Hepatitis E Outbreak in Africa Receives USA Support

The ambassador of the United States of America to Namibia, Lisa Johnson, has promised the USA will continue to assist Namibia in its fight against the outbreak of hepatitis E.

More than 1,569 people are suspected of having contracted hepatitis, while 15 people have died from the disease, of whom 6 were pregnant women.

This hepatitis E outbreak in Windhoek was declared an emergency by the World Health Organization (WHO) in December 2017 

Although hepatitis A and B are common in Namibia, hepatitis E virus (HEV) is rarely diagnosed in the country. As a result, the country has limited capacity for hepatitis E laboratory diagnostics.

The WHO estimates that hepatitis E caused approximately 20 million infections worldwide in 2015, with 44,000 deaths, which is a 3.3 percent mortality rate.

According to reporting by ReliefWeb Ambassador Johnson made this promise on July 6, 2018, after visiting Havana and Goreangab informal settlements in the Samora Machel Constituency, Windhoek, which is on the southwest section of Africa.  

The majority of hepatitis E cases during the current outbreak have been reported in informal settlements where water and sanitation are compromised.

Hepatitis E is a liver infection spread either by direct contact with an infected person’s feces or by indirect fecal contamination of food or water. Infection is more severe among pregnant women as they are at greater risk of acute liver failure, fetal loss, and death.

HEV belongs to the Hepeviridae, a diverse family of viruses infecting mammals, birds, and fish.

Strains of HEV infecting humans belong to the Orthohepevirus genus which is divided into four species (A–D). Human cases of hepatitis E are caused by strains within species A, which comprises eight genotypes.

“We are seeing that there are still new cases in the areas of Windhoek every week and that’s actually not to be unexpected, it does take months to get the hepatitis E outbreak under control,” said Ambassador Johnson. 

She said the US embassy is currently in discussions with the health ministry on whether it will be useful for her country to send another team from US Centers for Disease Control and Prevention (CDC) to take a look at the epidemic and provide technical assistance and advice on the response.

The CDC has not issued a Travel Alert for visiting Namibia but does suggest several vaccinations prior to arrival. 

But, there is not a CDC approved hepatitis E vaccine available today.

The only hepatitis E vaccine is available in China. Xiamen Innovax Biotech CO., LTD. launched the world’s first Hepatitis E Vaccine--Hecolin® in China in October 2012.

The Hepatitis E vaccine HEV 239 vaccine, Hecolin is considered a promising vaccine which has shown a high degree of efficacy in 16 to 65-year-old healthy subjects in China.

However, data on the incidence of hepatitis E virus infection and disease worldwide, and the contribution of hepatitis E to mortality in the general population where the infection is common is very limited, says the WHO.

“We will continue to assist, and I think in mid-July the National Health Emergency National Committee is going to have some sort of six months response review to see how we are doing altogether and what needs to be done next,” she said.

She said she thought it was very useful to see first-hand what some of the challenges the residents face and how the responses are working.

Ambassador Johnson was accompanied by the Khomas Governor Laura McLeod-Katjirua, Samora Machel Constituency Councillor Fanuel Shivute and health officials of both the City of Windhoek and the Ministry of Health.