Teacher: In this task, you are given a context, a subject, a relation, and many options. Based on the context, from the options select the object entity that has the given relation with the subject. Answer with text (not indexes).
Teacher: Now, understand the problem? If you are still confused, see the following example:
Context: Joanne McLeod is a Canadian figure skating coach. She is the skating director at the Champs International Skating Centre of BC (formerly known as the BC Centre of Excellence). Here current and former students include Emanuel Sandhu, Mira Leung, Kevin Reynolds, Jeremy Ten, Nam Nguyen, and many others. In 2012, McLeod became the first level 5 certified figure skating coach in British Columbia., Victor Kraatz, MSC (born April 7, 1971) is a Canadian former ice dancer. In 2003, he and his partner, Shae-Lynn Bourne, became the first North American ice dancers to win a World Championship., Allie Hann-McCurdy (born May 23, 1987 in Nanaimo, British Columbia) is a Canadian ice dancer. McCurdy began skating at age eight and was a singles skater until age 12 when she switched to ice dancing. In 2003 she teamed up with Michael Coreno, with whom she was the 2010 Four Continents silver medalist and the 2008 Canadian bronze medalist. The pair retired in June 2010, to coach at the Gloucester Skating Club., Maikki Uotila - Kraatz ( born 25 February 1977 ) is a Finnish ice dancer . She is a former Finnish national champion with Toni Mattila . She married Victor Kraatz on June 19 , 2004 . The two coach in Vancouver , where they are the ice dancing directors at the BC Centre of Excellence . She and Kraatz have two sons , born September 14 , 2006 and July 10 , 2010 ., Burnaby is a city in British Columbia, Canada, located immediately to the east of Vancouver. It is the third-largest city in British Columbia by population, surpassed only by nearby Surrey and Vancouver., Canada (French: ) is a country in the northern half of North America. Its ten provinces and three territories extend from the Atlantic to the Pacific and northward into the Arctic Ocean, covering , making it the world's second-largest country by total area and the fourth-largest country by land area. Canada's border with the United States is the world's longest land border. The majority of the country has a cold or severely cold winter climate, but southerly areas are warm in summer. Canada is sparsely populated, the majority of its land territory being dominated by forest and tundra and the Rocky Mountains. About four-fifths of the country's population of 36 million people is urbanized and live near the southern border. Its capital is Ottawa, its largest city is Toronto; other major urban areas include Montreal, Vancouver, Calgary, Edmonton, Quebec City, Winnipeg and Hamilton., British Columbia (BC) is the westernmost province of Canada, with a population of more than four million people located between the Pacific Ocean and the Rocky Mountains. 
British Columbia is also a component of the Pacific Northwest and the Cascadia bioregion, along with the U.S. states of Idaho, Oregon, Washington and Alaska., The "Champs International Skating Centre of British Columbia" (formerly known as the 'BC Centre of Excellence') is one of two major figure skating training centers in Canada. Located in Burnaby, British Columbia, it is home to many great national and international skaters. The programs there are overseen by a staff, including Joanne McLeod, who coaches 3-time Canadian men's national champion Emanuel Sandhu; Bruno Marcotte, who competed at the 2002 Winter Olympics; Victor Kraatz, the 2003 World Champion in ice dancing, and Maikki Uotila, who was a national champion in Finland. The center operates out of Canlan Ice Sports Burnaby 8 Rinks. Notable skaters who train there include Emanuel Sandhu, Mira Leung, Allie Hann-McCurdy & Michael Coreno, Jessica Millar & Ian Moram, Jeremy Ten, and Kevin Reynolds. This skating school is sometimes known as a training site for international competitors to practice for competitions in Vancouver. Champs International hosts its annual competition known as the BC/YK SummerSkate Competition every August., Shae-Lynn Bourne, MSC (born January 24, 1976) is a Canadian ice dancer. In 2003, she and partner Victor Kraatz became the first North American ice dancers to win a World Championship. They competed at three Winter Olympic Games, placing 10th at the 1994 Winter Olympics, 4th at the 1998 Winter Olympics, and 4th at the 2002 Winter Olympics., Vancouver, officially the City of Vancouver, is a coastal seaport city on the mainland of British Columbia, Canada, and the most populous city in the province., Subject: maikki uotila, Relation: country_of_citizenship, Options: (A) american (B) british (C) canada (D) finland (E) montreal
Solution: finland
Reason: This is a good example, as maikki uotila is citizen of the finland.

