Outbreak of Hepatitis E in Ouaddai Province, Chad.

An outbreak of Hepatitis E has resulted in seven deaths and over 2000 people becoming sick in Ouaddai Province, Chad, according to a press release issued by the World Health Organization on 8 May 2024. The outbreak was first detected on 2 January 2024 when to cases of Acute Jaundice Syndrome were reported by medics from Médecins Sans Frontières who were operating a clinic at a temporary high school at a refugee camp in the Adré Health District of Ouaddai Province.

Between 2 January and 15 February 2024 the number of reported cases of Acute Jaundice Syndrome in Adré Health District rose to 113, of which 28 were confirmed as being Hepatitis E using rapid diagnostic test kits. On 19 February a case was reported at the Allasha Refugee Camp in the Hadjer-Hadid Health District, also Ouaddai Province.

Between 1 and 19 March 2024 forty blood samples taken from Acute Jaundice Syndrome sufferers in Ouaddai Province were sent to the Institute Pasteur of Dakar, Sénégal, where they were tested for Hepatitis E, Yellow Fever, Dengue, West Nile Fever, Zika, Chikungunya, Rift Valley Fever and Crimean-Congo Haemorrhagic Fever. Of these, 36 tested positive for Hepatitis E.

A refugee camp in eastern Chad in January 2024. Médecins Sans Frontières.

Between 2 January and 28 April 2024 a total of 2092 suspected cases of Hepatitis E were reported in Ouaddai Province, with seven fatalities. One hundred and three of these cases were members of the local conflict, while the remaining 1989 were refugees from the conflict in neighbouring Sudan, with the Lycée d'Adré, Aboutengué, and Metché refugee camps being particularly badly hit. 

Hepatitis E is caused by a single-stranded, nonenveloped, RNA Virus, and is usually a self-limiting infection, causing fever, nausea, loss of appetite, vomiting, jaundice, abdominal and joint pain and discolouration of the urine and stool, which typically passes within 2-6 weeks. However, in some cases the disease can cause acute liver failure (hepatitis) which is often fatal. Pregnant women are considered to be at particular risk from this disease, with a fatality rate of about 30%, compared to about 1% for the general population.

The Hepatitis E Virus. Centers for Disease Control and Prevention/Wikipedia.

Hepatitis E is spread through faeces and contaminated water, and thrives in unsanitary and crowded conditions. This makes it a particular problem in settings like refugee camps, where large numbers of people fleeing conflict situations arrive over short periods of time, overwhelming local sanitation systems. 

A queue of water containers at the Metché Refugee Camp in Ouaddai Province, Chad, where Médecins Sans Frontières is providing clean water. Médecins Sans Frontières.

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Burkino Faso hit by outbreak of Hepatitis E.

The West African nation of Burkino Faso has been hit by an outbreak of febrile jaundice (fever combined with yellowing of the skin), with 442 cases and sixteen deaths reported between 8 September and 25 November 2020, the majority of the cases (387) in the Barsalogho Health District. Polymerase chain reaction tests carried out on samples taken from 10 of the patients have produced positive results for Hepatitis E, with none testing positive for any other causative agent for such fevers, such as Malaria, Leptospirosis or other forms of Hepatitis, nor have they tested positive for Covid 19, a disease which is currently running epidemic in Burkino Faso, with 2757 cases and 68 deaths reported so far this year. The majority of patients reporting symptoms (68%) are under 30, with an average age of 25, and 54% of the patients are female. Fifteen of the sixteen fatalities were women who were either pregnant or had recently given birth, which is typical of Hepatitis E, which is considered to be particularly dangerous to pregnant women.

 

Reported cases of febrile jaundice in the North-central Region of Burkino Faso in 2020 to 24 November. World Health Organisation.

Hepatitis E is caused by a single-stranded, nonenveloped, RNA Virus, and is usually a self-limiting infection, causing fever, nausea, loss of appetite, vomiting, jaundice, abdominal and joint pain and discolouration of the urine and stool, which typically passes within 2-6 weeks. However, in some cases the disease can cause acute liver failure (hepatitis) which is often fatal. Pregnant women are considered to be at particular risk from this disease, with a fatality rate of about 30%, compared to about 1% for the general population.

 

The Hepatitis E Virus. Centers for Disease Control and Prevention/Wikipedia.

Hepatitis E is spread through faeces and contaminated water, and thrives in unsanitary and crowded conditions. This was become a problem in Burkina Faso since September 2017, when an armed conflict broke out in the country, which has displaced many people internally, with people moving away from their traditional farmlands into lager towns where they receive some protection from the nation's security services, but resulting in many people living in overcrowded conditions with poor sanitation.

An internally displaced Burkinabe woman sits among belongings in Kaya, Burkina Faso, February 2020. Sylvain Cherkaoui/UNHCR.

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