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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DOI:
https://doi.org/10.4269/ajtmh.14-0196
Volume/Issue:
Volume 92: Issue 2
Page(s):
411–414
Restricted access
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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.

Copyright:
© The American Society of Tropical Medicine and Hygiene 2015
Received:
01 Apr 2014
|
Accepted:
12 Sep 2014
|
Published Online:
04 Feb 2015
Cover The American Journal of Tropical Medicine and Hygiene
The American Journal of Tropical Medicine and Hygiene
Print ISSN:
0002-9637
Online ISSN:
1476-1645
  • 1.

    Rein DBSG, Theaker J, Wittenborn JS, Wiersma ST, 2012. The global burden of hepatitis E virus. Hepatology 55: 988–997.

  • 2.

    Lozano R, Naghavi M, Foreman K, Lim S, Shibuya K, Aboyans V, Abraham J, Adair T, Aggarwal R, Ahn SY, Alvarado M, Anderson HR, Anderson LM, Andrews KG, Atkinson C, Baddour LM, Barker-Collo S, Bartels DH, Bell ML, Benjamin EJ, Bennett D, Bhalla K, Bikbov B, Bin Abdulhak A, Birbeck G, Blyth F, Bolliger I, Boufous S, Bucello C, Burch M, Burney P, Carapetis J, Chen H, Chou D, Chugh SS, Coffeng LE, Colan SD, Colquhoun S, Colson KE, Condon J, Connor MD, Cooper LT, Corriere M, Cortinovis M, de Vaccaro KC, Couser W, Cowie BC, Criqui MH, Cross M, Dabhadkar KC, Dahodwala N, De Leo D, Degenhardt L, Delossantos A, Denenberg J, Des Jarlais DC, Dharmaratne SD, Dorsey ER, Driscoll T, Duber H, Ebel B, Erwin PJ, Espindola P, Ezzati M, Feigin V, Flaxman AD, Forouzanfar MH, Fowkes FG, Franklin R, Fransen M, Freeman MK, Gabriel SE, Gakidou E, Gaspari F, Gillum RF, Gonzalez-Medina D, Halasa YA, Haring D, Harrison JE, Havmoeller R, Hay RJ, Hoen B, Hotez PJ, Hoy D, Jacobsen KH, James SL, Jasrasaria R, Jayaraman S, Johns N, Karthikeyan G, Kassebaum N, Keren A, Khoo JP, Knowlton LM, Kobusingye O, Koranteng A, Krishnamurthi R, Lipnick M, Lipshultz SE, Ohno SL, Mabweijano J, MacIntyre MF, Mallinger L, March L, Marks GB, Marks R, Matsumori A, Matzopoulos R, Mayosi BM, McAnulty JH, McDermott MM, McGrath J, Mensah GA, Merriman TR, Michaud C, Miller M, Miller TR, Mock C, Mocumbi AO, Mokdad AA, Moran A, Mulholland K, Nair MN, Naldi L, Narayan KM, Nasseri K, Norman P, O'Donnell M, Omer SB, Ortblad K, Osborne R, Ozgediz D, Pahari B, Pandian JD, Rivero AP, Padilla RP, Perez-Ruiz F, Perico N, Phillips D, Pierce K, Pope CA 3rd, Porrini E, Pourmalek F, Raju M, Ranganathan D, Rehm JT, Rein DB, Remuzzi G, Rivara FP, Roberts T, De León FR, Rosenfeld LC, Rushton L, Sacco RL, Salomon JA, Sampson U, Sanman E, Schwebel DC, Segui-Gomez M, Shepard DS, Singh D, Singleton J, Sliwa K, Smith E, Steer A, Taylor JA, Thomas B, Tleyjeh IM, Towbin JA, Truelsen T, Undurraga EA, Venketasubramanian N, Vijayakumar L, Vos T, Wagner GR, Wang M, Wang W, Watt K, Weinstock MA, Weintraub R, Wilkinson JD, Woolf AD, Wulf S, Yeh PH, Yip P, Zabetian A, Zheng ZJ, Lopez AD, Murray CJ, AlMazroa MA, Memish ZA, 2012. Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 380: 2095–2128.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 3.