Now, solve this instance: Context: The Hepatitis E virus, or HEV, is the causative agent of Hepatitis E. Its taxonomic name is "Orthohepevirus A"., Infection is the invasion of an organism's body tissues by disease-causing agents, their multiplication, and the reaction of host tissues to these organisms and the toxins they produce. Infectious disease, also known as transmissible disease or communicable disease, is illness resulting from an infection.
Infections are caused by infectious agents including viruses, viroids, prions, bacteria, nematodes such as parasitic roundworms and pinworms, arthropods such as ticks, mites, fleas, and lice, fungi such as ringworm, and other macroparasites such as tapeworms and other helminths., Modern humans ("Homo sapiens", primarily ssp. "Homo sapiens sapiens") are the only extant members of Hominina tribe (or human tribe), a branch of the tribe Hominini belonging to the family of great apes. They are characterized by erect posture and bipedal locomotion; manual dexterity and increased tool use, compared to other animals; and a general trend toward larger, more complex brains and societies., Bacteria (common noun bacteria, singular bacterium) constitute a large domain of prokaryotic microorganisms. Typically a few micrometres in length, bacteria have a number of shapes, ranging from spheres to rods and spirals. Bacteria were among the first life forms to appear on Earth, and are present in most of its habitats. Bacteria inhabit soil, water, acidic hot springs, radioactive waste, and the deep portions of Earth's crust. Bacteria also live in symbiotic and parasitic relationships with plants and animals., Hepatitis is inflammation of the liver. Some people have no symptoms whereas others develop yellow discoloration of the skin and whites of the eyes, poor appetite, vomiting, tiredness, abdominal pain, or diarrhea. Hepatitis may be temporary (acute) or long term (chronic) depending on whether it lasts for less than or more than six months. Acute hepatitis can sometimes resolve on its own, progress to chronic hepatitis, or rarely result in acute liver failure. Over time the chronic form may progress to scarring of the liver, liver failure, or liver cancer.
The most common cause worldwide is viruses. Other causes include heavy alcohol use, certain medications, toxins, other infections, autoimmune diseases, and non-alcoholic steatohepatitis (NASH). There are five main types of viral hepatitis: type A, B, C, D, and E. Hepatitis A and E are mainly spread by contaminated food and water. Hepatitis B is mainly sexually transmitted, but may also be passed from mother to baby during pregnancy or childbirth. Both hepatitis B and hepatitis C are commonly spread through infected blood such as may occur during needle sharing by intravenous drug users. Hepatitis D can only infect people already infected with hepatitis B.
Hepatitis A, B, and D are preventable with immunization. Medications may be used to treat chronic cases of viral hepatitis. There is no specific treatment for NASH; however, a healthy lifestyle, including physical activity, a healthy diet, and weight loss, is important. Autoimmune hepatitis may be treated with medications to suppress the immune system. A liver transplant may also be an option in certain cases.
Worldwide in 2015, hepatitis A occurred in about 114 million people, chronic hepatitis B affected about 343 million people and chronic hepatitis C about 142 million people. In the United States, NASH affects about 11 million people and alcoholic hepatitis affects about 5 million people. Hepatitis results in more than a million deaths a year, most of which occur indirectly from liver scarring or liver cancer. In the United States, hepatitis A is estimated to occur in about 2,500 people a year and results in about 75 deaths. The word is derived from the Greek "hêpar", meaning "liver", and "-itis", meaning "inflammation". , Needle sharing is the practice of intravenous drug-users by which a syringe is shared by multiple individuals to administer intravenous drugs, and is a primary vector for diseases which can be transmitted through blood (blood-borne pathogens)., Hepatitis C is an infectious disease caused by the hepatitis C virus (HCV) that primarily affects the liver. During the initial infection people often have mild or no symptoms. Occasionally a fever, dark urine, abdominal pain, and yellow tinged skin occurs. The virus persists in the liver in about 75% to 85% of those initially infected. Early on chronic infection typically has no symptoms. Over many years however, it often leads to liver disease and occasionally cirrhosis. In some cases, those with cirrhosis will develop complications such as liver failure, liver cancer, or esophageal and gastric varices.
HCV is spread primarily by blood-to-blood contact associated with intravenous drug use, poorly sterilized medical equipment, needlestick injuries in healthcare, and transfusions. Using blood screening, the risk from a transfusion is less than one per two million. It may also be spread from an infected mother to her baby during birth. It is not spread by superficial contact. It is one of five known hepatitis viruses: A, B, C, D, and E. Diagnosis is by blood testing to look for either antibodies to the virus or its RNA. Testing is recommended in all people who are at risk.
