Acute Hepatitis E Infection During the 1988 Floods in Khartoum, Sudan

摘要

Following catastrophic floods in August 1988, physicians in Khartoum andOmdurman, Sudan, observed an outbreak of acute hepatitis. During a period of 2 weeks in October 1988 we conducted a seroepidemiological study of icteric patients presenting to an acute-care clinic at the Omdurman Military Hospital. After informed consent was obtained, a standardized questionnaire was administered to each person and a venous blood sample was obtained. Acute and convalescent sera were tested for immunoglobulin (Ig) M and IgG antibody to hepatitis E virus (anti-HEV) using a Western blot assay (HE et al., 1993). Specimens were also tested for IgiM antibody to the hepatitis B core protein and IgM antibody to hepatitis A virus (anti-HAV) (Abbott). Fifty-five patients participated in the study, with 16 (29%) returning for follow-up. The average age of patients was 22 years (range 3-48 years), and 47 (85%) were male. The patients had been jaundiced for an average of 9 d (range 1-30 d) when the study began. Thirty-two patients (58%) had IgM anti-HEV detected in the acute serum specimens; IgG anti-HEV was also detected in 29 of these 32 specimens. Paired sera were available from 10 of the 32 cases of acute hepatitis E infection. In 3 of the 10 convalescent sera, IgM antibody was no longer detectable. lgG antibody to hepatitis A persisted in all 10, however. Of the remaining 23 patients in whom no IgAi anti-HEV was detected, paired sera were available from 6 patients and no IgG anti-HEV seroconversion was observed. There were 3 cases of acute hepatitis B and 3 of acute hepatitis A. Thus, there were 17 study subjects with no serological marker of acute hepatitis A, B or however, 10 of these 17 patients had IgG anti-HEV in the acute serum specimen.