Hepatitis E as a Cause of Acute Jaundice Syndrome in Northern Uganda, 2010–2012

Gemechu B. Gerbi Centers for Disease Control and Prevention, Atlanta, Georgia; The Uganda Virus Research Institute, Centers for Disease Control and Prevention Influenza Surveillance Project, World Health Organization Influenza Collaborating Center, Entebbe, Uganda; Centers for Disease Control and Prevention–Uganda, Kampala, Uganda

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Roxanne Williams Centers for Disease Control and Prevention, Atlanta, Georgia; The Uganda Virus Research Institute, Centers for Disease Control and Prevention Influenza Surveillance Project, World Health Organization Influenza Collaborating Center, Entebbe, Uganda; Centers for Disease Control and Prevention–Uganda, Kampala, Uganda

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Barnabas Bakamutumaho Centers for Disease Control and Prevention, Atlanta, Georgia; The Uganda Virus Research Institute, Centers for Disease Control and Prevention Influenza Surveillance Project, World Health Organization Influenza Collaborating Center, Entebbe, Uganda; Centers for Disease Control and Prevention–Uganda, Kampala, Uganda

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Stephen Liu Centers for Disease Control and Prevention, Atlanta, Georgia; The Uganda Virus Research Institute, Centers for Disease Control and Prevention Influenza Surveillance Project, World Health Organization Influenza Collaborating Center, Entebbe, Uganda; Centers for Disease Control and Prevention–Uganda, Kampala, Uganda

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Robert Downing Centers for Disease Control and Prevention, Atlanta, Georgia; The Uganda Virus Research Institute, Centers for Disease Control and Prevention Influenza Surveillance Project, World Health Organization Influenza Collaborating Center, Entebbe, Uganda; Centers for Disease Control and Prevention–Uganda, Kampala, Uganda

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Jan Drobeniuc Centers for Disease Control and Prevention, Atlanta, Georgia; The Uganda Virus Research Institute, Centers for Disease Control and Prevention Influenza Surveillance Project, World Health Organization Influenza Collaborating Center, Entebbe, Uganda; Centers for Disease Control and Prevention–Uganda, Kampala, Uganda

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Saleem Kamili Centers for Disease Control and Prevention, Atlanta, Georgia; The Uganda Virus Research Institute, Centers for Disease Control and Prevention Influenza Surveillance Project, World Health Organization Influenza Collaborating Center, Entebbe, Uganda; Centers for Disease Control and Prevention–Uganda, Kampala, Uganda

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Fujie Xu Centers for Disease Control and Prevention, Atlanta, Georgia; The Uganda Virus Research Institute, Centers for Disease Control and Prevention Influenza Surveillance Project, World Health Organization Influenza Collaborating Center, Entebbe, Uganda; Centers for Disease Control and Prevention–Uganda, Kampala, Uganda

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Scott D. Holmberg Centers for Disease Control and Prevention, Atlanta, Georgia; The Uganda Virus Research Institute, Centers for Disease Control and Prevention Influenza Surveillance Project, World Health Organization Influenza Collaborating Center, Entebbe, Uganda; Centers for Disease Control and Prevention–Uganda, Kampala, Uganda

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Eyasu H. Teshale Centers for Disease Control and Prevention, Atlanta, Georgia; The Uganda Virus Research Institute, Centers for Disease Control and Prevention Influenza Surveillance Project, World Health Organization Influenza Collaborating Center, Entebbe, Uganda; Centers for Disease Control and Prevention–Uganda, Kampala, Uganda

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Hepatitis E virus (HEV) is a common cause of acute viral hepatitis in developing countries; however, its contribution to acute jaundice syndrome is not well-described. A large outbreak of hepatitis E occurred in northern Uganda from 2007 to 2009. In response to this outbreak, acute jaundice syndrome surveillance was established in 10 district healthcare facilities to determine the proportion of cases attributable to hepatitis E. Of 347 acute jaundice syndrome cases reported, the majority (42%) had hepatitis E followed by hepatitis B (14%), malaria (10%), hepatitis C (5%), and other/unknown (29%). Of hepatitis E cases, 72% occurred in Kaboong district, and 68% of these cases occurred between May and August of 2011. Residence in Kaabong district was independently associated with hepatitis E (adjusted odds ratio = 13; 95% confidence interval = 7–24). The findings from this surveillance show that an outbreak and sporadic transmission of hepatitis E occur in northern Uganda.

Author Notes

* Address correspondence to Gemechu B. Gerbi, Centers for Disease Control and Prevention, 1600 Clifton Road, Mailstop G-37, Atlanta, GA 30333. E-mail: ggerbi@msm.edu

Authors' addresses: Gemechu B. Gerbi, Roxanne Williams, Stephen Liu, Jan Drobeniuc, Saleem Kamili, Fujie Xu, Scott D. Holmberg, and Eyasu H. Teshale, Division of Viral Hepatitis, Centers for Disease Control and Prevention, Atlanta, GA, E-mails: ggerbi@msm.edu, rewilli8@yahoo.com, ice5@cdc.gov, jqd6@cdc.gov, sek6@cdc.gov, fax1@cdc.gov, sdh1@cdc.gov, and eht4@cdc.gov. Barnabas Bakamutumaho, Uganda Virus Research Institute–Centers for Disease Control and Prevention Influenza Surveillance Project, World Health Organization Influenza Collaborating Center, Entebbe, Uganda, E-mail: bbarnabas2001@yahoo.com. Robert Downing, Centers for Disease Control and Prevention–Uganda, Kampala, Uganda, E-mail: rqd6@ug.cdc.gov.

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