The vaccine has previously been used on an individual basis in China, where it is licensed and used to vaccinate travellers
Health workers in South Sudan have carried out a historic vaccination campaign in response to an outbreak of hepatitis E, raising hopes in the fight against a disease that is especially fatal for pregnant women.
Hepatitis E is the most common cause of acute viral hepatitis, causing approximately 20 million infections and 44,000 deaths per year. It is transmitted through fecal contamination of food and water.
Large-scale outbreaks typically occur when water and sanitation are inadequate, such as in mass displacement camps. There is no specific treatment for hepatitis E, which has a fatality rate of up to 25 per cent among pregnant women. It also increases the risk of spontaneous abortions and stillbirths.
“The fight against hepatitis E has been long and frustrating,” said Dr Monica Rull, Medical Director, Médecins Sans Frontières/Doctors Without Borders (MSF).
“Over the last two decades, MSF has been responding to hepatitis E outbreaks in displacement camps, trying to control the disease in challenging conditions and seeing the devastating impact on extremely vulnerable communities. With the experience of this vaccination campaign, we hope to change the way we tackle hepatitis E in the future.”
In March and April 2022, MSF and South Sudan’s Ministry of Health jointly carried out the first two rounds of the hepatitis E vaccination campaign in Bentiu internally displaced persons camp in South Sudan’s Unity state. Around 25,000 people, including pregnant women, have received the vaccine. A third and final round will be conducted in October 2022.
Bentiu is the largest displaced persons camp in South Sudan, created in 2014 at the height of the war. Today, approximately 112,000 people reside there, many having fled recent violence and flooding.
In 2021 extreme flooding and new influxes of displaced people exacerbated already deplorable living conditions, increasing the spread of waterborne illnesses, including hepatitis E. Since July 2021, in its Bentiu hospital MSF has seen 759 patients with confirmed hepatitis E, 17 of whom have died.
The Ministry of Health of South Sudan asked MSF to help its efforts to control the outbreak, through a large-scale vaccination campaign. The only available hepatitis E vaccine, Hecolin, has been shown in clinical trials to be highly effective at preventing disease, and the World Health Organization has recommended that it be considered for use in outbreak responses since 2015.