Introduction Introduction

MoHSS declared a Hepatitis E outbreak on 14 December 2017 in Windhoek, Khomas region. The outbreak continued in Windhoek, and spread to other regions around April 2018, eventually involving Khomas, Erongo, Kavango East, Kavango West, Ohangwena, Omusati, Oshana, Oshikoto, Kunene, Hardap, Omaheke and Otjizondjupa regions.

According to WHO guidelines, an outbreak of Hepatitis E is defined as a total number of 5-10 laboratory confirmed cases reported from the same geographical area within a period of 4-6 weeks.

Cases have been reported mainly from informal settlements such as Havana and Goreangab in Windhoek, DRC in Swakopmund and similar settings in other regions where access to safe water, sanitation, and hygiene is limited. Most cases from less affected regions have a travel history to the above-mentioned informal settlements in Windhoek or Swakopmund.

On this webpage you will find information materials about hepatitis E and links to other websites that contain more information about the virus. 

What is Hepatitis E? What is Hepatitis E?

Hepatitis E is a liver infection. The virus that causes the infection is passed on through fecal matter (poo). This usually happens when fecal matter gets into water that someone eats or drinks. This can occur when either the water supply is not clean – such as getting water from a river or dam where someone may have gone to the toilet in the water – or if water is collected in a container that is not clean.

According to the Centers for Disease Control and Prevention, the symptoms of Hepatitis E are:

  •          Jaundice (yellowing of the whites of the eyes)
  •          Fever
  •          Fatigue
  •          Loss of appetite
  •          Nausea
  •          Vomiting
  •          Abdominal pain
  •          Enlarged liver
  •          Dark urine
  •          Clay-colored stool and/or diarrhea
  •          Joint pain
  •          Body itching
  •          Rash

If you think you have symptoms of Hepatitis E, you should see your doctor. Your doctor may order blood tests to confirm the infection. For a healthy person, infection with Hepatitis E usually gets better on its own with time. 

For pregnant women, Hepatitis E is a dangerous infection, and can cause serious complications, including liver failure and death. The overall case fatality rate during an outbreak is approximately 1%. However, for pregnant women, the case fatality rate can be 10-30%.  Pregnant women who think they may have been exposed to, or have symptoms consistent with Hepatitis E infection, should seek medical attention immediately.

There is no specific treatment for Hepatitis E. A person infected with the virus should rest, drink plenty of water, eat nutritious food, and avoid alcohol. Basic medications such as Panado/Paracetamol (acetaminophen) is not recommended because Panado is broken down by the liver and when the liver function is not working properly, taking this drug can further damage the liver.

Once a person has contracted the virus, he or she can possibly infect other people if this person does not practice adequate hygiene measures. This is why handwashing with single-use water is so important. This could be from a tap, or any clean water being poured over your hands. This should not include a basin where many people use the same water to wash their hands. If a person infected with Hepatitis E does not wash his or her hands properly after going to the toilet, he or she can pass the virus to other people when shaking hands, preparing food, collecting water for that others will use, or by touching something that another person touches. A person can transmit the virus before he or she experiences symptoms, and will continue to shed the virus for as long as he or she is infected.  You can be infected with Hepatitis E for a long time (15-60 days) before you show any symptoms. This can make it easy for the virus to be passed from person to person. It also makes it difficult to know how the person became infected.

To help prevent infection, good sanitation, clean food preparation and water storage in clean containers and use of clean water is critical. This responsibility applies to government, the municipality, local leadership and, importantly, individuals. While the government has a duty to provide access to clean water, communities and individuals can do many simple things to improve their own situation. This includes using clean, covered water containers, peeling or cooking vegetables and fruit, cooking food and boiling water thoroughly before consuming, avoiding undercooked food, frequent handwashing and keeping toilet/latrine areas clean and separate from water sources

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