Many people have heard of “jaundice,” which is not a disease but one of the myriad manifestations of liver ailments. Among them, viral hepatitis concerns me the most because I myself was a victim. “Hepatitis” means inflammation of the liver, which is the body’s storehouse and factory of biochemicals essential for digestion. You may have heard of viral hepatitis caused by A, B and C but hepatitis E virus (HEV) may be new to you. You may even brush it aside, thinking this is none of my business. But I’d like to share with you information about HEV and the suffering it causes every year. HEV is rampant in areas where safe water supply, sanitation, and hygiene practices are compromised. People get sick by ingesting drinking water contaminated with the feces from infected persons.

Once symptomatic, you will be bed-ridden for weeks. You will feel miserable and lethargic, and you will lose your appetite and have a complete aversion to food and its smells. The whites of your eyes turn yellow. This disease can spread quickly and has the potential for outbreaks that can sicken thousands of people in a community. The worst and most dreaded part is its potentially fatal impact on pregnant women. Infected pregnant women have a high chance of miscarriage and stillbirth and even death due to severe liver failure. Hepatitis E (HEV) is considered to be the most important cause of viral jaundice among adults in the subcontinent. Cases of jaundice caused by HEV crop up across Nepal every year, and cause fear and suffering in affected communities.

Two particular outbreaks stand out, which help us understand the gravity of the HEV problem in Nepal. One occurred on the premises of the Prime Minister’s official residence in 2007, where the then-Prime Minister, some of his cabinet ministers, and other staff caught the viral illness and were bedridden for weeks. The second one was more recent - from May to April in 2014. This outbreak occurred in the heart of Biratnagar where thousands of local residents were taken ill and some even died. The root cause of both outbreaks was fecal contamination of the municipality’s drinking water supply. Both outbreaks made the headlines of national and international media at the time. These examples sparked a sense of urgency for public health measures to prevent and control HEV.

The golden rule for the prevention of waterborne infectious diseases like HEV is health education, clean water, and sanitation and hygiene practices. Sadly, HEV has not attracted much global attention compared with other diseases like Ebola Virus, TB, HIV, and malaria.