Hepatitis E virus: background document for the WHO guidelines for drinking-water quality and the WHO guidelines on sanitation and health
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World Health Organization
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ii, 11 p.
This background document supports the WHO Guidelines for drinking-water quality and the WHO Guidelines on sanitation and health by reviewing the public health significance of Hepatitis E virus (HEV) in relation to water, sanitation and hygiene. The publication summarizes current evidence on the virology, epidemiology, transmission routes, environmental occurrence and health effects of HEV, with particular emphasis on waterborne transmission associated with faecal contamination. HEV is identified as a significant waterborne pathogen strongly linked to unsafe drinking-water, inadequate sanitation and poor hygiene, especially in low- and middle-income countries. The document describes the characteristics and geographic distribution of different HEV genotypes, including zoonotic genotypes associated with animal reservoirs and foodborne transmission. The publication reviews the occurrence of HEV in wastewater, surface water, groundwater, drinking-water, soil and crops, as well as available molecular detection methods and evidence on viral persistence. It highlights the role of outbreaks linked to contaminated drinking-water, flooding and humanitarian emergencies, particularly among displaced populations and pregnant women. The document also discusses sanitation safety plans and water safety plans, emphasizing source protection, wastewater management, effective treatment processes, disinfection and control of faecal contamination to reduce risks associated with HEV transmission.
This background document supports the WHO Guidelines for drinking-water quality and the WHO Guidelines on sanitation and health by reviewing the public health significance of Hepatitis E virus (HEV) in relation to water, sanitation and hygiene. The publication summarizes current evidence on the virology, epidemiology, transmission routes, environmental occurrence and health effects of HEV, with particular emphasis on waterborne transmission associated with faecal contamination. HEV is identified as a significant waterborne pathogen strongly linked to unsafe drinking-water, inadequate sanitation and poor hygiene, especially in low- and middle-income countries. The document describes the characteristics and geographic distribution of different HEV genotypes, including zoonotic genotypes associated with animal reservoirs and foodborne transmission. The publication reviews the occurrence of HEV in wastewater, surface water, groundwater, drinking-water, soil and crops, as well as available molecular detection methods and evidence on viral persistence. It highlights the role of outbreaks linked to contaminated drinking-water, flooding and humanitarian emergencies, particularly among displaced populations and pregnant women. The document also discusses sanitation safety plans and water safety plans, emphasizing source protection, wastewater management, effective treatment processes, disinfection and control of faecal contamination to reduce risks associated with HEV transmission.