[Hepatitis E in Hetian city. Analysis of 562 cases]

Between August and September 1987, 562 patients were hospitalized with acute non-A, non-B hepatitis. The male to female ratio was 1.4:1, and 75% of the patients was of 15-40 years of age. Jaundice developed in 87%. The overall case-fatality rate was 1.4%, but it was highest among pregnant women (5.2%) and newborn infants (24.2%). In general, the disease was self-limited with no evidence of chronic infection. Liver biopsies obtained during the acute illness showed portal inflammation and cytoplasmic cholestasis. Of 31 specimens of stool examined with a prototype ELISA for HEV antigen, 8 were found to be 'positive' and confirmed with immune electron microscopy (IEM). IEM examination of 'patients' stool revealed 27-32 nm viruslike particles. Inoculation of rhesus monkeys with patients stool containing virus-like particles produced acute hepatitis and the acute phase serum reacted with these particles in IEM, while preinoculation serum specimens were non-reactive.