An outbreak of hepatitis E in northern Namibia, 1983

In 1983 in Namibia's Kavango region, epidemic jaundice affected hundreds of people Living in settlements lacking potable water and waste disposal faci lities. Many were Angolan refugees. The disease, which after investigation was designated non-A non-B hepatitis, was most common in males (72%), in pe rsons aged 15-39 years, and was usually mild except in pregnant women, who incurred 6 (86%) of the 7 fatal infections. Fifteen years later, archived o utbreak-associated samples were analyzed. Hepatitis E virus (HEV) was detec ted by reverse transcription-polymerase chain reaction in feces from 9 of 1 6 patients tested. Total Ig and IgM to HEV were quantitated in serum from 2 4 residents of an affected settlement at the outbreak's end: 42% had IgM di agnostic of recent infection and 25% had elevated total Ig without IgM, con sistent with past HEV infection. The Namibia outbreak was typical hepatitis E clinically and epidemiologically. This first report of hepatitis E confi rmed by virus detection from southern Africa extends the known range of HEV and highlights its risk for refugees.