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Fighting Hepatitis E in Am Timan, Chad - January 2017

MSF calls for assistance to curb hepatitis E outbreak in Am Timan

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N’djamena, Chad - A hepatitis E outbreak is escalating across Am Timan, in the Salamat region in southeastern Chad.

Since September, MSF has treated 885 patients with Acute Jaundice Symptoms (AJS), with numbers increasing to an average of around 60 new cases a week. AJS, which commonly causes a yellowing of the skin and eyes, can indicate that a person has hepatitis E. To-date, 70 patients have confirmed cases of hepatitis E (HEV RDT+) while 64 have been hospitalised, and 11 have died, including four pregnant women.

Hepatitis E is transmitted from one person to another, mainly through contaminated water and in areas where access to quality water is limited.

"MSF is calling on all the humanitarian and development agencies present in Chad to step up the size and speed of their efforts to ensure an effective response to the hepatitis E outbreak in Am Timan", says Rolland Kaya, MSF's head of mission in Chad. "More actors are needed to implement preventative actions including water sanitation, especially as cases are increasing in frequency across the Salamat Region, and not only in the city of Am Timan."

Following the identification of the first hepatitis E cases five months ago, MSF has repeatedly called on other organisations to collectively respond to this emergency. 

Up to now, the few responses delivered by other actors have been minimal in terms of quantity, quality and timelines. A more consistent intervention is urgently needed, especially in the domain of water and sanitation. Without an immediate scale-up of support from other agencies, and the government of Chad, MSF alone cannot contain this escalating outbreak.

"As a medical organisation, it is not usually MSF's job to intervene on a large scale in water chlorination activities, but with no other options to help stop the spread of the virus, we are obliged to fill this gap", says Rolland Kaya. "Once again, we encourage the Chadian Ministry of Public Health to declare the current hepatitis E outbreak an epidemic to enable an appropriate response."

Fighting Hepatitis E in Am Timan Hospital, Chad - January 2017
Keeping hands clean is important in preventing the spread of hepatitis E.  
Abdoulaye Barry

More than 600 MSF staff have been testing for new cases, treating patients and improving water supplies and sanitation in the city of Am Timan, including chlorinating the city water towers. Water chlorination is a major part of an emergency response to prevent outbreaks of waterborne diseases such as hepatitis E. 

In addition to the medical response in Am Timan hospital, MSF has rolled out a large-scale bucket chlorination campaign at the 72 water points within Am Timan town. Outreach staff are also holding education sessions to explain the importance of washing hands with soap and of using the chlorinated water at designated water points.

MSF has been working in Chad since 1981. Before the current hepatitis E outbreak, MSF had been running regular medical programmes in Am Timan and in Moissala. Earlier last year, MSF launched an emergency nutrition response in Bokoro where, in partnership with the Ministry of Health, MSF ran 15 mobile outpatient clinics and an intensive therapeutic feeding centre in Bokoro hospital to treat malnourished children. MSF also launched an emergency response in March 2015 in the Lake Chad region for people displaced due to violence by Boko Haram. Teams based in Baga Sola and Bol continue to provide assistance to the people around Lake Chad.