Hepatitis E Virus in Chad

As of 11 January 2022, 385 suspected cases of Hepatitis E Virus have been reported, of which, 12 are confirmed and two associated deaths [case fatality ratio (CFR): 0.5%] have been reported in six villages in Laï district, Tandjile region (Chad). Health authorities began an investigation on 1 October 2021 for a cluster of 25 suspected Hepatitis E Virus cases presenting with jaundice, fever, and epigastric pain. Of the tested samples at the Ndjamena General Hospital, 65% (13/20) were positive for Hepatitis E Virus using rapid diagnostic tests. The same batch of 20 samples was referred to the Centre Pasteur in Yaoundé, Cameroon, a WHO collaborating centre for confirmation and 12 tested positive for Hepatitis E Virus by enzyme-linked immunosorbent assay. The results for blood samples from a further 29 of the suspected cases remain pending.

Of the 385 reported cases, more than half were male (n=215; 57%). Cases aged less than 10 years (n=90; 23.4%) and 21-30 years (n=89; 23.1%) accounted for the largest proportion of cases.

Heavy rain in Chad since June 2021 have greatly impacted the Tandjile region and by October 2021, approximately 161,000 people were affected. Floodwaters caused substantial infrastructural damage in a setting that already has pre-existing water, sanitation and hygiene (WASH) challenges such as a poor access to safe drinking water and high rates of open defecation.

The last known outbreak of Hepatitis E Virus in Chad began in August 2016 and lasted for 17 months before the Ministry of Health declared the end of the outbreak in February 2018. A total of 1874 suspected Hepatitis E Virus cases and 23 associated deaths were reported. The area affected in this outbreak was located in the Salamat region, just over 700 km north east of the current outbreak.

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