Mismanaged Epidemic: Hepatitis E Death Toll Climbs to 97

In March, the Red Cross reported poor latrine coverage (over 100 people sharing 1 latrine in many camps) as the largest contributing factor to the spread of the deadly Hepatitis E epidemic.

The epidemic continues to spiral out of control as the government slowly begins to respond to an outbreak first reported in October of 2007.

The Ugandan government's negligence in the face of dire disease outbreaks like Ebola, have contributed to the ongoing genocide in northern Uganda.

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97 Dead as Epidemic Ravages the North

The Monitor (Kampala)/ 1 August 2008 / By Evelyn Lirri / Kampala

The government yesterday announced an emergency plan to fight the Hepatitis E epidemic in northern Uganda after the death toll from the preventable disease rose to 97.

At least 25 people have died in the two weeks since July 17 when the Ministry of Health last issued an update, while the number of infected people rose from 4,829 to 5,779 in the last fortnight.

Health Minister Stephen Mallinga told journalists in Kampala yesterday that the government was launching a Shs10 billion "accelerated emergency response plan" to contain the epidemic in Kitgum, Pader and Gulu districts.

Hepatitis E is an acute viral disease that can cause liver failure. The virus is transmitted to humans through consumption of drinks or food contaminated with faecal matter.

An infected person develops a fever, headache, general body weakness, muscle pains and eventually develops yellow eyes and passes urine of a deep yellow colour. Hepatitis E initially struck Kitgum District in October 2007, but has since spread to Gulu, Pader and Yumbe.

The Health minister revealed that while it is not easy to get infected, the appalling hygiene in the affected districts - where many people displaced by the Lord's Resistance Army insurgency live in squalid conditions in camps - had fuelled the disease's spread.

"You have to take in a substantial amount of faeces -- about one gram-- to be able to get Hepatitis E," Dr Mallinga said. "I don't think anyone intends to eat faeces but because of poor hygiene they end up consuming food with faeces."

He added: "The main thrust of the accelerated response will be to break the transmission chain at individual and household levels where the problem originates."

The emergency response will focus on teaching residents about proper hygiene, improvement of sanitation through construction of boreholes and pit latrines in internally displaced people's camps, and monitoring infected people to ensure they are treated.

Dr Mallinga told a press conference yesterday that the ministry and other partners also plan to strengthen early disease detection and reporting by village health teams and community members.

"The accelerated response will also reinforce case management through provision of medicines and supplies and increase the number of qualified health workers in some health facilities," he said. Gulu District Woman MP Betty Ochan said the epidemic has affected every sub county in the Acholi sub region with women being more prone.

"The Ministry of Health should send film vans to carry out sensitisation because much as we are blaming the local leaders for not doing enough to sensitise the people, the people at the centre have also not done much," she said. "We need these technical people to tell us what interventions they have put in place."

The Ministry of Health has also discouraged the use of clay pots to store drinking water, which they say were found to be harbouring the Hepatitis E virus. Instead, the population is being urged to use chlorine to purify their water before drinking. Twenty-litre jerry cans will also be given to people in the affected districts to store their drinking water.

The acting World Health Organisation representative, Dr Jean Baptiste Tapko, pledged more support to control the outbreak. "We are committed to supporting the government to prevent and control this outbreak. In this regard we are supporting training of village health teams," he said.

Uganda has recently been hit by a string of epidemics including; Ebola, Meningitis, cholera, Bubonic plague in West Nile and yellow fever. A rare strain of cholera ravaged the eastern districts Pallisa, Tororo, Butaleja, Mbale and Manafwa in June, killing 28 people out of 350 who were infected.