Outbreak of Hepatitis E Virus Infection in Displaced Persons Camps in Diffa Region, Niger, 2017

Abstract

Hepatitis E virus (HEV) infection in developing countries is associated with poor hygiene, lack of clean drinking water, and inadequate sanitation. In this study, we report the first case investigation and describe the present situation of HEV outbreak within displaced persons camps in the Diffa region, Republic of Niger. The investigation showed the outbreak to be closely linked to unclean water supply, low hygiene, and sanitation facility standards. Between January and September 2017, a total of 1,917 HEV suspect cases were recorded from which 736 (38.4%) have been confirmed positive for HEV by reverse transcription polymerase chain reaction and enzyme linked immunosorbent assay. Overall, 38 (1.9%) deaths were recorded, including 17 (44.7%) pregnant women. The ongoing outbreak highlights poor drinking water quality and sanitation conditions in displaced persons camps in the Diffa region. Disease containment and patient care activities, particularly for pregnant women, may have resulted in decreased transmission of infection and deaths.

Hepatitis E Virus Infections among Patients with Acute Febrile Jaundice in Burkina Faso

“…It has caused a chronic infection in an immunocompromised patient who regularly ate camel products [4]. Hepatitis E virus infections are a significant public health problem in Africa where they can cause large outbreaks of acute hepatitis in displaced-person camps [5,6,7,8,9,10,11,12,13,14,15]. While the disease is usually self-limiting, HEV genotype 1 can kill up to 20% of infected pregnant women [13,16].…”

Setting a course for preventing hepatitis E in low and lower-middle-income countries: A systematic review of burden and risk factors

“…The copyright holder for this this version posted November 30, 2020. ; https://doi.org/10.1101/2020.11.27.20239715 doi: medRxiv preprint HEV seropositivity, in general, increased with age among all population groups except occupational groups exposed to animals ( Figure 3). (50,78,111,119,123,123), with 31% of all suspected cases (24,341/77,372 suspected cases) identified in our review occurring in these settings.…”

“…At least one large-scale outbreak with over 5,000 suspected cases occurred in every decade since 1988, and outbreaks in the last 15 years (2004-2017) had a median of 1152 suspected cases reported (IQR: 252-2362). Among all outbreaks, 12% occurred in refugee camp/informal settlements (N=6) (50,78,111,119,123,123), with 31% of all suspected cases (24,341/77,372 suspected cases) identified in our review occurring in these settings.…”

Hepatitis E Virus Infection: Circulation, Molecular Epidemiology, and Impact on Global Health

“…Important factors contributing to water-related outbreaks of HEV are population density, socio-economic conditions, the level of sanitation, and access to drinking water [ 14 , 138 ]. There are also frequent outbreaks in refugee camps, military camps, and emergency shelters in conflict- and catastrophe-affected regions [ 127 , 139 , 140 , 141 , 142 ]. In summary, HEV outbreaks can be prevented by improving sanitary conditions and ensuring access to clean drinking water.…”

“…Studies have shown that HEV-1 and HEV-2 infections occur most frequently in men during their adolescence (15–30 years), and most patients experience acute self-limiting hepatitis [ 94 , 100 ]. In addition, HEV outbreaks were recognized among people living in refugee camps and in emergency shelters after natural disasters [ 127 , 139 , 140 , 141 , 142 ]. Few studies have reported human-to-human transmission; however, this needs to be elucidated [ 156 ].…”