Pregnant women at risk after earthquake

SURVIVORS of the recent earthquake that destroyed parts of Nepal face a “very high” risk of a hepatitis E outbreak during the coming monsoon season.

Infectious disease experts warn any outbreak of hepatitis E could be especially deadly for pregnant women.

The document, published in The Lancet, says conditions in the April tremor that killed 8800 people and injured more than 23,000 have left conditions ripe for the hepatitis E virus (HEV), which is primarily spread from faeces to mouth via contaminated water.

Some 500 pregnant women could die from the virus in the coming months and many more could fall i l l, the researchers say.

“Ear thquake-affected areas are faced with a ‘perfect storm’ of risk factors: large displaced populations with limited access to clean drinking water, lack of sanitary facilities, the approaching monsoon, overburdened healthcare infrastructure, large amounts of circulating HEV, and an at-risk population that mostly lacks protective antibodies,” say the experts, Alain Labrique of the Johns Hopkins Bloomberg School of Public Health, and six others.

There are an estimated 20 million hepatitis E infections in the world every year. While the virus can lead to liver disease, it mostly runs its course with few long-term complications. However, pregnant women have a mortality rate of 25 per cent when infected by it.

The researchers say there is a safe and effective vaccine available, but it is currently only licensed for use in China. The World Health Organisation has not recommended its routine use because there is a need for additional safety and efficacy data, particularly in pregnant women. It has also said, however, that its use should be “considered” in outbreaks such as this.

The researchers estimate more than 400 pregnant women could be saved if the vaccine were used in Nepal.