The World Health Organization (WHO) has been alerted by the Chad International Health Regulation (IHR) national focal point (NFP) regarding an outbreak of hepatitis E in the eastern Ouaddai province of Chad. This region, heavily affected by an influx of refugees and returnees fleeing the Sudan conflict since April 2023, primarily comprises women and children.
Between January 2 and April 28, 2024, a total of 2092 suspected cases of hepatitis E, resulting in seven deaths (case fatality ratio (CFR) 0.3%), have been reported from two health districts within Ouaddai province: Adré and Hadjer-Hadid. Among these cases, 103 (4.9%) were from the host community, while 1989 (95%) originated from seven refugee camps and transit sites.
Diagnostic procedures involved both rapid diagnostic tests (RDT) and polymerase chain reaction (PCR) to confirm the diagnosis on collected samples. The most impacted age groups were 6 to 17 years (1113 cases) and 18 to 59 years (500 cases), constituting 53.2% and 23.9% of suspected cases, respectively. Additionally, 27 pregnant women (1.3%) were among the suspected cases.
Hepatitis E outbreaks are often prevalent in humanitarian settings, especially in conflict-affected areas and displacement sites, due to limited access to safe drinking water and inadequate sanitation and hygiene facilities.
In response to the situation, the national health authorities have activated the Public Health Emergency Operations Centre. WHO has deployed a multidisciplinary team in Adré to facilitate the setup of response measures, which are currently underway with support from various partners.
Prevention remains the most effective approach against hepatitis E. Ensuring provision of safe drinking water, promoting good hygiene practices, maintaining quality standards for public water supplies, and offering safely managed sanitation services can significantly reduce the risk of transmission.
WHO has assessed the risk as high at the national level, moderate at the regional level, and low at the global level. The organization continues to work closely with local health authorities and international partners to mitigate the impact of the outbreak and prevent further spread of hepatitis E in the affected region.