There is no vaccine against hepatitis C. Prevention includes harm reduction efforts among people who use intravenous drugs and testing donated blood. Chronic infection can be cured about 90% of the time with treatments that include the medications sofosbuvir or simeprevir. Previous to this a combination of peginterferon and ribavirin was used which had a cure rate around 50% and greater side effects. Getting access to the newer treatments however can be expensive. Those who develop cirrhosis or liver cancer may require a liver transplant. Hepatitis C is the leading reason for liver transplantation, though the virus usually recurs after transplantation.
An estimated 130200 million people worldwide are infected with hepatitis C. In 2013 about 11 million new cases occurred. It occurs most commonly in Africa and Central and East Asia. About 343,000 deaths due to liver cancer and 358,000 deaths due to cirrhosis occurred in 2013 due to hepatitis C. The existence of hepatitis C  originally identifiable only as a type of non-A non-B hepatitis  was suggested in the 1970s and proven in 1989. Hepatitis C infects only humans and chimpanzees., Macroparasites are parasites that are large enough to be seen with the naked eye, in contrast to microparasites. They grow in one host but reproduce by infective stages outside this host. These generally include ticks, mites, helminths (nematodes, flatworms, etc.), and can be either external parasites (ectoparasitic) or internal parasites (endoparasitic). The most abundant macroparasite in humans is the nematode "Ascaris lumbricoides "which causes an infection called ascariasis. Macroparasites are also parasitic of many plant species and can be a significant agricultural pest., An autoimmune disease is a condition arising from an abnormal immune response to a normal body part. There are at least 80 types of autoimmune diseases. Nearly any body part can be involved. Common symptoms include low grade fever and feeling tired. Often symptoms come and go.
The cause is generally unknown. Some autoimmune diseases such as lupus run in families, and certain cases may be triggered by infections or other environmental factors. Some common autoimmune disease include celiac disease, diabetes mellitus type 1, Graves disease, inflammatory bowel disease, multiple sclerosis, psoriasis, rheumatoid arthritis, and systemic lupus erythematosus. The diagnosis can be difficult to determine.
Treatment depends on the type and severity of the condition. Nonsteroidal anti-inflammatory drugs (NSAIDs) and immunosuppressants are often used. Intravenous Immunoglobulin may also occasionally be used. While treatment usually improves symptoms they do not typically cure the disease.
About 24 million (7%) of people in the United States are affected by an autoimmune disease. Women are more commonly affected than men. Often they start during adulthood. The first autoimmune diseases were described in the early 1900s., Steatohepatitis is a type of fatty liver disease, characterized by inflammation of the liver with concurrent fat accumulation in liver. Mere deposition of fat in the liver is termed steatosis, and together these constitute fatty liver changes. 
There are two main types of fatty liver disease: alcohol-related fatty liver disease and non-alcoholic fatty liver disease (NAFLD). Risk factors for NAFLD include diabetes, obesity and metabolic syndrome. When inflammation is present it is referred to as alcoholic steatohepatitis and nonalcoholic steatohepatitis (NASH). Steatohepatitis of either cause may progress to cirrhosis, and NASH is now believed to be a frequent cause of unexplained cirrhosis (at least in Western societies). NASH is also associated with lysosomal acid lipase deficiency.
The word is from "steato-", meaning "fat" and "hepatitis", meaning "inflammation of the liver"., Alcoholic hepatitis is hepatitis (inflammation of the liver) due to excessive intake of alcohol. It is usually found in association with fatty liver, an early stage of alcoholic liver disease, and may contribute to the progression of fibrosis, leading to cirrhosis. Signs and symptoms of alcoholic hepatitis include jaundice, ascites (fluid accumulation in the abdominal cavity), fatigue and hepatic encephalopathy (brain dysfunction due to liver failure). Mild cases are self-limiting, but severe cases have a high risk of death. Severe cases may be treated with glucocorticoids., Diarrhea, also spelled diarrhoea, is the condition of having at least three loose or liquid bowel movements each day. It often lasts for a few days and can result in dehydration due to fluid loss. Signs of dehydration often begin with loss of the normal stretchiness of the skin and irritable behaviour. This can progress to decreased urination, loss of skin color, a fast heart rate, and a decrease in responsiveness as it becomes more severe. Loose but non-watery stools in babies who are breastfed, however, may be normal.
