A large outbreak of hepatitis E among a displaced population in Darfur, Sudan, 2004: the role of water treatment methods
| Autor: | Elisabeth Nicand, Francisco Diaz, Loretxu Pinoges, Mercedes Tatay, Philippe J Guerin, Alain Moren, Rebecca F. Grais, Delia Boccia, Iza Ciglenecki, Jacques-Yves Nizou, Hilde Kløvstad, Nuha Hamid, Jean-Paul Guthmann |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2006 |
| Předmět: |
Adult
Male Microbiology (medical) Aging medicine.medical_specialty Adolescent Population Attack rate medicine.disease_cause Asymptomatic Disease Outbreaks Water Purification Sudan Hepatitis E virus Risk Factors Internal medicine Case fatality rate Odds Ratio medicine Humans Child education education.field_of_study business.industry Infant Newborn Infant Outbreak Odds ratio Middle Aged Hepatitis E medicine.disease Virology Infectious Diseases Child Preschool RNA Viral Female medicine.symptom business |
| Zdroj: | Clinical infectious diseases : an official publication of the Infectious Diseases Society of America. 42(12) |
| ISSN: | 1537-6591 1058-4838 |
| Popis: | BACKGROUND: The conflict in Darfur, Sudan, was responsible for the displacement of 1.8 million civilians. We investigated a large outbreak of hepatitis E virus (HEV) infection in Mornay camp (78,800 inhabitants) in western Darfur. METHODS: To describe the outbreak, we used clinical and demographic information from cases recorded at the camp between 26 July and 31 December 2004. We conducted a case-cohort study and a retrospective cohort study to identify risk factors for clinical and asymptomatic hepatitis E, respectively. We collected stool and serum samples from animals and performed a bacteriological analysis of water samples. Human samples were tested for immunoglobulin G and immunoglobulin M antibody to HEV (for serum samples) and for amplification of the HEV genome (for serum and stool samples). RESULTS: In 6 months, 2621 hepatitis E cases were recorded (attack rate, 3.3%), with a case-fatality rate of 1.7% (45 deaths, 19 of which involved were pregnant women). Risk factors for clinical HEV infection included age of 15-45 years (odds ratio, 2.13; 95% confidence interval, 1.02-4.46) and drinking chlorinated surface water (odds ratio, 2.49; 95% confidence interval, 1.22-5.08). Both factors were also suggestive of increased risk for asymptomatic HEV infection, although this was not found to be statistically significant. HEV RNA was positively identified in serum samples obtained from 2 donkeys. No bacteria were identified from any sample of chlorinated water tested. CONCLUSIONS: Current recommendations to ensure a safe water supply may have been insufficient to inactivate HEV and control this epidemic. This research highlights the need to evaluate current water treatment methods and to identify alternative solutions adapted to complex emergencies. |
| Databáze: | OpenAIRE |
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