Hepatitis E claims three more lives

30 July 2019 | Health

Nearly 290 new hepatitis E virus infections were diagnosed between June and July, while the virus also claimed three more lives in that time, bringing the total death toll to 48 since the outbreak erupted close to two years ago.

Since the start of 2019, the total number of hepatitis E infections has risen by nearly 1 500 new cases, up from 4 227 by 6 January to 5 711 cases by 14 July.

Since January the death toll has climbed from 40 fatalities on 6 January to 48, including 21 deaths of new mothers or pregnant women by 14 July this year.

The latest three deaths, and 288 infections, were recorded in a span of less than a month, between 16 June and 14 July.

During this period fatalities increased by three from 45 to 48, while the cumulative number of infections rose from 5 423 to 5 711.

The majority of cases continue to emerge in the Khomas and Erongo regions. A total of 3 678 (64%) of the confirmed cases have been reported in Khomas, followed by Erongo where 1 322 (23%) of the cases have been reported.

The remaining regions account for 711 of the reported cases to date.

The latest situation report on the hepatitis outbreak issued by the health ministry on Monday, further confirms an outbreak of hepatitis A, a similar strain to hepatitis E, is also increasing.

“The Omusati Region continues to report an increased number of hepatitis A cases, presumed to be with a total of 51 cases to date, however all other regions except Kavango and Kunene have reported few (46) sporadic cases since 2018 to date.”

The increased number of hepatitis A cases are likely a result of closer monitoring and testing, as a result of the hepatitis E outbreak.

Namibian Sun was recently informed the only way to know which strain of hepatitis a person has is through a blood test.





When a person is given a blood test for hepatitis in Namibia, the testing will detect a range of viruses that can cause hepatitis.



For the reporting period 1 to 14 July, the main challenges and gaps in the response to the outbreak mirror the previous challenges described, including the protracted and far-spread nature of the outbreak.

Moreover, those leading the response activities have said “suboptimal coordination of the response at all levels” is a major issue hampering efforts to bring the outbreak under control.

Nevertheless, these challenges are being addressed, the report notes.

The recommendations of a list of priority interventions include “intensification of (the) outbreak response through effective coordination and (the) use of available resources (financial and human)”.



Priorities

Key activities recommended include the massive scaling up massive scaling up of water, sanitation and hygiene (WASH) activities, including community-led total sanitation (CLTS).

Recent activities by the response teams on the ground included efforts to support awareness-raising for individuals and collective responsibility, including coordination in fighting hepatitis E in the country.

The United Nations Children's Fund (UNICEF) and the City of Windhoek have started the process of implementing CLTS tailor-made solutions to suit the urban setting. Moreover, the nationally-costed activity plan for the hepatitis E response has been finalised.

“We need to break the chain of transmission. We haven't broken it yet,” Dr Bernard Haufiku, who is heading the national health emergency management committee in response to the outbreak, said recently.

He underlined that hepatitis E and now hepatitis A, is “far from being only a health issue”.

He said it “is a socioeconomic issue”, related to poverty, unemployment, poor hygiene and other social issues; particularly faced by communities living in informal settlements.

He stressed the outbreak “begins with sanitation, water provision and personal hygiene”.

“And it will end with us addressing those three challenges. Those are the three fundamental challenges we are facing.”

CLTS is aimed at enabling communities to analyse their sanitation conditions and collectively understand the impact of open defecation on public health and their environment.

It aims to completely eliminate open defecation. Haufiku underlined the strategy can only work if clean water is provided to these communities. “We have to make it a priority.”

During the week ending on 13 October 2017, the first identified case of hepatitis E was admitted to a public hospital in Windhoek. The health ministry declared a hepatitis E outbreak on 14 December 2017 in Windhoek.

JANA-MARI SMITH

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