Hepatitis E outbreak can be contained

A rare outbreak of hepatitis E virus (HEV) spread by contaminated water in Windhoek's informal settlements claimed the life of a 26-year-old mother in November, while eight other patients have tested positive to date.

Namibia's first confirmed outbreak of HEV, a waterborne disease that can be prevented through good sanitation and the availability of clean drinking water, was more than 30 years ago at Rundu in 1983.

The last outbreak was also reported at Rundu between 1995 and 1996.

Minister of health Bernhard Haufiku says the main prevention tool to contain the outbreak is personal hygiene, including washing hands as often as possible and disinfecting water before drinking it.

He also cautions against hysteria, noting that at this stage, the outbreak can still be contained and the key focus is to ensure affected communities improve basic sanitation and hygiene.

Since October, a total of 26 patients from informal settlements in Windhoek presented with symptoms of liver disease, of which nine have tested positive for HEV. Four were negative and eight results are still pending.

The 26-year-old mother died shortly after giving birth to a healthy baby on 19 November. The baby survived, authorities confirmed yesterday at a press briefing.

An outbreak is defined as more than five confirmed cases of HEV from the same area.

All 26 patients live in one of Windhoek's informal housing areas which are at high risk of waterborne diseases, including HEV.

The majority of patients are from Havana (16), while six live in Goreangab, and the rest in Greenwell Matongo, Ombili, and Hakahana.

Apart from one, all have been discharged from hospital.

On 14 December, a hepatitis E outbreak was officially declared and emergency task teams set to work.

The newly appointed acting permanent secretary for the health ministry, Petronella Masabane, said she was confident that the emergency teams, including health outreach workers in the communities and global partners, were equipped to respond to the outbreak.

She said the outbreak can be contained but it is vital that affected residents are made aware of the ways in which they can drastically reduce their risk of infection.

Experts note that the festive season increases the risk of the disease continuing to spread, as families and friends get together in large numbers.

Clean drinking water and sanitation, including frequent hand washing, are crucial in containing the rate of infection, authorities say.

The virus is transmitted via the faecal-oral route, principally via contaminated drinking water, and the disease is most common in areas with limited access to water, sanitation, hygiene and health services.

According to the World Health Organisation (WHO), “the risk factors for hepatitis E are related to poor sanitation, allowing virus excreted in the faeces of infected people to reach drinking water supplies.”

Health authorities are urging residents to ensure they frequently wash their hands before and after using bathrooms, handling food, changing nappies or shaking hands. People should keep their homes clean and purify their drinking water.

The WHO also recommends that authorities ensure that residents have access to quality water supply and that proper disposal systems for human faeces are provided to help reduce the risk of HEV outbreaks.

Symptoms include jaundice, fever, fatigue, loss of appetite, dark urine, pale-coloured stool, joint pain, nausea and vomiting.

Health officials urge anyone presenting with these symptoms to go to the nearest health facility.

Most people with hepatitis E recover completely and the fatality rate is about 1% for the general population.

However, for pregnant women, hepatitis E can be a serious illness, with mortality reaching 10%–30% in their third trimester of pregnancy.

Hepatitis E could also be serious among persons with pre-existing chronic liver disease or persons with suppressed immune systems.

JANA-MARI SMITH