Outbreak of acute hepatitis E virus infection among military personnel in northern Ethiopia

Tsega, E; Krawczyński, K.; Hansson, Bengt; Nordenfelt, Erik; Negusse, Y.; Alemu, Wudma; Bahru, Y.

doi:10.1002/jmv.1890340407

Cited by 107 publications

(57 citation statements)

References 17 publications

(5 reference statements)

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“…2 Epidemics of HEV have been reported in African countries, including Sudan, Ethiopia, Somalia, Chad, the Democratic Republic of the Congo, and Uganda. [3][4][5][6] HEV infection in pregnancy can progress to fulminant hepatitis with a high mortality rate among pregnant women. [7][8][9] A recent study showed that pregnant Indian women with acute hepatitis E virus infection had a three times higher relative risk for fulminant hepatic failure and a six times higher risk for mortality.…”

Section: Introductionmentioning

confidence: 99%

An outbreak of hepatitis E and high maternal mortality at Port Sudan, Eastern Sudan

Rayis

Jumaa

Gasim

et al. 2013

Pathogens and Global Health

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During 4 months (November 2010-March 2011) of an outbreak of hepatitis E virus (HEV), 39 pregnant women presented at Port Sudan Hospital, Sudan, with various symptoms of viral hepatitis. The diagnosis of viral hepatitis was confirmed by serology using ELISA anti-HEV IgG and IgM. The mean (SD) maternal age and gestational age were 24.0 (4.2) years and 33.6 (3.7) weeks, respectively. Eight (20.5%) women were primigravidae. There were 11 (28.2%) maternal deaths, 14 (36.0%) intrauterine fetal deaths, and eight (20.5%) cases of postpartum haemorrhage. There were nine (23.0%) cases of preterm (,37 weeks of gestation) deliveries. Fulminant hepatitis with hepatic encephalopathy was the most common cause of death among these patients. Nine of these women died before delivery and the other two died immediately following the delivery due to severe haemorrhage. There were no significant differences in clinical and biochemical data between the women who died (11) and those who survived.

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Section: Introductionmentioning

confidence: 99%

An outbreak of hepatitis E and high maternal mortality at Port Sudan, Eastern Sudan

Rayis

Jumaa

Gasim

et al. 2013

Pathogens and Global Health

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“…In addition to civilian cases, hepatitis E outbreaks have been documented in military populations in Chad, 9 Djibouti, 10 Nepal, 11 Ethiopia, 12 and among Bangladeshi soldiers serving with the United Nations Forces in Haiti. 13 French and Italian soldiers, but apparently not American or Belgian Forces serving in Somalia, 14 have also been infected.…”

Section: Introductionmentioning

confidence: 99%

Epidemic of hepatitis E in a military unit in Abbotrabad, Pakistan.

Bryan¹,

Iqbal²,

Tsarev³

et al. 2002

The American Journal of Tropical Medicine and Hygiene

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Abstract. An outbreak of hepatitis caused by hepatitis E virus (HEV) in Abbottabad, Pakistan was traced to fecal contamination of a water system. Of 109 men hospitalized with hepatitis, 104 (95%) had serologic evidence of acute hepatitis E (IgM antibody to HEV [anti-HEV]), three (3%) probably had acute hepatitis E (high titers of IgG anti-HEV without IgM), and two had acute hepatitis A. Among a subset of 44 men with acute hepatitis E from whom three serum specimens were obtained over a four-month period, the anti-HEV IgG geometric mean titers (GMTs) decreased from 1,519 during the outbreak to 657 at four months. The IgM anti-HEV was detected in 40 (91%) of 44 sera obtained at admission (GMT ‫ס‬ 533 during acute disease), but in only six (14%) four months later. The prevalence of anti-HEV in this population before the outbreak was estimated to be 30%. The presence of IgG anti-HEV appeared to protect against clinical hepatitis or development of serologic evidence of new infection with HEV. This is the second major epidemic of hepatitis E in the Pakistani military confirmed by an anti-HEV enzyme-linked immunosorbent assay (ELISA). Evidence that pre-existing antibody as measured by this ELISA protects against disease is important for assessment of vaccine development.

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“…[1][2][3] Until now, nine outbreaks of HEV have been identified in African countries, including Algeria, Chad, Ethiopia, Gambia, Kenya, Nigeria, and Somalia. [4][5][6][7][8][9] The development of specific serologic tests has been necessary to demonstrate the existence of sporadic HEV infections. [9][10][11][12][13][14] In China, sporadic cases have been estimated to represent 10% of all acute hepatitis cases.…”

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confidence: 99%

Role of hepatitis E virus in sporadic cases of acute and fulminant hepatitis in an endemic area (Chad).

Coursaget¹,

Buisson²,

N'gawara³

et al. 1998

The American Journal of Tropical Medicine and Hygiene

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Abstract. Forty-one patients with acute or fulminant hepatitis and 86 control patients were entered into a study of sporadic, acute, and fulminant hepatitis in the N'Djamena area of Chad in 1993. Acute hepatitis B was diagnosed in nine (22%) patients and acute hepatitis E in 27 (66%) patients. No acute hepatitis A was observed and 10% of the patients had serologic markers of hepatitis C virus (HCV) infection. Dual acute hepatitis B and E were observed in four patients (10%) and acute HEV infection was associated with chronic hepatitis B surface antigen carriage in 16 (39%). Epidemiologic findings concerning HBV from Chad suggest that these patients had undiagnosed chronic liver disease due to HBV, with acute deterioration caused by superimposed HEV replication. Moreover, it is obvious that in developing countries only the most severe cases of hepatitis are seen in hospital settings and a large proportion of them are related to superinfection with HBV and HEV. Antibody to HEV was observed in 22% of the control patients. This observation and the fact that epidemic and sporadic cases of HEV are observed in Chad indicates that HEV is highly endemic in this country.Hepatitis E virus (HEV) infection is generally easily recognized when the virus provokes epidemic outbreaks that are identified or suspected, predominantly in tropical and subtropical areas. The contamination of water supplies with HEV-positive feces appears to be responsible for these epidemics, whereas person-to-person transmission of the virus or food-borne spread have been rarely observed.

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Outbreak of acute hepatitis E virus infection among military personnel in northern Ethiopia

Cited by 107 publications

References 17 publications

An outbreak of hepatitis E and high maternal mortality at Port Sudan, Eastern Sudan

An outbreak of hepatitis E and high maternal mortality at Port Sudan, Eastern Sudan

Epidemic of hepatitis E in a military unit in Abbotrabad, Pakistan.

Role of hepatitis E virus in sporadic cases of acute and fulminant hepatitis in an endemic area (Chad).

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