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Facts About Hepatitis E

The Organization for International Migration said this week that around 4,800 people have presented with symptoms of Hepatitis E at refugee camps in South Sudan’s Upper Nile state. Doctors Without Borders says 88 people have died, including 15 pregnant women.

Pregnant women make up 17 percent of Hepatitis E fatalities in South Sudan.

Hepatitis E is a serious liver disease caused by a virus. The illness is most often transmitted by ingesting fecal matter in microscopic amounts, such as in unclean drinking water. Outbreaks usually occur in places where the water supply is contaminated and in countries with poor sanitation. Hepatitis E also occurs, albeit rarely, in developed countries, where the usual mode of transmission is through undercooked or uncooked products from infected animals, particularly deer and pigs.

Infection with the Hepatitis E Virus usually results in acute illness, characterized by rapid onset of disease, a relatively brief period of symptoms, and resolution within days.

But symptoms of Hepatitis E can take up to 60 days to develop after exposure. They include fever, fatigue, loss of appetite, nausea, vomiting, abdominal pain, jaundice, dark urine, discolored stool and joint pain.
Symptoms of Hepatitis E include fever, fatigue, loss of appetite, nausea, vomiting, abdominal pain, jaundice, dark urine and joint pain.
Centers for Disease Control and Prevention

In developing countries, Hepatitis E usually affects people in the 15-44 year age group, with pregnant women likely to experience severe illness and sometimes death. Children infected with hepatitis E usually have only mild or no symptoms.

The fatality rate for the illness is usually very low – around one percent of cases – and most people recover completely. Among pregnant women, however, mortality from Hepatitis E can reach 10-30 percent. In the South Sudan outbreak as of early February, pregnant women made up 17 percent of fatalities and the overall mortality rate was nearly two percent.

Immune globulin is not effective in preventing Hepatitis E, and there is no specific antiviral treatment for the disease. Treatment usually involves rest, sufficient fluid intake, a nutritious diet and no consumption of alcohol, and hospitalization should be considered for severe cases and for pregnant women.

Proper sanitation is key in preventing Hepatitis E, with boiling and chlorination of drinking water an effective way of killing the virus that causes the illness.

MSF has warned that Hepatitis E will claim more lives in the refugee camps in Maban county, which house around 110,000 displaced people. In 1991, some 79,100 people in Kanpur, India were affected by one of the largest Hepatitis E epidemics in the world, and between 2007 and 2009, some 10,200 people in northern Uganda were affected by an outbreak, which claimed 160 lives.