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HEPATITIS E VIRUS - UGANDA
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A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>
Date: Mon 3 Mar 2008
Source: ReliefWeb, The International Federation of Red Cross And Red
Crescent Societies [edited]
<http://www.reliefweb.int/rw/RWB.NSF/db900SID/ASAZ-7CDJED?OpenDocument>
Hepatitis E Virus Epidemic in Uganda
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The Ugandan Ministry of Health (MoH) and the World Health
Organization (WHO) in Uganda have confirmed an outbreak of Hepatitis
E in Madi Opei Sub-county in Lamwo County, Kitgum District of
Northern Uganda neighbouring the South of Sudan. A total of 314 cases
with 11 deaths have been registered since the epidemic began to
spread in November 2007 and the outbreak in Madi Opei has shown
minimal reduction in its trend of progression. About 75 percent of
the cases are between the age group of 15 and 44 years. Meanwhile,
about 60 percent (186/314) of the cases are females. The risk factors
responsible for this continued transmission of HEV have been
discovered to be extremely low latrine coverage, contamination of
water at household levels and poor hygiene practices in the affected
IDP camps.
According to findings of a situational analysis carried out in 25
villages located in Madi Opei, an average of 112 people share one
latrine facility within the IDP camp. This is almost 6 times above
the standard requirement of 20 people per latrine facility.
Furthermore, most villages are lacking latrines and thus the
communities have formed the habits of open defecation. Most of the
available latrines are not being maintained, making their use
difficult. This also encourages open air defecation.
Hygiene practices at household levels such as routine washing hands
with soap after visiting the toilet or before meals are hardly
practiced. Despite the fact that soaps were distributed to the
community, there are no indications to show that soap was being used
for hand washing at all. Water samples (from pots and buckets)
collected from households showed heavy presence of coli
micro-organisms giving the indication that contamination of water is
taking place at household levels, attributed to the use of pots and
poor personal hygiene practices.
Madi Opei IDP camp has a total of 19 functional boreholes that supply
optimal amount of water to the community. Bucket chlorination is
being conducted at all water sources in Madi Opei and the
surrounding. It was established that there were occasional
interruption in the supply of chlorine tablets, resulting into
erratic discontinuation in chlorination of water at source. This was
largely attributed to weak supervisory/oversight role provided to the
chlorination activity.
--
Communicated by:
ProMED-mail Rapporteur Brent Barrett
[Hepatitis E is a liver disease caused by hepatitis E virus (HEV)
which is transmitted in much the same way as other enteric viruses.
Hepatitis E outbreaks have occurred world-wide in recent years (see
references below). The signs and symptoms of HEV infection are loss
of appetite, nausea, vomiting, discoloured urine, jaundice and
abdominal pain. However, there is no chronic (long-term) infection.
Hepatitis E is more severe among pregnant women, especially in the
3rd trimester. HEV is found in the feces of persons and animals with
hepatitis E. HEV is spread by eating or drinking contaminated food or
water. Transmission from person to person may occur.
It seems likely in view of the deficiencies in basic sanitation
pertaining in rural Uganda that other enteric agents in addition to
HEV are contributing to the epidemic situation described above.
The map of Uganda accompanying this report is available at
<http://www.un.org/Depts/Cartographic/map/profile/uganda.pdf>. - Mod.CP]
[See also:
2007
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Hepatitis E virus - Europe (02) 20070920.3120
Hepatitis E virus - Europe 20070918.3093
Hepatitis E - India (Kashmir) 20070806.2556
Hepatitis E - Afghanistan (Laghman) 20070226.0695
Hepatitis E - Nepal (03): background 20070220.0637
Hepatitis E, porcine carriers - UK (England) 20070218.0615
Hepatitis E - Nepal (02): background 20070216.0576
Hepatitis E, porcine carriers - Spain 20070215.0561
Hepatitis E - Nepal 20070214.0554
2006
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Hepatitis E - Congo DR (Equateur) 20061018.2994
2005
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Hepatitis E - Chad (Eastern) 20050822.2477
Hepatitis - India (Maharashtra): hepatitis E conf. 20050329.0908
Hepatitis E - India (Mumbai) 20050107.0044
2004
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Hepatitis E virus, fatal - Japan (Hokkaido) 20041128.3183
Hepatitis E virus, wildlife to humans - Japan (02) 20041127.3172
Hepatitis E - Sudan (Darfur)(06) 20040929.2689
Hepatitis E - Chad (Goz Amer)(05) 20040927.2667
Hepatitis E, waterborne - Iraq (02) 20040924.2642
Hepatitis E - Chad (Goz Amer)(04) 20040915.2570]
...........................ccp/ejp/lm
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