The most common cause is an infection of the intestines due to either a virus, bacteria, or parasite; a condition known as gastroenteritis. These infections are often acquired from food or water that has been contaminated by stool, or directly from another person who is infected. It may be divided into three types: short duration watery diarrhea, short duration bloody diarrhea, and if it lasts for more than two weeks, persistent diarrhea. The short duration watery diarrhea may be due to an infection by cholera, although this is rare in the developed world. If blood is present it is also known as dysentery. A number of non-infectious causes may also result in diarrhea, including hyperthyroidism, lactose intolerance, inflammatory bowel disease, a number of medications, and irritable bowel syndrome. In most cases, stool cultures are not required to confirm the exact cause.
Prevention of infectious diarrhea is by improved sanitation, clean drinking water, and hand washing with soap. Breastfeeding for at least six months is also recommended as is vaccination against rotavirus. Oral rehydration solution (ORS), which is clean water with modest amounts of salts and sugar, is the treatment of choice. Zinc tablets are also recommended. These treatments have been estimated to have saved 50 million children in the past 25 years. When people have diarrhea it is recommended that they continue to eat healthy food and babies continue to be breastfed. If commercial ORS are not available, homemade solutions may be used. In those with severe dehydration, intravenous fluids may be required. Most cases; however, can be managed well with fluids by mouth. Antibiotics, while rarely used, may be recommended in a few cases such as those who have bloody diarrhea and a high fever, those with severe diarrhea following travelling, and those who grow specific bacteria or parasites in their stool. Loperamide may help decrease the number of bowel movements but is not recommended in those with severe disease.
About 1.7 to 5 billion cases of diarrhea occur per year. It is most common in developing countries, where young children get diarrhea on average three times a year. Total deaths from diarrhea are estimated at 1.26 million in 2013  down from 2.58 million in 1990. In 2012, it was the second most common cause of deaths in children younger than five (0.76 million or 11%). Frequent episodes of diarrhea are also a common cause of malnutrition and the most common cause in those younger than five years of age. Other long term problems that can result include stunted growth and poor intellectual development., Detoxification or detoxication (detox for short) is the physiological or medicinal removal of toxic substances from a living organism, including the human body, which is mainly carried out by the liver. Additionally, it can refer to the period of withdrawal during which an organism returns to homeostasis after long-term use of an addictive substance. In medicine, detoxification can be achieved by decontamination of poison ingestion and the use of antidotes as well as techniques such as dialysis and (in a limited number of cases) chelation therapy., Pregnancy, also known as gravidity or gestation, is the time during which one or more offspring develops inside a woman. A multiple pregnancy involves more than one offspring, such as with twins. Pregnancy can occur by sexual intercourse or assisted reproductive technology. It usually lasts around 40 weeks from the last menstrual period (LMP) and ends in childbirth. This is just over nine lunar months, where each month is about 29 days. When measured from conception it is about 38 weeks. An embryo is the developing offspring during the first eight weeks following conception, after which, the term "fetus" is used until birth. Symptoms of early pregnancy may include missed periods, tender breasts, nausea and vomiting, hunger, and frequent urination. Pregnancy may be confirmed with a pregnancy test.
Pregnancy is typically divided into three trimesters. The first trimester is from week one through 12 and includes conception. Conception is when the sperm fertilizes the egg. The fertilized egg then travels down the fallopian tube and attaches to the inside of the uterus, where it begins to form the fetus and placenta. The first trimester carries the highest risk of miscarriage (natural death of embryo or fetus). The second trimester is from week 13 through 28. Around the middle of the second trimester, movement of the fetus may be felt. At 28 weeks, more than 90% of babies can survive outside of the uterus if provided high-quality medical care. The third trimester is from 29 weeks through 40 weeks.
Prenatal care improves pregnancy outcomes. Prenatal care may include taking extra folic acid, avoiding drugs and alcohol, regular exercise, blood tests, and regular physical examinations. Complications of pregnancy may include high blood pressure of pregnancy, gestational diabetes, iron-deficiency anemia, and severe nausea and vomiting among others. Term pregnancy is 37 to 41 weeks, with early term being 37 and 38 weeks, full term 39 and 40 weeks, and late term 41 weeks. After 41 weeks, it is known as post term. Babies born before 37 weeks are preterm and are at higher risk of health problems such as cerebral palsy. Delivery before 39 weeks by labor induction or caesarean section is not recommended unless required for other medical reasons.
