An outbreak investigation of hepatitis E reveals a large common-source waterborne outbreak. Which epidemiological feature of hepatitis E BEST distinguishes it from hepatitis A in outbreak settings?

• A Hepatitis E has a shorter incubation period than hepatitis A
• B Hepatitis E causes significantly higher case fatality in pregnant women (15–25%) ✓
• C Hepatitis E is spread primarily by the feco-oral person-to-person route like hepatitis A
• D Hepatitis E is associated with chronic infection unlike hepatitis A

Explanation

The most clinically and epidemiologically distinguishing feature of hepatitis E versus hepatitis A is its dramatically elevated case fatality rate in pregnant women (15–25%, compared to <1% in the general population), particularly in the third trimester. This leads to fulminant hepatic failure, DIC, and high maternal and fetal mortality. Both viruses are transmitted by contaminated water (fecal-oral route). Hepatitis E (genotype 3/4) can rarely cause chronic infection in immunocompromised hosts, but this does not define outbreak epidemiology.

Reference: Park's Textbook of Preventive and Social Medicine, 27th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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