BEYOND OUR BORDERS DECEMBER 2020
HEPATITIS E: BURKINA FASO
Between 8 September and 24 November 2020, a cumulative total of 442 cases of febrile jaundice was reported in the North Central region of Burkina Faso. A large majority of these were in the Barsalogho health district where 287 cases and 16 deaths have thus far been totalled. Of note, 15 of the 16 deaths in the district were reported in pregnant or postpartum women. The case fatality rate currently stands at 4.1%.
Testing began in early September when specimens were sent to the National Reference Laboratory for Viral Haemorrhagic Fever (NRL-VHF). Of the 14 specimens initially sent, one yielded a positive IgM result for yellow fever; nine were indeterminate and thus sent to Lapeyronie Hospital, Montpellier, France for hepatitis E testing. Here, eight of the nine samples were hepatitis E IgM positive. Hepatitis E has been confirmed in ten cases to date. This event has now been confirmed as a hepatitis E outbreak.
Case descriptions according to individual characteristics show that 67% of cases are younger than 30 years with nearly 5% of cases being less than 5 years old. In addition, 54% were in female patients.
The public health response to this rise in hepatitis E cases has been hampered by the great social and economic strife currently facing Burkina Faso. There are many internally displaced persons in the region, most of whom are currently residing with host families and some are living in camps. Furthermore, the North Central region is affected by the closure of health facilities due to insecurity raised from frequent attacks by unidentified armed men. The lack of essential water, hygiene, sanitation and health services only worsens the spread of this disease which is transmitted via the faecal-oral route.
Burkina Faso is also affected by the COVID-19 pandemic, and as of 6 December 2020, 3 156 COVID-19 cases and 68 deaths have been reported. The context of the COVID-19 pandemic further complicates the response to this hepatitis E outbreak.
ENTEROHAEMORRHAGIC ESCHERICHIA COLI (EHEC): GERMANY
Enterohaemorrhagic Escherichia coli (EHEC) is a human pathogen responsible for outbreaks of bloody diarrhoea and haemolytic uremic syndrome (HUS) worldwide. More than 25 cases of EHEC (also known as Shiga-toxin producing E. coli) are being investigated with outbreaks reported in four day-care centres in the Luetzow-Luebstorf District, Germany. Authorities warned that further testing is underway and numbers are expected to rise. Those affected currently include children, their relatives as well as a few day-care centre employees. Currently, there have been no hospitalised cases with the majority having no to mild symptoms, and a few having severe diarrhoea.
Testing of products as well as the premises of the food processing company that supplies the day-care centres was negative. Despite multiple centres being affected, authorities believe that the pathogen entered the centres through means outside of their common food supply source. The investigation is still ongoing.
In 2020, 2 643 cases and six deaths related to malaria were recorded in the Zambezi region, Namibia. This is a dramatic rise from the 261 positive cases and one death that had been recorded at the same time last year. Regional health director Agnes Mwillima told reporters that the increase in malaria cases might be because the climate in the region is conducive for mosquitoes to breed throughout the year. She further urged the community to allow residual spraying teams access to their houses as well as to practice the standard behaviours that prevent mosquito bites, including use of mosquito repellents and wearing clothes that covers skin.
The World Malaria Report released on 1 December stated that there were 229 million cases of malaria in 2019 compared to 228 million cases in 2018. The estimated number of malaria deaths in the world stood at 409 000 in 2019, compared with 405 000 in 2018. The World Health Organization African Region continues to carry the largest global burden of the disease, contributing 94% of the total number of malaria cases and deaths in 2019, highlighting once again the need for continued efforts to both prevent and manage the disease on this continent.
COMMUNICATED BY: NATIONAL INSTITUTE FOR COMMUNICABLE DISEASES