About 213 million pregnancies occurred in 2012, of which, 190 million were in the developing world and 23 million were in the developed world. The number of pregnancies in women ages 15 to 44 is 133 per 1,000 women. About 10% to 15% of recognized pregnancies end in miscarriage. In 2013, complications of pregnancy resulted in 293,000 deaths, down from 377,000 deaths in 1990. Common causes include maternal bleeding, complications of abortion, high blood pressure of pregnancy, maternal sepsis, and obstructed labor. Globally, 40% of pregnancies are unplanned. Half of unplanned pregnancies are aborted. Among unintended pregnancies in the United States, 60% of the women used birth control to some extent during the month pregnancy occurred., Hepatitis B is an infectious disease caused by the hepatitis B virus (HBV) which affects the liver. It can cause both acute and chronic infections. Many people have no symptoms during the initial infection. Some develop a rapid onset of sickness with vomiting, yellowish skin, tiredness, dark urine and abdominal pain. Often these symptoms last a few weeks and rarely does the initial infection result in death. It may take 30 to 180 days for symptoms to begin. In those who get infected around the time of birth 90% develop chronic while less than 10% of those infected after the age of five do. Most of those with chronic disease have no symptoms; however, cirrhosis and liver cancer may eventually develop. These complications result in the death of 15 to 25% of those with chronic disease.
The virus is transmitted by exposure to infectious blood or body fluids. Infection around the time of birth or from contact with other people's blood during childhood is the most frequent method by which hepatitis B is acquired in areas where the disease is common. In areas where the disease is rare, intravenous drug use and sexual intercourse are the most frequent routes of infection. Other risk factors include working in healthcare, blood transfusions, dialysis, living with an infected person, travel in countries where the infection rate is high, and living in an institution. Tattooing and acupuncture led to a significant number of cases in the 1980s; however, this has become less common with improved sterility. The viruses cannot be spread by holding hands, sharing eating utensils, kissing, hugging, coughing, sneezing, or breastfeeding. The infection can be diagnosed 30 to 60 days after exposure. The diagnosis is usually confirmed by testing the blood for parts of the virus and for antibodies against the virus. It is one of five known hepatitis viruses: A, B, C, D, and E.
The infection has been preventable by vaccination since 1982. Vaccination is recommended by the World Health Organization in the first day of life if possible. Two or three more doses are required at a later time for full effect. This vaccine works about 95% of the time. About 180 countries gave the vaccine as part of national programs as of 2006. It is also recommended that all blood be tested for hepatitis B before transfusion and condoms be used to prevent infection. During an initial infection, care is based on the symptoms that a person has. In those who develop chronic disease, antiviral medication such as tenofovir or interferon may be useful; however, these drugs are expensive. Liver transplantation is sometimes used for cirrhosis.
About a third of the world population has been infected at one point in their lives, including 240 million to 350 million who have chronic infections. Another 129 million new infections occurred in 2013. Over 750,000 people die of hepatitis B each year. About 300,000 of these are due to liver cancer. The disease is now only common in East Asia and sub-Saharan Africa where between 5 and 10% of adults are chronically infected. Rates in Europe and North America are less than 1%. It was originally known as "serum hepatitis". Research is looking to create foods that contain HBV vaccine. The disease may affect other great apes as well.
Signs and symptoms.
Acute infection with virus is associated with acute viral hepatitis, an illness that begins with general ill-health, loss of appetite, nausea, vomiting, body aches, mild fever, and dark urine, and then progresses to development of jaundice. It has been noted that itchy skin has been an indication as a possible symptom of all hepatitis virus types. The illness lasts for a few weeks and then gradually improves in most affected people. A few people may have a more severe form of liver disease known as (fulminant hepatic failure) and may die as a result. The infection may be entirely asymptomatic and may go unrecognized., Vomiting, also known as emesis and throwing up, among other terms, is the involuntary, forceful expulsion of the contents of one's stomach through the mouth and sometimes the nose.
Vomiting can be caused by a wide variety of conditions; it may present as a specific response to ailments like gastritis or poisoning, or as a non-specific sequela of disorders ranging from brain tumors and elevated intracranial pressure to overexposure to ionizing radiation. The feeling that one is about to vomit is called nausea, which often precedes, but does not always lead to, vomiting. Antiemetics are sometimes necessary to suppress nausea and vomiting. In severe cases, where dehydration develops, intravenous fluid may be required., Viral hepatitis is liver inflammation due to a viral infection. It may present in acute (recent infection, relatively rapid onset) or chronic forms.
