An outbreak of fulminant hepatitis delta in the Waorani, an indigenous people of the Amazon basin of Ecuador.

S R ManockHospital Vozandes del Oriente, Shell, Pastaza, Ecuador.

Search for other papers by S R Manock in
Current site
Google Scholar
PubMed
Close
,
P M KelleyHospital Vozandes del Oriente, Shell, Pastaza, Ecuador.

Search for other papers by P M Kelley in
Current site
Google Scholar
PubMed
Close
,
K C HyamsHospital Vozandes del Oriente, Shell, Pastaza, Ecuador.

Search for other papers by K C Hyams in
Current site
Google Scholar
PubMed
Close
,
R DouceHospital Vozandes del Oriente, Shell, Pastaza, Ecuador.

Search for other papers by R Douce in
Current site
Google Scholar
PubMed
Close
,
R D SmalliganHospital Vozandes del Oriente, Shell, Pastaza, Ecuador.

Search for other papers by R D Smalligan in
Current site
Google Scholar
PubMed
Close
,
D M WattsHospital Vozandes del Oriente, Shell, Pastaza, Ecuador.

Search for other papers by D M Watts in
Current site
Google Scholar
PubMed
Close
,
T W SharpHospital Vozandes del Oriente, Shell, Pastaza, Ecuador.

Search for other papers by T W Sharp in
Current site
Google Scholar
PubMed
Close
,
J L CaseyHospital Vozandes del Oriente, Shell, Pastaza, Ecuador.

Search for other papers by J L Casey in
Current site
Google Scholar
PubMed
Close
,
J L GerinHospital Vozandes del Oriente, Shell, Pastaza, Ecuador.

Search for other papers by J L Gerin in
Current site
Google Scholar
PubMed
Close
,
R EngleHospital Vozandes del Oriente, Shell, Pastaza, Ecuador.

Search for other papers by R Engle in
Current site
Google Scholar
PubMed
Close
,
A Alava-AlprechtHospital Vozandes del Oriente, Shell, Pastaza, Ecuador.

Search for other papers by A Alava-Alprecht in
Current site
Google Scholar
PubMed
Close
,
C M MartínezHospital Vozandes del Oriente, Shell, Pastaza, Ecuador.

Search for other papers by C M Martínez in
Current site
Google Scholar
PubMed
Close
,
N B BravoHospital Vozandes del Oriente, Shell, Pastaza, Ecuador.

Search for other papers by N B Bravo in
Current site
Google Scholar
PubMed
Close
,
A G GuevaraHospital Vozandes del Oriente, Shell, Pastaza, Ecuador.

Search for other papers by A G Guevara in
Current site
Google Scholar
PubMed
Close
,
K L RussellHospital Vozandes del Oriente, Shell, Pastaza, Ecuador.

Search for other papers by K L Russell in
Current site
Google Scholar
PubMed
Close
,
W MendozaHospital Vozandes del Oriente, Shell, Pastaza, Ecuador.

Search for other papers by W Mendoza in
Current site
Google Scholar
PubMed
Close
, and
C VimosHospital Vozandes del Oriente, Shell, Pastaza, Ecuador.

Search for other papers by C Vimos in
Current site
Google Scholar
PubMed
Close

An outbreak of delta hepatitis occurred during 1998 among the Waorani of the Amazon basin of Ecuador. Among 58 people identified with jaundice, 79% lived in four of 22 Waorani communities. Serum hepatitis B surface antigen (HBsAg) was found in the sera of 54% of the jaundiced persons, and 14% of asymptomatic persons. Ninety-five percent of 105 asymptomatic Waorani had hepatitis B core (HBc) IgG antibody, versus 98% of 51 with jaundice. These data confirm that hepatitis B virus (HBV) infection is highly endemic among the Waorani. Sixteen of 23 (70%) HBsAg carriers identified at the onset of the epidemic had serologic markers for hepatitis D virus (HDV) infection. All 16 were jaundiced, where as only two of seven (29%) with negative HDV serology were jaundiced (P = .0006). The delta cases clustered in families, 69% were children and most involved superinfection of people chronically infected with HBV. The data suggest that HDV spread rapidly by a horizontal mode of transmission other than by the sexual route.

Save