A Hepatitis E outbreak had been declared by Chadian health authorities in mid-November 2021 in Sategui health area, Lai health district in the Tandjile region.
As of November 20, there have been 377 suspected cases and 2 deaths (CFR 0.5%) reported. Among those affected, the majority have been men with 216 cases (57%) and the most affected age group has been less than 10 years of age with 90 cases (23.8%).
Hepatitis E is endemic in Chad, particularly in the Tangile region, which previously experienced large-scale outbreaks in 2017 and 2018. Poor hygiene and sanitation conditions coupled with limited access to safe water are risk factors for outbreaks in this region. All the six villages that reported cases have few improved water points that are below the standards of 500 inhabitants per water point. The ongoing floods in the affected southern part of the country may affect the quality of the outbreak response.
The clinical course of hepatitis E is similar to that of hepatitis A with no chronic form of the disease. Jaundice, fever, loss of appetite and lethargy are common symptoms.
People are infected primarily through the fecal-oral route, usually through contaminated water or food. There have been several cases of hepatitis E infection in France due to eating raw figatellu, which is made with pig liver.
Much like hepatitis A, the fatality rate is low with the exception of pregnant women where it can reach 20% among those infected in the third trimester. Liver failure is a frequent outcome with pregnant women.
Hepatitis E is found endemically in countries that have inadequate environmental sanitation. It is most frequently seen in Asia, Africa, Central America and the Middle East.
According to WHO, every year, there are an estimated 20 million hepatitis E infections worldwide, leading to an estimated 3.3 million symptomatic cases of hepatitis E, and 56,600 hepatitis E-related deaths.