The most common causes of viral hepatitis are the five unrelated hepatotropic viruses Hepatitis A, Hepatitis B, Hepatitis C, Hepatitis D, and Hepatitis E. In addition to the nominal hepatitis viruses, other viruses that can also cause liver inflammation include Cytomegalovirus, EpsteinBarr virus, and Yellow fever. Up to 1997 there has been also 52 cases of Viral hepatitis caused by Herpes simplex virus.
There is the opportunity to prevent or treat the most common types. Hepatitis A and hepatitis B can be prevented by vaccination. Effective treatments for hepatitis C are available but expensive.
In 2013 about 1.5 million people died from viral hepatitis. Most deaths are due to hepatitis B and hepatitis C. East Asia is the region of the world most affected., Childbirth, also known as labour and delivery, is the ending of a pregnancy by one or more babies leaving a woman's uterus. In 2015 there were about 135 million births globally. About 15 million were born before 37 weeks of gestation, while between 3 and 12% were born after 42 weeks. In the developed world most deliveries occur in hospital, while in the developing world most births take place at home with the support of a traditional birth attendant.
The most common way of childbirth is a vaginal delivery. It involves three stages of labour: the shortening and opening of the cervix, descent and birth of the baby, and the pushing out of the placenta. The first stage typically lasts twelve to nineteen hours, the second stage twenty minutes to two hours, and the third stage five to thirty minutes. The first stage begins with crampy abdominal or back pains that last around half a minute and occur every ten to thirty minutes. The crampy pains become stronger and closer together over time. During the second stage pushing with contractions may occur. In the third stage delayed clamping of the umbilical cord is generally recommended. A number of methods can help with pain such as relaxation techniques, opioids, and spinal blocks.
Most babies are born head first; however about 4% are born feet or buttock first, known as breech. During labour a woman can generally eat and move around as she likes, but pushing is not recommended during the first stage or during delivery of the head, and enemas are not recommended. While making a cut to the opening of the vagina is common, known as an episiotomy, it is generally not needed. In 2012, about 23 million deliveries occurred by a surgical procedure known as Caesarean section. Caesarean sections may be recommended for twins, signs of distress in the baby, or breech position. This method of delivery can take longer to heal from.
Each year complications from pregnancy and childbirth result in about 500,000 maternal deaths, 7 million women have serious long term problems, and 50 million women have health negative outcomes following delivery. Most of these occur in the developing world. Specific complications include obstructed labour, postpartum bleeding, eclampsia, and postpartum infection. Complications in the baby include birth asphyxia., India, officially the Republic of India ("Bhrat Gaarjya"), is a country in South Asia. It is the seventh-largest country by area, the second-most populous country (with over 1.2 billion people), and the most populous democracy in the world. It is bounded by the Indian Ocean on the south, the Arabian Sea on the southwest, and the Bay of Bengal on the southeast. It shares land borders with Pakistan to the west; China, Nepal, and Bhutan to the northeast; and Myanmar (Burma) and Bangladesh to the east. In the Indian Ocean, India is in the vicinity of Sri Lanka and the Maldives. India's Andaman and Nicobar Islands share a maritime border with Thailand and Indonesia. Its capital is New Delhi; other metropolises include Mumbai, Kolkata, Chennai, Bangalore, Hyderabad and Ahmedabad., Hepatitis A (formerly known as infectious hepatitis) is an infectious disease of the liver caused by the hepatitis A virus (HAV). Many cases have few or no symptoms, especially in the young. The time between infection and symptoms, in those who develop them, is between two and six weeks. When symptoms occur, they typically last eight weeks and may include nausea, vomiting, diarrhea, jaundice, fever, and abdominal pain. Around 1015% of people experience a recurrence of symptoms during the six months after the initial infection. Acute liver failure may rarely occur, with this being more common in the elderly.
It is usually spread by eating food or drinking water contaminated with infected feces. Shellfish which have not been sufficiently cooked are a relatively common source. It may also be spread through close contact with an infectious person. While children often do not have symptoms when infected, they are still able to infect others. After a single infection, a person is immune for the rest of his or her life. Diagnosis requires blood testing, as the symptoms are similar to those of a number of other diseases. It is one of five known hepatitis viruses: A, B, C, D, and E.
