## **Core Concept**
Hepatitis E virus (HEV) is a type of liver infection caused by a virus that is primarily spread through the fecal-oral route, often due to contaminated water or food. It is known for causing acute hepatitis and is particularly severe in pregnant women. HEV is distinct from other hepatitis viruses in its transmission and clinical manifestations.

## **Why the Correct Answer is Right**
The correct answer involves understanding the characteristics of HEV. Hepatitis E virus is primarily transmitted through the **feco-oral route**, which involves contaminated food, water, or direct contact with an infected person. This mode of transmission is a key feature distinguishing HEV from other hepatitis viruses, which are often transmitted through blood or bodily fluids.

## **Why Each Wrong Option is Incorrect**
- **Option A: Seen in Post transfusion cases** - This is incorrect because HEV is not typically associated with post-transfusion cases. Post-transfusion hepatitis is more commonly linked to hepatitis B and C viruses, which are transmitted through blood products.
- **Option C: Associated with hepatitis B virus** - This is incorrect because HEV and hepatitis B virus (HBV) have different modes of transmission and are distinct viruses. While both can cause liver infections, they are not directly associated in terms of causation or transmission.
- **Option a and c are clearly wrong; let's focus on b and d.**

## **Why the Correct Answer is D and B are correct statements**
- **Option b: Associated with increased mortality in pregnant females** - This statement is true. HEV infection is known to cause more severe disease in pregnant women, particularly in the third trimester, leading to increased mortality rates compared to the general population.
- **Option d: Acquired by feco oral route** - This statement is also true and is a primary mode of HEV transmission.

## **Clinical Pearl / High-Yield Fact**
A key clinical pearl is that **hepatitis E virus infection can lead to fulminant hepatic failure in pregnant women**, with mortality rates significantly higher than in the general population. This highlights the importance of considering HEV in the differential diagnosis of acute hepatitis, especially in pregnant women traveling to or from endemic areas.

## **Correct Answer:** B, D.