Advising on travel during pregnancy

Contrary to what was stated in the article entitled "Advising on
travel during pregnancy"(1), there is a vaccine against hepatitis E(2).

Whether or not it is available in the United Kingdom is another matter. The
vaccine was trialled in a study where participants aged 16-65 were
randomly assigned to vaccine (n=56302) or placebo (n=56302). The vaccine
consisted of recombinant hepatitis E antigen adsorbed to aluminium
hydroxide suspended in buffered saline. During 12 months after 30 days
from vaccination 15 participants in the placebo group developed hepatitis
E compared with none in the vaccine group. Adverse effects were mild, and
included pain, swelling, and itching at the injection sites(2).

It is also worth noting that there have been anecdotal reports of
succesful treatment of chronic hepatitis E virus infection with ribavirin,
in two patients(3), and with pegylated interferon-alpha in one
instance(4). So, the otlook for hepatitis E is beginning to improve.

References

(1) Hezelgrave NL., Whitty CJM., Shennan AH., Chappell LC
Advising on travel during pregnancy
BMJ 2011;342:doi:10.1136/bmjd.2506

(2) Zhu F-C., Zhang J., Zhang X-F et al
Efficacy and safety of a recombinant hepatitis E vaccine in healthy
adults: a large scale, randomised, double-blind placebo-controlled, phase
3 trial
Lancet 2010;376:895-902

(3) Mallet V., Nicand E., Sultanik P et al
Brief communication: case reports of ribavirin treatment of chronic
hepatitis E
Ann Intern Med 2010;153:85089

(4) Alric L., Bonnet D., Laurent G., Kamar N., Izopet J
Chronic hepatitis E virus infection: succesful virological response to
pegylated interferon-alpha therapy
AnnIntern Med 2010;153:135-6