The hepatitis A vaccine is effective for prevention. Some countries recommend it routinely for children and those at higher risk who have not previously been vaccinated. It appears to be effective for life. Other preventive measures include hand washing and properly cooking food. No specific treatment is available, with rest and medications for nausea or diarrhea recommended on an as-needed basis. Infections usually resolve completely and without ongoing liver disease. Treatment of acute liver failure, if it occurs, is with liver transplantation.
Globally, around 1.4 million symptomatic cases occur each year and about 102 million infections (symptomatic and asymptomatic). It is more common in regions of the world with poor sanitation and not enough safe water. In the developing world about 90% of children have been infected by age 10 and thus are immune by adulthood. It often occurs in outbreaks in moderately developed countries where children are not exposed when young and vaccination is not widespread. Acute hepatitis A resulted in 102,000 deaths in 2010. World Hepatitis Day occurs each year on July 28 to bring awareness to viral hepatitis., Hepatitis E is a viral hepatitis ( liver inflammation ) caused by infection with a virus called hepatitis E virus ( HEV ) . It is one of five known human hepatitis viruses : A , B , C , D , and E. HEV is a positive - sense single - stranded non-enveloped RNA icosahedral virus with a 7.5 kilobase genome . HEV has a fecal - oral transmission route . Infection with this virus was first documented in 1955 during an outbreak in New Delhi , India . A preventative vaccine ( HEV 239 ) is approved for use in China . Although Hepatitis E often causes an acute and self - limiting infection ( it usually goes away by itself and the patient recovers ) with low mortality rates in the western world , it bears a high risk of developing chronic hepatitis in immunocompromised patients with substantial mortality rates . Organ transplant recipients who receive immunosuppressive medication to prevent rejection are thought to be the main population at risk for chronic hepatitis E. Furthermore , in healthy individuals during the duration of the infection ( usually several weeks ) , the disease severely impairs a person 's ability to work , care for family members , and obtain food . Hepatitis E occasionally develops into an acute , severe liver disease , and is fatal in about 2 % of all cases . Clinically , it is comparable to hepatitis A , but in pregnant women the disease is more often severe and is associated with a clinical syndrome called fulminant liver failure . Pregnant women , especially those in the third trimester , suffer an elevated mortality rate from the disease of around 20 % ., Liver cancer, also known as hepatic cancer and primary hepatic cancer, is cancer that starts in the liver. Cancer which has spread from elsewhere to the liver, known as liver metastasis, is more common than that which starts in the liver. Symptoms of liver cancer may include a lump or pain in the right side below the rib cage. Other symptoms includes swelling of the abdomen, yellowish skin, easy bruising, weight loss, and weakness.
The leading cause of liver cancer is cirrhosis due to either hepatitis B, hepatitis C, or alcohol. Other causes include aflatoxin, non-alcoholic fatty liver disease, and liver flukes. The most common types are hepatocellular carcinoma (HCC) which makes up 80% of cases and cholangiocarcinoma. Less common types include mucinous cystic neoplasm and intraductal papillary biliary neoplasm. The diagnosis may be supported by blood tests and medical imaging with confirmation by tissue biopsy.
Preventive efforts include immunization against hepatitis B and treating those infected with hepatitis B or C. Screening is recommended in those with chronic liver disease. Treatment options may include surgery, targeted therapy, and radiation therapy. In certain cases ablation therapy, embolization therapy, or liver transplantation may be used. Small lumps in the liver may be simply closely followed.
Primary liver cancer is globally the sixth most frequent cancer (6%) and the second leading cause of death from cancer (9%). In 2012 it occurred in 782,000 people and resulted in 746,000 deaths. In 2013, 300,000 deaths from liver cancer were due to hepatitis B, 343,000 to hepatitis C, and 92,000 to alcohol. Higher rates of liver cancer occur where hepatitis B and C are common, including Asia and sub-Saharan Africa. Males are more often affected with HCC than females. Diagnosis is most frequent among those 55 to 65 years old. Five-year survival rates are 18% in the United States. The word "hepatic" is from the Greek "hêpar", meaning "liver".
Classification.
