Hepatitis E Virus epidemic hits South Sudan refugees: how it spreads

Hepatitis E Virus epidemic hits South Sudan refugees: how it spreads?

Since September 2012, an outbreak of Hepatitis E Virus has been affecting Sudanese refugees in Maban County (South Sudan). As of October 2013, more than 11,000 cases of Hepatitis E have been recorded in Maban's refugee camps with 241 people having died as a result of the infection (UNHCR).

While WADHE project has a main objective of developing protocols for Hepatitis E Virus (HEV) disinfection in outbreak settings, a complementary field study has been programmed to evaluate potential routes of HEV transmission in a real outbreak scenario. The WADHE team, with the support of Médecins Sans Frontières (MSF), visited the camps of Batil and Jamam in April 2013 in order to understand how the virus spreads through water to the population, by analysing environmental samples.

Although the outbreak, by the time of our visit, was reduced significantly in number of cases, important data could be obtained regarding potential transmission pathways of human viruses within the camps. The samples were taken at ground water, surface water and household level in both camps, in a punctual campaign. Ten to twenty litres of water were filtered and concentrated to be transported into the reference laboratory for analysis (University of Barcelona). Results showed a high prevalence of human viruses in water at household level, confirming that risk of transmission is high at domestic level by recontamination, as water at the sources was not polluted. Those findings are consistent with the epidemiological study carried out by Epicentre in the same outbreak scenario, showing lack of obvious point sources of infection and higher risk by close contact with infected individuals. Overall, findings suggest that, in outbreaks scenarios transmission may be multifactorial and include household level.

With this precious information we are going back to the laboratory to keep working on our experiments and see if we can find out which water treatment would be more efficient to clean water in a Hepatitis E outbreak scenario.

We will keep you informed!

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