Risk at a Glance

Hepatitis E virus and Food safety: Understanding the Foodborne threat


Foodborne-associated Hepatitis E cases have been commonly linked to the consumption of undercooked pig liver. Pig liver can be found in many local dishes and most people like it slightly undercooked for its texture, but is it actually safe to eat undercooked pig liver?

What is Hepatitis E virus?

Hepatitis E virus (HEV) is a type of virus that can cause an inflammation of the liver. HEV can be spread through two ways; first, through water that is contaminated with stools of infected patients, and second, through contaminated food. In recent years, there has been an increasing concern about the spread of the virus particularly after eating raw or undercooked pork, pig liver and offal, venison, and wild boar meat. Pigs and wild boars are common reservoirs for HEV as these animals can be asymptomatic when infected with HEV and consumers who consume raw or undercooked contaminated meat can fall ill and spread the virus. 

pork hep e

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Lovers of under-cooked pig liver could be at a higher risk of hepatitis E infection. Many people with Hepatitis E, especially young children, do not have any symptoms. Symptomatic Hepatitis E is most common in young adults aged 15-40 years old. The signs and symptoms of Hepatitis E include fatigue, abdominal pain, loss of appetite, nausea, jaundice, joint pain, dark urine, vomiting, and/or a low-grade fever. While most people infected with HEV recover and have no long-term liver problems, in rare cases, immunocompromised people, especially those who had organ transplant or chronic liver disease, as well as pregnant women in the second or third trimester are at increased risk of acute liver failure, fetal loss and death.

How can consumers protect themselves?

Consumers can play a part in protecting themselves. While we cannot tell if the meat, especially pig liver, is contaminated with HEV, we can take steps to reduce the risk of foodborne-associated Hepatitis E infection. Here’s what you can do: 

  • Purchase meat from SFA- approved businesses (importers, retailers)

  • Avoid consuming raw or undercooked meat dishes, especially for people with weakened immune system

  • Store raw food in containers with lids to prevent juices from dripping onto other raw or read-to-eat food in the refrigerator

  • Cook pork, particularly pig liver, thoroughly until it reaches an internal temperature of 71°C, or when there is no pink meat visible

  • Use separate chopsticks (hot pot) and utensils for handling raw and cooked foods to prevent cross contamination 

  • Wash your hands with soap after handling raw meat

  • Thoroughly clean food appliances and utensils that have been in contact with raw meat

References and further reading

About the Author

    Dr Adeline Yong is a Scientist from the Risk Assessment and Communications Department of the National Centre for Food Science. With a PhD in Public health Microbiology from Nanyang Technological University, Dr Yong is responsible for microbiological risk assessments and safety assessments of Novel Foods derived from biomass and precision fermentation.

    She is also a proud parent of one daughter and was an educator for science.