A youngster presented with fever (100degF), nausea and vomiting. He also complained of vague abdominal discomfo. On general examination icterus was present and also hepatic tenderness. One of his family member also had the same symptoms and had diagnosed hepatitis E. Which of the following can be the route of transmission of hepatitis-E virus to this patient?

Hepatitis E virus (HEV) is a major cause of hepatitis transmitted by the fecal-oral route, second only to HAV. It is a common cause of waterborne epidemics of hepatitis in Asia, Africa, India, and Mexico but is uncommon in the United States. Must know: HEV is a nonenveloped, single-stranded RNA virus classified as a member of the hepevirus family. Clinically the disease resembles hepatitis A, with the exception of a high moality rate in pregnant women. Chronic liver disease does not occur, and there is no prolonged carrier state. Ref: (2012). Chapter 41. Hepatitis Viruses. In Levinson W (Eds), Review of Medical Microbiology & Immunology, 12e.