Facts about Hepatitis E outbreak in Namibia

By Molly Power

CONTAMINATED water sources – The virus is most often transmitted via the fecal-oral route. In areas with poor or nonexistent sanitation services, contamination is particularly rampant. This is the case in Namibia, where 65 percent of the population uses unimproved sanitation facilities. This is largely due to the fact that much of the human waste in the country is managed unsafely.

Limited resources – Two months after the first case of hepatitis E was identified in Namibia’s highly populated capital of Windhoek, officials declared an outbreak. Because other forms of hepatitis were more common in the country, the laboratory resources for diagnosing type E, in particular, were limited. Consequently, diagnostic services were inadequate during the first few weeks of the outbreak. While the outbreak began in Windhoek, it has made its way to other areas including Khomas and Erongo.

Government efforts – Within a week of the outbreak’s confirmation, Namibia’s Ministry of Health began the campaign against the disease with a media briefing to educate the public. Since then, authorities have strengthened data collection and reporting, conducted environmental investigations, begun a national informative radio campaign and worked with local community leaders to develop culturally-sensitive interventions. Despite these efforts, however, the virus has persisted. Of note, between July 22 and 28, there were 19 new cases in the Otjozondjupa region alone.

A potential cure – In 2015, Chinese scientists developed a vaccine to cure Hepatitis E. While the vaccine has not yet been endorsed by the World Health Organization, testing showed that the vaccine could protect subjects from Hepatitis E for up to 4.5 years. However, the vaccine has not been licensed in any country other than China, so it cannot be administered yet in Namibia.

Preventative efforts – Health officials have maintained that the best way to fight Namibia’s Hepatitis E outbreak is through proper sanitation practices such as hand-washing and effective waste disposal. Dr. Kalumbi Shangula, the country’s Minister of Health and Social Services, commented that “the fact that the outbreak is persisting and has the potential to become endemic in Namibia is a wake-up call to action.” He also remarked on the public’s apathy towards the situation, despite several governmental efforts to communicate its urgency.

Worryingly, the rainy season is set to begin again in November. Because the virus is most often spread through contaminated water, the influx of water to the country will increase the chances of transmission. Hopefully, as the outbreak grows in severity, the government and the public will respond with renewed vigor to improve the country’s infrastructure and bring the virus to an end.

Final thoughts

The current hepatitis E outbreak in Namibia is certainly concerning, but provides several opportunities for the country to improve its standards of living. By fixing the sanitation infrastructure and water systems, the spread of the virus will slow and the prosperity of citizens will increase. Addressing hepatitis E will also allow the country’s officials to reinforce health care systems against other, more deadly outbreaks.

– Borgen Project