Which of the following hepatitis is spread through the fecal-oral route?

Appeared in: Haryana CHO - 2022

Explanation

Hepatitis E virus (HEV) is an enterically-transmitted virus, meaning it spreads through the intestines.
The primary mode of transmission is the fecal-oral route, typically through the ingestion of water contaminated with fecal matter.
This is similar to Hepatitis A, and both are often associated with poor sanitation and hygiene.
Unlike Hepatitis B, C, and D, Hepatitis E does not typically cause chronic liver disease (except in rare cases of immunosuppression).

Option A: Hepatitis B virus (HBV) is transmitted parenterally, through contact with infected blood and body fluids.
Option B: Hepatitis C virus (HCV) is primarily transmitted through direct contact with infected blood, most commonly through intravenous drug use and, historically, blood transfusions.
Option C: Hepatitis D virus (HDV), or delta virus, is a defective virus that requires a co-infection with Hepatitis B to replicate and be transmitted. Its transmission route is therefore the same as HBV (parenteral).

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Transmission routes of viral hepatitis as background academic context rather than a clinical decision trigger.
Understanding the transmission route is critical for implementing appropriate infection control measures. For Hepatitis E, this includes advising patients on hand hygiene, ensuring safe drinking water, and proper food handling.
Nurses must educate patients, especially those traveling to endemic areas, about the risks of consuming untreated water or uncooked food.
A key nursing consideration for Hepatitis E is its high mortality rate in pregnant women. Any pregnant patient presenting with jaundice or hepatitis symptoms requires urgent evaluation for HEV.

How to Approach the Question

First, identify the core question, which is about the mode of transmission for hepatitis.
The keywords are 'hepatitis' and 'fecal-oral route'.
Recall the different types of hepatitis viruses and their primary transmission pathways. A useful mnemonic is: 'Vowels (A, E) come from the bowels'. This helps to quickly associate Hepatitis A and E with the fecal-oral route.
Evaluate each option based on this knowledge.
Hepatitis B, C, and D are known to be transmitted through blood and body fluids (parenteral, sexual, perinatal routes).
Hepatitis E is transmitted via the fecal-oral route. Therefore, it is the correct answer.

Concept Tested & Keywords

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E6 Pathology-Textbook of PATHOLOGYHarsh Mohan Part 3 (515-969) pp. 96-98, 100-102

E6 PATHOLOGY QUICK REVIEWBased on Harsh Mohan Textbook of PATHOLOGY p. 157-159

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Attempt every question from this paper in a timed mock, then review the full solution for each one.