Namibia’s Long-Standing Hepatitis E Outbreak Is Coming To An End

An Informal Settlement Outside of Windhoek, Namibia’s Capital (Wikimedia Commons)

The World Health Organization (WHO) and Namibia’s Ministry of Health and Social Services (MoHSS) speculated that a long-standing hepatitis E outbreak is beginning to end as of October 4. The outbreak infected more than 7,954 people with 65 confirmed deaths since its official beginning in December 2017.

Although cases have been declining since April, experts warn that the outbreak may continue to fester as the country still lacks proper sanitation and potable water. However, Namibia has been through similar situations in the past three decades.

Hepatitis E was first documented in Namibia in 1983 when doctors in the Kavango region observed a jaundice-like epidemic infecting local villagers. Researchers initially perplexed by the new strain opted to call it a non-A non-B hepatitis infection. Since then, researchers have officially classified it as a hepatitis E virus (HEV). Namibia has been plagued by several outbreaks of HEV, a virus mainly impacting people from improper settlements who lack potable water and waste facilities.  

The hepatitis E virus primarily spreads through fecal excretions, with the main form of transmission being through the fecal-oral route or the consumption of water contaminated with feces. Although the virus can be inactivated through the usage of hand sanitizer and proper hygiene, many African countries like Namibia lack not only the proper supplies but also clean, safe water. The Namibian government currently estimates that 40 percent of the population lives in informal areas without proper access to potable water, consequently increasing the severity of the most recent outbreak. 

Once inside the body, the hepatitis E virus infects the liver, causing inflammation as well as a fever and jaundice. With no preventative vaccine, doctors rely on palliative treatment options that merely relieve the expressed symptoms without suppressing the viral particles. Death from the virus is typically rare; however, the current outbreak is different.

Of the 7,954 cases, 5,681 of them were between the ages of 20 and 39. Although men were more likely to be infected, pregnant women represented 40 percent of deaths. Despite this, the U.S. Centers for Disease Control and Prevention and the WHO’s provisions of aid contributed to the last hepatitis E death being reported on March 3, 2020.

Unfortunately, the situation resembles that of ebola in the Democratic Republic of Congo and cholera in Ethiopia. The WHO’s support for Namibia dwindles as resources are stripped in order to fight another virus: COVID-19. Without the proper support, Namibia currently lacks hepatitis E rapid diagnostic kits (RDT) while experiencing severe data quality issues, meaning that cases are not being counted.