Hepatitis E in the UK and developed countries

Meat

The most common way for people to pick up hepatitis E in developed countries is by eating meat that has not been cooked well enough. Pork is the most common source of hepatitis E. Venison and wild boar are also at higher risk of having the virus.

Animals

Hepatitis E virus comes out in the poo of animals and humans who have the condition.

People who work with animals have a higher risk of picking up hepatitis E. This includes farmers, vets and slaughterhouse workers.

Water, crops and shellfish

Poo from animals with hepatitis E can sometimes get into water. For example if farm animals are close to a river. Or sewage is pumped into a river or the sea.

If this happens it could be possible to pick up the virus if you eat raw or undercooked shellfish that live in the water.

Hepatitis E virus can also be found on crops that have been watered with contaminated water.

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Person to person spread of hepatitis E

It is extremely rare for hepatitis E to be passed directly from one person to another.

There are a few reported cases of it being passed on between men who have sex with men.

It could also be picked up by people who have contact with human poo. For example sewage workers, or some care or healthcare workers.

Hepatitis E can be passed on through blood transfusions. In the UK this does not happen.  Since 2018 all donor blood has been tested for hepatitis E. But most other countries, including countries in Europe, do not routinely test donated blood for hepatitis E.

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Hepatitis E in developing countries

In other parts of the world, including parts of Africa, Asia and central America, there are different types of hepatitis E. These only live in humans.

When someone has hepatitis E, the virus comes out in their poo and can get into water. If people do not have easy access to clean water, they can pick up the virus by drinking contaminated water. You might hear these types of the virus called “waterborne viruses”.

The virus can also get onto crops if they are watered with contaminated water. People can pick up the virus from these crops if they are not cooked or washed in clean water before being eaten.

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Who is at risk of serious illness from hepatitis E?

Most people who pick up hepatitis E will not be seriously ill and may never even know they have had it. But a few groups of people have a higher risk of becoming very unwell. Or having the condition for a long time. In the most extreme cases hepatitis E can cause liver failure and even death.

Those at greater risk from hepatitis E include:

• People who are immunosuppressed, especially those who have had a liver or other organ transplant.

If you are immunosuppressed because of a medical condition, or because of medicine you are taking, then your immune system might not be able to get rid of hepatitis E on its own.

• People with another liver condition.

If you already have a problem with your liver then the extra damage from hepatitis E can make it more likely that you will become seriously ill.

• Pregnant women.

Pregnant women and their babies are at more risk from type 1 hepatitis E. Especially if it is picked up in the third trimester. This type of hepatitis E is not found in the UK but could be picked up overseas. You can find out more about hepatitis E and pregnancy here.

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Types of hepatitis E

There are 4 main types of hepatitis E. These are called “genotypes” because doctors can tell them apart by looking at the genes in the virus.

In the UK the most common type is type 3. You can find out more about the different types of hepatitis E in the drop-down boxes below:

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