Hepatisis E on increase in Boko Haram-ravaged Borno, NCDC warns

Hepatitis screening centre [Vanguard News]

The Nigeria Centre for Disease Control, NCDC, has reported an increasing number of cases of suspected Hepatitis E in Borno State, Northeast, Nigeria.

Borno is the state most ravaged by the Boko Haram insurgency which has caused tens of thousands of deaths there.

The health agency in its weekly epidemiological report for week 29, (July 17-23), showed that a total of 562 cases were reported in ten local government areas, LGAs of the state.

The LGAs are Mobbar, Munguno, Chibok, Askira Uba, Bayo, Dikwa, Gubio, Mafa and Maiduguri.

Borno State has been experiencing an outbreak of the disease for some weeks and NCDC and WHO had reported the presence of medical personnel on site, the first week the deadly disease was detected, to help treat and contain the spread.

The Nigerian Ministry of Health on June 18 had notified WHO of an outbreak of the disease in the state.

The first case was detected on May 3 in Damasak, at the border with the Republic of Niger, with subsequent cases reported in Ngala, one of the local government areas which border Cameroon.

As at July 2, 146 confirmed and suspected cases had been reported from three local government areas: Ngala (112), Mobbar (19), and Monguno (14).

However, the newest report indicates that the disease is yet to be contained.

About 84 per cent of the cases reported were from Ngala LGA, one of the first local governments infected with the outbreak.

According to NCDC, a total of 252 samples were collected for laboratory testing, of which 64 have been tested. 42 (64% per cent) of samples tested came out positive.

Six deaths in unconfirmed cases have been reported, giving a case fatality rate of 1.1 per cebt.

A total of 52 suspected cases were reported amongst pregnant women spread across the local governments, Ngala, Damask, and Munguno, with four deaths recorded.

Hepatitis E is one of the deadly viral hepatitis infections types; others are A, B, C,D.

Hepatitis E is a viral infection of the liver with an incubation period that ranges from two to eight weeks. It is transmitted via faeco-oral route, especially through faecal contamination of food and water supplies.

NCDC said the disease is associated with poor environmental hygiene practices and most times, outbreaks occur after heavy rainfalls which usually cause a disruption of public water supplies.

“Pregnant women are a susceptible population for Hepatitis E infection, particularly in their third trimester causing a severe form of the disease and leading to liver failure,” it said.

The agency added that people living in refugee camps or temporary overcrowded houses after natural disasters are also at risk of Hepatitis E infection.

The health agency also advised states to create increased awareness of Hepatitis E infection in their communities and implement preventive measures, in view of the heavy rainfalls recorded recently in the country as case detection requires a high index of suspicion.

“Surveillance for Hepatitis E infection can be done in line with Hepatitis A infection as a clinical manifestation of the two disease conditions is similar,” it advised.

Signs and symptoms of the disease are usually non-specific-mild fever, reduced appetite, nausea and vomiting, jaundice, abdominal pain, fatigue, skin itching, joint pains, dark urine and clay-colored stool.

Meanwhile, NCDC said it has been working with the Borno State Government, the WHO and other partners to support the response to the Hepatitis E outbreak.

“It is important that ongoing control measures and strategies are sustained in the state even after the outbreak, given the peculiarity of the region,” it said.

The agency also issued prevention and control measures for Hepatitis E infection.

It advised this should be geared towards providing safe and clean water supply, ensuring food hygiene practices and improvement of environmental hygiene practices.


1. Clean Water Supply
Institute and maintain quality standards for public water supplies.
Boil drinking water.
Water chlorination.
Avoid consumption of water and/ice of unknown origin and purity.

2. Food Hygiene Practices

Wash your hands frequently with clean water and soap, particularly before handling food.
Ensuring sanitary food preparation and preservation practices.
Clean food preparation areas and kitchen utensils with soap and safe water and dry completely before reuse.

3. Environmental Hygiene Practices.
Good sanitation practices in living areas.
Proper waste disposal systems, particularly for faecal waste.
Clear drainages and all bodies of stagnant water.


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