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    Apr 11, 2021
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    High mortality associated with an outbreak of hepatitis E among displaced persons in Darfur, Sudan

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    Authors
    Boccia, Delia
    Guthmann, Jean-Paul
    Klovstad, Hilde
    Hamid, Nuha
    Tatay, Mercedes
    Ciglenecki, Iza
    Nizou, Jacques-Yves
    Nicand, Elisabeth
    Guerin, Philippe Jean
    Affiliation
    European Programme for Intervention Epidemiology Training, Stockholm, Sweden; Health Protection Agency–Centre for Infection, London, United Kingdom; Epicentre, Paris, France; Medecins Sans Frontieres, Paris, France; National Reference Centre of Enterically Transmitted Hepatitis (Hepatitis E Virus), Teaching Military Hospital Val de Grace, Paris, France; Norwegian Institute of Public Health, Oslo, Norway; Norwegian Field Epidemiology Training Programme, Oslo, Norway; World Health Organization, Khartoum, Sudan
    Issue Date
    2006-05-12
    
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    Journal
    Clinical Infectious Diseases : an official publication of the Infectious Diseases Society of America
    Abstract
    BACKGROUND: Hepatitis E virus (HEV) causes acute onset of jaundice and a high case-fatality ratio in pregnant women. We provide a clinical description of hospitalized case patients and assess the specific impact on pregnant women during a large epidemic of HEV infection in a displaced population in Mornay camp (78,800 inhabitants), western Darfur, Sudan. METHODS: We reviewed hospital records. A sample of 20 clinical cases underwent laboratory confirmation. These patients were tested for immunoglobulin G (IgG) and immunoglobulin M (IgM) antibody to HEV (serum) and for amplification of the HEV genome (serum and stool). We performed a cross-sectional survey in the community to determine the attack rate and case-fatality ratio in pregnant women. RESULTS: Over 6 months, 253 HEV cases were recorded at the hospital, of which 61 (24.1%) were in pregnant women. A total of 72 cases (39.1% of those for whom clinical records were available) had a diagnosis of hepatic encephalopathy. Of the 45 who died (case-fatality ratio, 17.8%), 19 were pregnant women (specific case-fatality ratio, 31.1%). Acute hepatitis E was confirmed in 95% (19/20) of cases sampled; 18 case-patients were positive for IgG (optical density ratio > or =3), for IgM (optical density ratio >2 ), or for both, whereas 1 was negative for IgG and IgM but positive for HEV RNA in serum. The survey identified 220 jaundiced women among the 1133 pregnant women recorded over 3 months (attack rate, 19.4%). A total of 18 deaths were recorded among these jaundiced pregnant women (specific case-fatality ratio, 8.2%). CONCLUSIONS: This large epidemic of HEV infection illustrates the dramatic impact of this disease on pregnant women. Timely interventions and a vaccine are urgently needed to prevent mortality in this special group.
    URI
    http://hdl.handle.net/10144/116354
    DOI
    10.1086/504322
    PubMed ID
    16705571
    Additional Links
    http://www.journals.uchicago.edu/doi/abs/10.1086/504322?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%3dpubmed
    Type
    Article
    Language
    en
    ISSN
    1537-6591
    ae974a485f413a2113503eed53cd6c53
    10.1086/504322
    Scopus Count
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