The most frequent liver cancer, accounting for approximately 75% of all primary liver cancers, is hepatocellular carcinoma (HCC) (also named "hepatoma", which is a misnomer because adenomas are usually benign). HCC is a cancer formed by liver cells, known as hepatocytes, that become malignant. Another type of cancer formed by liver cells is hepatoblastoma, which is specifically formed by immature liver cells.<ref name="doi10.1016/j.mpsur.2008.12.005"></ref> It is a rare malignant tumor that primarily develops in children, and accounts for approximately 1% of all cancers in children and 79% of all primary liver cancers under the age of 15. Most hepatoblastomas form in the right lobe., Digestion is the breakdown of large insoluble food molecules into small water-soluble food molecules so that they can be absorbed into the watery blood plasma. In certain organisms, these smaller substances are absorbed through the small intestine into the blood stream. Digestion is a form of catabolism that is often divided into two processes based on how food is broken down: mechanical and chemical digestion. The term mechanical digestion refers to the physical breakdown of large pieces of food into smaller pieces which can subsequently be accessed by digestive enzymes. In chemical digestion, enzymes break down food into the small molecules the body can use., Autoimmune hepatitis, formerly called lupoid hepatitis, is a chronic, autoimmune disease of the liver that occurs when the body's immune system attacks liver cells causing the liver to be inflamed. Common initial symptoms include fatigue or muscle aches or signs of acute liver inflammation including fever, jaundice, and right upper quadrant abdominal pain. Individuals with autoimmune hepatitis often have no initial symptoms and the disease is detected by abnormal liver function tests., Asia is Earth's largest and most populous continent, located primarily in the eastern and northern hemispheres and sharing the continental landmass of Eurasia with the continent of Europe. Asia covers an area of , about 30% of Earth's total land area and 8.7% of the Earth's total surface area. The continent, which has long been home to the majority of the human population, was the site of many of the first civilizations. Asia is notable for not only its overall large size and population, but also dense and large settlements as well as vast barely populated regions within the continent of 4.4 billion people., A prion is an infectious agent composed entirely of protein material, called PrP (short for prion protein), that can fold in multiple, structurally distinct ways, at least one of which is transmissible to other prion proteins, leading to disease that is similar to viral infection. They are suspected to be the cause of transmissible spongiform encephalopathies (TSEs) among other diseases., Life is a characteristic distinguishing physical entities having biological processes, such as signaling and self-sustaining processes, from those that do not, either because such functions have ceased, or because they never had such functions and are classified as inanimate. Various forms of life exist, such as plants, animals, fungi, protists, archaea, and bacteria. The criteria can at times be ambiguous and may or may not define viruses, viroids, or potential artificial life as "living". Biology is the primary science concerned with the study of life, although many other sciences are involved., Orthohepevirus is a genus of viruses assigned to the "Hepeviridae" family. Orthohepevirus is a fairly isolated viral genus in which the virions are characterized by round, non-enveloped and isometric capsids with a diameter of 2734 nm. The type species is "Orthohepevirus A", more commonly known as the Hepatitis E virus., Weight loss, in the context of medicine, health, or physical fitness, refers to a reduction of the total body mass, due to a mean loss of fluid, body fat or adipose tissue and/or lean mass, namely bone mineral deposits, muscle, tendon, and other connective tissue. Weight loss can either occur unintentionally due to malnourishment or an underlying disease or arise from a conscious effort to improve an actual or perceived overweight or obese state. "Unexplained" weight loss that is not caused by reduction in calorific intake or exercise is called cachexia and may be a symptom of a serious medical condition. Intentional weight loss is commonly referred to as slimming., A disease is a particular abnormal condition, a disorder of a structure or function, that affects part or all of an organism. The study of disease is called pathology which includes the causal study of etiology. Disease is often construed as a medical condition associated with specific symptoms and signs. It may be caused by external factors such as pathogens, or it may be caused by internal dysfunctions particularly of the immune system such as an immunodeficiency, or a hypersensitivity including allergies and autoimmunity., A virus is a small infectious agent that replicates only inside the living cells of other organisms. Viruses can infect all types of life forms, from animals and plants to microorganisms, including bacteria and archaea., The liver is a vital organ of vertebrates and some other animals. In the human, it is located in the upper right quadrant of the abdomen, below the diaphragm. The liver has a wide range of functions, including detoxification of various metabolites, protein synthesis, and the production of biochemicals necessary for digestion., Subject: hepatitis e, Relation: has_cause, Options: (A) bacteria (B) cholera (C) cirrhosis (D) diabetes mellitus (E) diarrhea (F) drug (G) egg (H) food (I) hepatitis (J) hepatitis b virus (K) hepatitis c virus (L) human (M) infection (N) life (O) nausea (P) pathology (Q) poisoning (R) pregnancy (S) prion (T) rotavirus (U) virus (V) vomiting (W) weight loss
Student:
hepatitis b virus