Hepatitis E should be considered a neglected tropical disease

Abstract

Hepatitis E virus (HEV) is a major cause of acute jaundice worldwide, with a case fatality risk (CFR) as high as 30% among symptomatic pregnant women. Human HEV includes four genotypes; the nonepidemic, zoonotic genotypes (typically 3 and 4) have gained increasing recognition in North America and Europe over the past decade [1] because of the potential risk of transmission through food, blood transfusions, and organ donation. However, relatively little attention and few resources have been invested into genotypes 1 and 2 (g1/g2), which cause outbreaks among the world's most vulnerable populations living with poor access to safe water and sanitation infrastructure. Here, we argue that the burden of this disease, combined with the neglect by the public health, research, and clinical communities and limited options for treatment and control, make it a serious candidate for classification as a neglected tropical disease (NTD).