:

  • Bottled water that is sealed (carbonated is safer)
  • Water that has been disinfected (boiled, filtered, treated)
  • Ice made with bottled or disinfected water
  • Carbonated drinks
  • Hot coffee or tea
  • Pasteurized milk
Don't drink
  • Tap or well water
  • Ice made with tap or well water
  • Drinks made with tap or well water (such as reconstituted juice)
  • Flavored ice and popsicles
  • Unpasteurized milk

Eat safe foods:

  • Food that is cooked and served hot
  • Hard-cooked eggs
  • Fruits and vegetables you have washed in clean water or peeled yourself
  • Pasteurized dairy products
Don't eat
  • Food served at room temperature
  • Food from street vendors
  • Raw or soft-cooked (runny) eggs
  • Raw or undercooked (rare) meat or fish
  • Unwashed or unpeeled raw fruits and vegetables
  • Peelings from fruit or vegetables
  • Condiments (such as salsa) made with fresh ingredients
  • Salads
  • Unpasteurized dairy products
  • ”Bushmeat” (monkeys, bats, or other wild game)

For more information see Food and Water Safety.

Practice hygiene and cleanliness:

  • Wash your hands often.
  • If soap and water aren’t available, clean your hands with hand sanitizer (containing at least 60% alcohol).
  • Don’t touch your eyes, nose, or mouth. If you need to touch your face, make sure your hands are clean.
  • Try to avoid close contact, such as kissing, hugging, or sharing eating utensils or cups with people who are sick.

If you feel sick and think you may have hepatitis E:

  • Talk to your doctor or nurse if you feel seriously ill, especially if you have a fever.
  • Avoid contact with other people while you are sick.
  • Take medicine to control your fever and reduce your pain. Take medicine that contains aspirin, ibuprofen (Advil), or naproxen (Aleve). Take acetaminophen (Tylenol) in moderation.
  • Do not prepare or serve food to other people.

Traveler Information

Clinician Information