Division of Viral Hepatitis, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30333, USA.
Epidemiol Infect. 2012 May;140(5):767-87. doi: 10.1017/S0950268811002925. Epub 2012 Jan 25.
Space-time clustering of people who fall acutely ill with jaundice, then slip into coma and death, is an alarming phenomenon, more markedly so when the victims are mostly or exclusively pregnant. Documentation of the peculiar, fatal predisposition of pregnant women during outbreaks of jaundice identifies hepatitis E and enables construction of its epidemic history. Between the last decade of the 18th century and the early decades of the 20th century, hepatitis E-like outbreaks were reported mainly from Western Europe and several of its colonies. During the latter half of the 20th century, reports of these epidemics, including those that became serologically confirmed as hepatitis E, emanated from, first, the eastern and southern Mediterranean littoral and, thereafter, Southern and Central Asia, Eastern Europe, and the rest of Africa. The dispersal has been accompanied by a trend towards more frequent and larger-scale occurrences. Epidemic and endemic hepatitis E still beset people inhabiting Asia and Africa, especially pregnant women and their fetuses and infants. Their relief necessitates not only accelerated access to potable water and sanitation but also vaccination against hepatitis E.
时空聚集的人突然病倒黄疸，然后陷入昏迷和死亡，是一个令人震惊的现象，当受害者主要或完全是孕妇时，更为明显。对孕妇在黄疸爆发时的特殊、致命倾向的记录确定了戊型肝炎，并构建了其流行病史。在 18 世纪最后十年到 20 世纪初，主要来自西欧及其几个殖民地的报告了类似戊型肝炎的爆发。在 20 世纪后半叶，包括那些被血清学确认为戊型肝炎的报告，首先来自东地中海沿岸和南部，然后来自南亚和中亚、东欧以及非洲其他地区。这种传播伴随着更频繁和更大规模发生的趋势。在亚洲和非洲，特别是孕妇及其胎儿和婴儿，仍受到流行和地方性戊型肝炎的困扰。为了缓解这一问题，不仅需要加速获得饮用水和卫生设施，还需要接种戊型肝炎疫苗。
