Hepatitis E virus (HEV) is usually transmitted by the fecal-oral route through contaminated water supplies or food and poor personal hygiene. Occurrence in the United States is mostly associated with travel to endemic regions. Incubation period is 15-60 days with an average of 40 days. Symptoms are usually abrupt and include malaise, anorexia, nausea and/or vomiting, abdominal pain, and fever. The highest rates of symptomatic disease (jaundice) have been in young to middle-age adults. IgG anti-HEV persists and appears to provide at least short-term protection against disease. There is currently no vaccine or immune globulin available to prevent the transmission of HEV. Long term prevention relies primarily on provision of safe drinking water, prudent hygiene, and avoiding uncooked foods in endemic areas.