A surge in the number of cases of Hepatitis E in the four refugee camps near the border with Sudan has contaminated 3,319 people and led to 69 deaths since July, the Southern Sudanese government, UNHCR, and the World Health Organization (WHO) confirmed Saturday.
The increase in the number of cases and suspected cases has mainly affected the Yusuf Batil camp, which alone accounted for 1,908 cases, including 39 deaths, or 71 percent of all reported new cases. The camp currently holds 36,371 refugees. The increase of Hepatitis E in the camp was confirmed during a camp-wide registration in early December.
"The hepatitis E situation is of serious concern to the government of the Republic of South Sudan, and I appeal to all partners to put every effort to contain the outbreak as soon as possible," Dr. Samson Paul Baba, the government's Director General, Community and Public Health, said after visiting the camps this week.
There have been few indications thus far that the disease has spread to the host communities, although Hepatitis E has been endemic in the region for years. UNHCR health officials say the growth in the population due to the refugee influx from Blue Nile State in Sudan could be one of the factors in the spread of the disease.
While there is no treatment or WHO approved vaccine for Hepatitis E, the risk of being infected can be dramatically reduced by washing hands with soap, especially after using the toilet, drinking clean water, using latrines, and avoiding eating uncooked fruits and vegetables.
Emergency steps are being taken to curb the increase, including accelerating the construction of latrines in Yusuf Batil, with some 700 latrines expected to be built by the end of January. An additional soap distribution comprising 168,000 bars is also planned in the camp this month, more than doubling the monthly rate of 250 grams per month and per person. More regular soap distributions, especially for washing hands, will be carried out in the future.
Plans are under way to replace about 22,000 10-liter capacity jerry cans, household water containers which can become a source of infection if filled with contaminated water. An additional 5,000 buckets are expected to arrive in the camp in the coming days and an additional borehole is currently being drilled.
"We are not waiting this out, we are trying to deal with it quickly and efficiently," says Brendan Dineen, UNHCR's Public Health Officer in South Sudan.
Additional measures include enhanced disease surveillance, water chlorination, and a health and hygiene promotion campaign in markets, schools, and at the household level.
"The plan is to focus on control measures," Claudia Perlongo, a UNHCR Water, Sanitation and Hygiene Officer working in Yusuf Batil said. "We have met with the government and our partners to harmonize the educational messages regarding Hepatitis E, and these will be disseminated to the entire camp population as an on-going educational process."
"UNHCR, the South Sudanese government, and all our partners in all the camps are on high alert for the detection of Hepatitis E," Perlongo added.
The infection first appeared in the Jamam Camp last year and to date it has affected 1,030 people and led to 25 deaths. UNHCR and its implementing partners are also trying to stop the spread of Hepatitis E to Doro Camp, the largest refugee setting in Upper Nile State with nearly 45,000 refugees, but few cases have been reported there thus far.