Figure 1

Time series of the events by date of occurrence in the three case reports of fatal hepatitis E viral infection in pregnant women in Ghana: (a) case 1 was a 31-year-old woman with a week’s history of dark urine and yellowish discoloration of the eyes. She was subsequently diagnosed of Hepatitis E viral infection, spontaneously aborted at 24 weeks of gestation and later died; (b) case 2, also a 31-year-old who was admitted with a four-day history of jaundice. She had low grade fever, but no history of abdominal pain, haematuria, pale stool or pruritus. Later diagnosed of Hepatitis E viral infection, did not miscarry but died at 28 weeks of gestation; (c) case 3, a 17-year-old woman who was referred to the tertiary health facility on account of jaundice and anaemia. She had delivered a live male infant at maturity of 32 weeks but noticed she was jaundiced and had a presentation of active disease 3 days prior to delivery. The baby was icteric at birth and hepatitis E virus infection was confirmed in both mother and baby. However, the jaundice and the hepatomegaly resolved in mother and baby after 5 and 12 days respectively.