Hepatitis E is usually transmitted through the fecal-oral route-first shed in the feces of infected individuals, then ingested in contaminated water or food. Therefore, the epidemiology of hepatitis E is similar to that of hepatitis A.

Hepatitis E is rare in the but is prevalent in developing countries. The only reported cases of hepatitis E in the involve those who have traveled to countries where the disease is common.

Hepatitis E has an incubation period ranging from two to nine weeks, with an average length of 45 days. This means that someone infected with the virus will not show symptoms for that period of time. After that, the symptoms of acute hepatitis E are the same as those seen in other hepatitis infections. As in hepatitis A, most people with hepatitis E recover with no long-term problems and have life-long protection from hepatitis E.

In general, hepatitis E does not cause a chronic carrier state (when someone carries and transmits the virus without showing symptoms). It is usually not transmitted from mother to baby. There are isolated exceptions to this rule, however, and rare cases of severe infection and death in newborns have been reported.

In developing countries, maternal death from hepatitis E is alarmingly high, ranging from 10 to 20%. Extreme poverty, coexisting medical illnesses, malnutrition, and poor prenatal care are at least partially responsible for this poor maternal prognosis.