A large outbreak of Hepatitis E virus genotype 1 infection in an urban setting in Chad likely linked to household level transmission factors, 2016-2017 (original) (raw)
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BMC infectious diseases, 2018
From September 2016-April 2017, Am Timan, Chad, experienced a large HEV outbreak in an urban setting with a limited impact in terms of morbidity and mortality. To better understand HEV epidemiology in this context, we estimated the seroprevalence of anti-HEV antibodies (IgM and IgG) and assessed the risk factors for recent HEV infections (positive anti-HEV IgM) during this outbreak. A serological survey using simple random sampling was implemented in Am Timan at the tail-end of the outbreak (sample size aim = 384 household). Household members provided us with blood samples and household heads answered questions around water, sanitation and hygiene practices and animal ownership. Blood samples were tested for HEV IgG and IgM antibodies using Enzyme-Immune-Assay (EIA). We calculated weighted prevalence estimates and prevalence ratios (PRs) for possible risk factors for recent infection using multivariate Cox regression. We included 241 households (1529 participants). IgM prevalence de...
BMC Infectious Diseases
Background: Hepatitis E is self-limiting, but can cause death in most at risk groups like pregnant women and those with preexisting acute liver disease. In developing countries it presents as epidemic, in 2014 Hepatitis E Virus (HEV) outbreak was reported in Napak district Uganda. The role of factors in this setting that might have propagated this HEV epidemic, including host, agent, and environmental characteristics, were still not clear. This study was therefore conducted to investigate the risk factors, person, place and time characteristics, associated with the hepatitis E virus (HEV) epidemic in Napak district. Methods: Review of line lists data for epidemiological description and matched case control study on neighborhood and age in the ratio of 1:2 were used to assess risk factors for HEV outbreak in Napak. Cluster and random sampling were used to obtain a sample size of 332, (111 cases, 221 controls). Possible interaction and confounding was assessed using conditional logistic regression. Results: Over 1359 cases and 30 deaths were reported during 2013/2014 HEV outbreak. The mean age of patients was 29 ± years, 57.9% of cases were females. Overall case Fatality Ratio was 2.2% in general population but 65.2% in pregnant women. More than 94% of the cases were reported in the sub counties of Napak, 5.7% of cases were reported in the outside neighboring districts. The epidemic peaked in January 2014 and gradually subsided by December 2014. Risk factors found to be associated with HEV included drinking untreated water (OR 6.69, 95% CI 3.15-14.16), eating roadside food (OR 6.11, 95% CI 2.85-13.09), reported not cleaning utensils (OR 3.24, 95% CI 1.55-1.76), and being a hunter (OR 1.14, 95% CI 1.03-12.66). Conclusion: The results of this study suggest that the virus is transmitted by the feco-oral route through contaminated water. They also suggest that active surveillance and appropriate measures targeting community and routine individual health actions are important to prevent transmission and decrease the deaths.
Journal of Medical Virology, 2018
Objectives: Hepatitis E virus (HEV) is hyperendemic in many countries, but data on this virus are not available in Jordan. This study determined the seroprevalence, risk factors and zoonotic potential of HEV in a Jordanian population. Methods: A total of 450 sera samples from 8 different governorates were tested for HEV-IgG. A pre-tested and validated questionnaire was used to collect risk factor data including animal interaction and environmental exposures. Results: The overall seroprevalence was 30.9%. Eating undercooked meat was significantly associated with HEV seropositivity (OR = 2.06, 95%CI 1.04-4.06) after controlling for age, gender, travel history and source of water. Age was also associated with HEV seropositivity; the youngest (14 years of age) and oldest age groups (60 and 80 years of age) had the highest prevalence (45.5% and 53.2%, respectively), compared to those between 20 to 29 years of age and 30 to 39 years of age (20.2 and 15.2%, respectively), although the small sample size among the youngest group tempers this association. There was evidence of a marginal association between owning camels and an increased odds of HEV seropositivity. Place of residence and source of drinking water were not associated with infection. Conclusion: This is the first study to report HEV seroprevalence in Jordan and shows that HEV exposure is high in Jordan. Surveillance for acute and chronic Hepatitis E is needed to estimate the frequency of the actual disease.