    Guthmann JP, Klovstad H, Boccia D, Hamid N, Pinoges L, Nizou JY, Tatay M, Diaz F, Moren A, Grais RF, Ciglenecki I, Nicand E, Guerin PJ, 2006. A large outbreak of hepatitis E among a displaced population in Darfur, Sudan, 2004: the role of water treatment methods. Clin Infect Dis 42: 1685–1691.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 4.

    Teshale EH, Grytdal SP, Howard C, Barry V, Kamili S, Drobeniuc J, Hill VR, Okware S, Hu DJ, Holmberg SD, 2010. Evidence of person-to-person transmission of hepatitis E virus during a large outbreak in northern Uganda. Clin Infect Dis 50: 1006–1010.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 5.

    Isaacson M, Frean J, He JK, Seriwatana J, Innis BL, 2000. An outbreak of hepatitis E in northern Namibia, 1983. Am J Trop Med Hyg 62: 619–625.

  • 6.

    Nguyen GC, Segev DL, Thuluvath PJ, 2007. Nationwide increase in hospitalizations and hepatitis C among inpatients with cirrhosis and sequelae of portal hypertension. Clin Gastroenterol Hepatol 5: 1092–1099.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 7.

    WHO. WHO Recommended Surveillance Standard of Acute Viral Hepatitis. Available at: http://www.who.int/immunization_monitoring/diseases/hepatitis_surveillance/en/. Accessed March 17, 2013.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 8.

    The International Federation, 2011. The International Federation’s Disaster Relief Emergency Fund Operation Final Report. Available at: http://www.ifrc.org/docs/appeals/08/MDRUG009fr.pdf. Accessed March 15, 2013.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 9.

    SAS Institute Inc., Cary, NC.

  • 10.

    Buisson YGM, Nicand E, Cheval P, van Cuyck-Gandre H, Innis B, Rehel P, Coursaget P, Teyssou R, Tsarev S, 2000. Identification of a novel hepatitis E virus in Nigeria. J Gen Virol 81: 903–909.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 11.

    Bradley DW, 1990. Enterically-transmitted non-A, non-B hepatitis. Br Med Bull 46: 442–461.

  • 12.

    Isaacson MFJ, He J, Seriwatana J, Innis BL, 2000. An outbreak of hepatitis E in northern Namibia, 1983. Am J Trop Med Hyg 62: 619–625.

  • 13.

    Saeddi MI, Mahmood K, Amanullah, Ziauddin M, Ilyas N, Zarif M, 2004. Frequency and clinical course of hepatitis E in tertiary care hospitals. J Coll Physicians Surg Pak 14: 527–529.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 14.

    Chadha MS, Walimbe AM, Chobe LP, Arankalle VA, 2003. Comparison of etiology of sporadic acute and fulminant viral hepatitis in hospitalized patients in Pune, India during 1978–81 and 1994–97. Indian J Gastroenterol 22: 11–15.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 15.

    Das K, Agarwal A, Andrew R, Frosner GG, Kar P, 2000. Role of hepatitis E and other hepatotropic virus in aetiology of sporadic acute viral hepatitis: a hospital based study from urban Delhi. Eur J Epidemiol 16: 937–940.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 16.

    Khan A, Tanaka Y, Kurbanov F, Elkady A, Abbas Z, Azam Z, Subhan A, Raza S, Hamid S, Jafri W, Shih J, Xia N, Takahashi K, Mishiro S, Mizokami M, 2011. Investigating an outbreak of acute viral hepatitis caused by hepatitis E virus variants in Karachi, South Pakistan. J Med Virol 83: 622–629.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 17.

    Manmohan Gupta, 2011. Retrospective hospital based study of infective causes of jaundice in Tamil Nadu, India. Calcutta Med J 9: e4.

  • 18.

    Teshale EH, Grytdal SP, Howard C, Barry V, Kamili S, Drobeniuc J, Hill VR, Okware S, Hu DJ, Holmberg SD, 2010. Evidence of person-to-person transmission of hepatitis e virus during a large outbreak in northern Uganda. Clin Infect Dis 50: 1006–1010.

    • PubMed
    • Search Google Scholar
    • Export Citation
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