Coursaget P, Buisson Y, Enogat N, Bercion R, Baudet J M, Delmaire P, Prigent D, Desramé J
Institut de Virologie de Tours and Laboratoire d'Immunologie des Maladies Infectieuses, Faculté de Pharmacie, Tours, France.
J Hepatol. 1998 May;28(5):745-50. doi: 10.1016/s0168-8278(98)80222-5.
BACKGROUND/AIMS: One hundred and eleven patients with acute hepatitis and 61 controls were investigated for hepatitis serological markers in order to determine the viral etiology of cases involved in a waterborne epidemic of hepatitis observed in 1993 in Djibouti, Republic of Djibouti (East Africa). These cases occurred both in indigenous Djiboutians, and in French soldiers and their families in Djibouti. A retrospective study of the viral etiology of acute hepatitis cases observed in French soldiers and relatives living in Djibouti during the 3-year period preceding the epidemic was also undertaken.
HAV, HBV and HCV infections were investigated using commercial ELISA tests. HEV infections were investigated by testing IgG and IgM-specific antibodies by means of three different ELISA tests using recombinant proteins or synthetic peptides.
Hepatitis A was observed in 37 (33%) and hepatitis E in 43 (39%) of the 111 cases of acute hepatitis recorded during this epidemic. Hepatitis B represented only 6% of the indigenous cases and hepatitis C was not observed among the cases investigated. Anti-HEV IgG antibodies were also detected in 19% of the indigenous control group.
These results suggest that both HAV and HEV were responsible for this waterborne epidemic of acute hepatitis. However, HAV and HEV infections were not equally distributed between French expatriates and Djibouti residents. Whereas HAV infections were mainly observed in French patients, HEV was almost exclusively found in indigenous patients. This study reports for the first time a waterborne outbreak of acute hepatitis simultaneously due to HAV and HEV.
背景/目的：对111例急性肝炎患者和61名对照者进行肝炎血清学标志物检测，以确定1993年在吉布提共和国（东非）发生的一次水源性肝炎疫情中所涉病例的病毒病因。这些病例既发生在当地的吉布提人身上，也发生在驻吉布提的法国士兵及其家属身上。还对疫情发生前3年期间在吉布提生活的法国士兵及其亲属中观察到的急性肝炎病例的病毒病因进行了回顾性研究。
采用商用酶联免疫吸附测定（ELISA）检测甲型肝炎病毒（HAV）、乙型肝炎病毒（HBV）和丙型肝炎病毒（HCV）感染情况。采用三种不同的ELISA检测方法，利用重组蛋白或合成肽检测戊型肝炎病毒（HEV）特异性IgG和IgM抗体，以调查HEV感染情况。
在此次疫情记录的111例急性肝炎病例中，37例（33%）为甲型肝炎，43例（39%）为戊型肝炎。乙型肝炎仅占当地病例的6%，在所调查的病例中未观察到丙型肝炎。在19%的当地对照组中也检测到抗HEV IgG抗体。
这些结果表明，HAV和HEV均为此起水源性急性肝炎疫情的病因。然而，HAV和HEV感染在法国侨民和吉布提居民中的分布并不相同。HAV感染主要见于法国患者，而HEV几乎仅见于当地患者。本研究首次报告了由HAV和HEV同时引起的水源性急性肝炎暴发。
