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Epidemic Control Toolkit
for community volunteers
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Hepatitis E

Last update: 2022-06-07

Key facts

Transmission

  • Water contaminated with human waste (stools)
  • Eating raw or undercooked meat or meat products (such as liver) and seafood (such as shellfish)
  • Blood transfusion
  • From mother to unborn baby during pregnancy

Symptoms

  • Most people with hepatitis E have no signs or symptoms of disease at all.
  • Symptoms can include mild fever, loss of appetite, abdominal pain, nausea, dark urine, pale stools and yellow skin or whites of eyes (jaundice).
  • Pregnant women are particularly at risk of falling severely ill with Hepatitis E and can die.

Prevention

  • Safe, clean water (including a clean, covered water container in the household)
  • Use of appropriate sanitation facilities (sound, clean latrines)
  • Handwashing with soap (especially after using the toilet or cleaning a baby)
  • Good food hygiene (thoroughly cooked food, covered food, clean utensils, etc.)
  • Social mobilization and behaviour change communication

Vulnerable people

  • Pregnant women, especially those later in pregnancy (after the third month)
  • People with liver diseases
  • Displaced populations
  • People living in areas that have poor water, sanitation and hygiene facilities and services

If an epidemic occurs

  • Detect and refer cases to health facilities
  • Promote handwashing with soap (especially after using the toilet or cleaning a baby)
  • Promote safe, clean drinking water (including a clean, covered water container in the household)
  • Promote use of appropriate sanitation facilities (sound, clean latrines)
  • Promote good food hygiene (thoroughly cooked food, covered food, clean utensils, etc.)
  • Increase social mobilization and behaviour change communication
  • Health promotion

Community-based assessment - questions

Make a map of the community and mark the information you gather on the map. Record other details.

  • When did people start to fall sick with hepatitis E?
  • How many people have fallen sick with hepatitis E? Where?
  • How many people have died from hepatitis E? Where?
  • How many people live in the affected community or area? How many children under five years of age live in the area? How many pregnant women live in the area?
  • Who and where are the vulnerable people? Are children in the affected community
  • generally well nourished?
  • Do people always have enough food?
  • How common is breastfeeding?
  • Where do people obtain their drinking water? Is the source safe? Do people treat their water?
  • What sanitation facilities (including communal latrines) are available? Do people use them?
  • What handwashing facilities are available? Do they have soap?
  • Where are the local health facilities and services? (Include traditional and community carers.)
  • What are the community’s habits, practices and beliefs about caring for and feeding sick people? When babies and infants are sick, do women continue to breastfeed them?
  • Do people have specific practices related to pregnancy, such as withholding fluids?
  • Is a social mobilization or health promotion programme in place?
  • What are the community’s habits, practices and beliefs about hygiene, sanitation and water?
  • Which sources or channels of information do people use most?
  • Are rumours or is misinformation about hepatitis E spreading in the community?
  • Can people identify the signs and symptoms of dehydration?
  • Do people know how to make oral rehydration solution (ORS)? Do they have resources at hand to make it?
  • Do people know how to treat water?