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Hepatitis E A003

Last amended 
14 September 2015

In this section

Current RMA Instruments:
Reasonable Hypothesis SOP
112 of 2015
Balance of Probabilities SOP
113 of 2015
Changes from Previous Instruments:

SOP Bulletin 185

ICD coding:

ICD-9-CM:       070.53

ICD-10-AM:    B17.2

Brief description:

Hepatitis E is a viral infection of the liver similar in form to hepatitis A and as such is contracted normally through faecally contaminated food, water or fomites. A fomite is an inanimate object which is capable of carrying and transmitting the infection between persons.

Confirming the diagnosis:

To confirm the diagnosis there needs to be both:

  • evidence of clinical symptoms and signs (fever, nausea and vomiting, jaundice)


  • blood serology positive for the hepatitis E virus with a pattern indicative of a recent infection.

Either symptoms/signs alone or serological evidence alone is insufficient for diagnosis, both components must be present.

The serology during an active infection should have positive IgM antibodies.  A negative IgM in combination with a positive IgG indicates a past infection.   Asymptomatic past infection is common.

The relevant medical specialist is a gastroenterologist or an infectious disease physician.

Additional diagnoses covered by these SOPs
  • Nil
Conditions not covered by these SOPs   
  • Hepatitis A*, B*, C*, D*

  • Viral hepatitis not due to hepatitis E –

    • Acute infecious mononucleosis*

    • Cytomegalovirus#

    • Herpes simplex*

    • Coxsackievirus#

  • Toxoplasmosis#
  • Steatohepatitis#
  • Non-infectious hepatitis#

    * another SOP applies  - the SOP has the same name unless otherwise specified

    # non-SOP condition

Clinical onset

To have a clinical onset of hepatitis E there needs to be both serology testing showing recent or current infection and a clinical illness at around that time (no more than a six months before) with symptoms consistent with Hepatitis E.  The clinical onset will then be when the symptoms of that illness started.  The clinical onset is not the date of the positive serology.

Clinical worsening

Clinical worsening of hepatitis E is unlikely, as it is an acute infection which normally resolves without residual impairment, or causes death.  There is no chronic form of Hepatitis E.

Further comments on diagnosis

Hepatitis E is an acute viral infection of the liver.  It resolves completely, usually within 2 months and in no longer than 12 months.  A relapsing course over a number of months is possible, but there are no long term effects.  A claim for hepatitis E determined more than 1 year after disease onset should be diagnosed as “Hepatitis E – resolved”, or “No Incapacity Found”.