On 5 March 2024, the World Health Organization (WHO) was notified by the Chad International Health Regulation (IHR) national focal point (NFP) of an outbreak of hepatitis E in the eastern Ouaddai province of Chad.
Ouaddai province has been heavily affected by an influx of refugees and returnees fleeing the Sudan conflict since April 2023, with a majority being women and children. From 2 January to 28 April 2024, a total of 2092 suspected hepatitis E cases, including seven deaths (case fatality ratio (CFR) 0.3%), were reported from two health districts of the Ouaddai province, namely, Adré and Hadjer-Hadid.
Among the 2092 suspected cases, 103 (4.9%) were from the host community and 1989 (95%) were reported from seven refugee camps and transit sites.. Both rapid diagnostic tests (RDT) and polymerase chain reaction (PCR) were used to confirm the diagnosis on collected samples. The most affected age groups are 6 -17 years (1113 cases) and 18-59 years (500 cases), representing 53.2% and 23.9% of the suspected cases respectively. A total of 27 pregnant women (1.3%) have been reported among the suspected cases.
Hepatitis E is often occurring in humanitarian settings such as in areas affected by conflict and in displacement sites. Limited access to safe drinking water and inadequate sanitation and hygiene increases the risk of hepatitis E virus outbreaks. The Public Health Emergency Operations Centre has been activated by the national health authorities. WHO deployed a multidisciplinary team in Adré to support setting up the response and response activities are ongoing with partners support.
Prevention is the most effective approach against hepatitis E. Provision of safe drinking water, good hygiene practices, quality standards for public water supplies and provision of safely managed sanitation services can significantly decrease the risk of spread. WHO assesses the risk to be high at the national level, moderate at the regional level and low at the global level.
