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. 2020 Apr 3;20(1):260.
doi: 10.1186/s12879-020-04961-4.

Hepatitis E virus outbreak associated with rainfall in the Central African Republic in 2008-2009

Vianney Tricou  1 , Julie Bouscaillou  2 , Gina-Laure Laghoe-Nguembe  3 , Aubin Béré  4 , Xavier Konamna  5 , Benjamin Sélékon  5 , Emmanuel Nakouné  5 , Mirdad Kazanji  6 , Narcisse P Komas  3
Affiliations

Hepatitis E virus outbreak associated with rainfall in the Central African Republic in 2008-2009

Vianney Tricou et al. BMC Infect Dis. .

Abstract

Background: Infection by hepatitis E virus (HEV) can cause a high burden of morbidity and mortality in countries with poor access to clean water and sanitation. Our study aimed to investigate the situation of HEV infections in the Central African Republic (CAR).

Methods: A retrospective analysis of the blood samples and notification forms collected through the national yellow fever (YF) surveillance program, but for which a diagnosis of YF was discarded, was carried out using an anti-HEV IgM ELISA and a HEV-specific RT-PCR.

Results: Of 2883 YF-negative samples collected between January 2008 and December 2012, 745 (~ 26%) tested positive by at least either of the 2 tests used to confirm HEV cases. The results revealed that the CAR was hit by a large HEV outbreak in 2008 and 2009. The results also showed a clear seasonal pattern with correlation between HEV incidence and rainfall in Bangui. A phylogenetic analysis showed that the circulating strains belonged to genotypes 1e and 2b.

Conclusions: Overall, this study provides further evidences that HEV can be a significant cause of acute febrile jaundice, particularly among adults during rainy season or flood, in a country from Sub-Saharan Africa.

Keywords: Central Africa; Epidemiology; Hepatitis E virus; Preventable disease; Waterborne disease.

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Conflict of interest statement

Vianney Tricou is currently employed by Takeda Pharmaceuticals International AG, Zurich, Switzerland. All other authors have declared that no competing interests exist.

Figures

Fig. 1
Fig. 1
Flow chart of the HEV testing. NA: not available
Fig. 2
Fig. 2
Temporal and geographical distribution of HEV cases in the CAR with the monthly rainfall in Bangui – 2008-2012
Fig. 3
Fig. 3
Phylogenetic analysis of HEV strains from the CAR – 2008-2012. Scale bar represents nucleotide substitutions per site. Percentages of replicate trees in which the associated virus isolates clustered together in the bootstrap test (100 replicates) are shown next to the branches. The sequences generated in this study are depicted in blue. The sequences generated in Bouscaillou et al. 2013 [11] are depicted in green. These sequences are also from samples collected in the CAR during the period 2008–2012
See this image and copyright information in PMC

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