Bile K, Isse A, Mohamud O, Allebeck P, Nilsson L, Norder H, Mushahwar I K, Magnius L O
Department of Medicine, Faculty of Medicine, Somali National University, Mogadishu.
Am J Trop Med Hyg. 1994 Oct;51(4):466-74.
In early 1988, an increased incidence of acute hepatitis was observed in villages along the Shebeli River in the Lower Shebeli region of Somalia. This was followed by a large epidemic that lasted until late 1989. In a survey of 142 villages with a population of 245,312 individuals, 11,413 icteric cases were recorded, of which 346 died, corresponding to an attack rate and a case fatality rate of 4.6% and 3.0%, respectively. The etiologic role of hepatitis E virus (HEV) in this epidemic was proven by demonstrating anti-HEV in 128 of 145 sampled cases as a sign of recent infection with HEV. In three villages, where a special study protocol was implemented, the attack rate was found to increase significantly with age from 5% in the group 1-4 years of age to 13% in the group 5-15 years of age and to 20% for persons older than 15 years of age. Among cases 20-39 years of age, the female-to-male ratio was 1.5:1, which was a significant predominance of females. As in other hepatitis E outbreaks, there was a high fatality rate in pregnant females, estimated to be 13.8%. The epidemic peaked with the rise in the level of the river during rainfall, suggesting that the disease was waterborne. The attack rate was higher (6.0%) in villages supplied with river water, while fewer cases were recorded in those relying on wells or ponds for their water supply, 1.7% and 1.2%, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)
1988年初，索马里下谢贝利地区谢贝利河沿岸村庄的急性肝炎发病率上升。随后出现了一场大规模疫情，一直持续到1989年末。在对142个村庄、245312人的调查中，记录到11413例黄疸病例，其中346人死亡，发病率和病死率分别为4.6%和3.0%。通过在145例抽样病例中的128例检测到抗戊型肝炎病毒（HEV），证明了HEV在此次疫情中的病因作用，这是近期感染HEV的迹象。在实施了特殊研究方案的三个村庄中，发病率随年龄显著增加，1-4岁组为5%，5-15岁组为13%，15岁以上人群为2
