Jp. Burans et al., THREAT OF HEPATITIS-E VIRUS-INFECTION IN SOMALIA DURING OPERATION RESTORE HOPE, Clinical infectious diseases, 18(1), 1994, pp. 100-102
In support of Operation Restore Hope, the United States military estab
lished a diagnostic laboratory for infectious diseases, the Joint Forw
ard Laboratory, in Mogadishu, Somalia. Because sporadic hepatitis due
to unknown causes was a frequent problem, staff members of the Joint F
orward Laboratory evaluated 31 Somalis, five displaced Ethiopians, and
three Western relief workers who had acute clinical hepatitis. Patien
ts lived in multiple locations in Somalia-Mogadishu, Baidoa, and Merca
-and became ill between December 1992 and February 1993. IgM antibody
to hepatitis A virus was found in one English relief worker, and IgM I
antibody to hepatitis E virus was found in 20 (65%) of 31 Somalis, tw
o (40%) of five Ethiopians, and two (67%) of three Western relief work
ers. No patient had evidence of acute hepatitis B, malaria, yellow fev
er, or other arbovirus infections. These data indicate that hepatitis
E virus-the major cause of enterically transmitted non-A, non-B hepati
tis-was a common cause of acute sporadic hepatitis in Somalia during t
he initial stages of Operation Restore Hope.