Epidemiology and Associated Risk Factors of Hepatitis E Virus Infection in Plateau State, Nigeria
Virology: Research and Treatment, 2014
A cross-sectional study in Nigeria was undertaken to determine the epidemiology, seroprevalence, and associated risk factors, of hepatitis E virus (HEV). A total of 462 subjects were used for the study, categorized into four groups: apparently healthy persons, pregnant women, HIV positive subjects, and animal handlers. Information was obtained from subjects using interviewer-administered questionnaire. Blood samples were collected and analyzed for HEV antibodies (IgG and IgM) using enzyme-linked immunosorbent assay (ELISA) technique. Results obtained were analyzed using Statistical Package for Social Sciences (SPSS) version 17.0 statistical software. The overall seroprevalence of IgG and IgM was 42.7 and 0.9%, respectively. Animal handlers had the highest seroprevalence (66.7%). The associated risk factors for IgM seroprevalence were rural dwelling (P = 0.039, odds ratio (OR) 3.3, 95% confidence interval (CI) 0.7-15.4), blood transfusion (P 0.001, OR 9.6, 95% CI 2.6-35.6), attending to animals (P = 0.032, OR 4.9, 95% CI 0.9-26.6), and waste disposal (P 0.001). Factors associated with IgG were age (P = 0.044), location (P 0.001), marital status (P 0.001), formal education (P 0.001), farming as occupation (P 0.001), rural dwelling (P = 0.001), waste disposal (P 0.001), alcohol consumption (P = 0.001, OR 2.4, 95% CI 1.4-4.0), open defecation (P 0.001, OR 2.9, 95% CI 1.4-5.7), attending to animals (P 0.001, OR 2.3, 95% CI 1.6-3.4), consuming unwashed fruits/vegetables (P 0.001, OR 4.2, 95% CI 0.3-54.1), and stream/river as a source of drinking water (P 0.001, OR 3.6, 95% CI 1.6-7.8). Preventive public health measures should be reinforced among all communities, particularly domestic animal handlers and pregnant women. Potable water should be provided for all communities. Data suggest that HEV remains an under-recognized and significant public health problem, warranting further attention and research.
Virology Journal, 2008
Hepatitis E virus (HEV) is highly endemic in several African countries with high mortality rate among pregnant women. Nothing is known about the circulation of this virus in central Africa. We evaluated therefore the prevalence of anti-HEV IgG in samples collected from pregnant women living in the five main cities of Gabon, central Africa. We found that 14.1% (119/840) of pregnant women had anti-HEV IgG. The prevalence differed between regions and between age groups. In 391 newly collected samples from the region where the highest prevalence was found, a significant difference (p < 0.05) in seroprevalence was found between rural (6.4%) and urban (13.5%) areas. These data provide evidence of a high prevalence of HEV in Gabon, providing indirect evidence of past contact with this virus.
Acute Hepatitis E Virus infection in two geographical regions of Nigeria
2017
Hepatitis E virus (HEV) remains a major public health concern in resource limited regions of the world. Yet data reporting is suboptimal and surveillance system inadequate. In Nigeria, there is dearth of information on prevalence of acute HEV infection. This study was therefore designed to describe acute HEV infection among antenatal clinic attendees and asymptomatic community dwellers from two geographical regions in Nigeria.In this study 750 plasma samples were tested for HEV IgM by Enzyme Linked lmmunosorbent Assay (ELISA) technique. The tested samples were randomly selected from a pool of 1,115 samples previously collected from selected populations (pregnant women – 272, Oyo community dwellers – 438, Anambra community dwellers – 405) for viral hepatitis studies between September 2012 and August 2013.One (0.4%) pregnant woman in her 3rd trimester had detectable HEV IgM, while community dwellers from the two study locations had zero prevalence rates of HEV IgM.Detection of HEV IgM...
Seroprevalence of hepatitis E virus infection in rural and urban populations, Tunisia
Clinical Microbiology and Infection, 2012
hepatitis. This study investigated the prevalence and risk factors of HEV infection in the Tunisian adult general population, either in blood donors (n = 687) or in patients hospitalized for acute hepatitis (n = 202). The mode of transmission differed between these two populations: contact with animals and living in a rural habitat were the main risk factors for being in contact with HEV in asymptomatic blood donors, while HEV was contracted through contaminated water in symptomatic cases. HEV seroprevalence in adult blood donors in Tunisia was relatively low (5.4%) and increased with age.