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An outbreak of hepatitis E in Northern Namibia, 1983
1Department of Clinical Microbiology and Infectious Diseases, South African Institute for Medical Research, Johannesburg.
The American Journal of Tropical Medicine and Hygiene
|April 6, 2001
Summary
An epidemic of non-A non-B hepatitis in Namibia was confirmed as Hepatitis E virus (HEV) infection 15 years later. This study highlights HEV risk in refugees and extends its known geographic range.
Area of Science:
- Virology
- Epidemiology
- Public Health
Background:
- An epidemic of jaundice occurred in Namibia in 1983, affecting hundreds, particularly Angolan refugees in areas with poor sanitation.
- The outbreak was initially classified as non-A non-B hepatitis, predominantly affecting males aged 15-39, with severe outcomes in pregnant women.
Purpose of the Study:
- To confirm the causative agent of the 1983 epidemic in Namibia using archived samples.
- To determine the seroprevalence of Hepatitis E virus (HEV) infection in the affected population.
- To characterize the clinical and epidemiological features of the outbreak.
Main Methods:
- Retrospective analysis of archived fecal samples using reverse transcription-polymerase chain reaction (RT-PCR) for HEV detection.
- Quantification of total Immunoglobulin (Ig) and IgM antibodies to HEV in serum samples collected at the end of the outbreak.
- Clinical and epidemiological data review from the original outbreak investigation.
Main Results:
- Hepatitis E virus (HEV) was detected in fecal samples from 9 out of 16 patients tested.
- Antibody testing revealed 42% of residents had IgM indicative of recent HEV infection and 25% had past HEV infection.
- The outbreak's clinical and epidemiological profile was consistent with known Hepatitis E cases.
Conclusions:
- The 1983 epidemic in Namibia was confirmed as Hepatitis E.
- This study provides the first virological confirmation of HEV in southern Africa, extending its known geographical distribution.
- The findings underscore the significant risk of HEV infection among refugee populations and in areas with inadequate water and sanitation infrastructure.