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Hepatitis E outbreak in Chittagong city

  • Published at 09:14 pm June 27th, 2018
  • Last updated at 05:20 pm June 28th, 2018
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Chittagong Civil Surgeon Dr Azizur Rahman Siddiqui briefing the media at his office on Wednesday, June 27, 2018 on the outbreak of Hepatitis E in the city’s Halishahar area Dhaka Tribune

As many as 178 people in the city’s Halishahar area are infected with the virus

An outbreak of Hepatitis E virus in Chittagong city's Halishahar area for the last two months has put the lives of citizens at high risk.

According to Chittagong’s Civil Surgeon, Dr Azizur Rahman Siddiqui, as many as 178 people in Halishahar have been found infected with the virus so far, a situation that has spread mass panic among the 800,000 residents of the area.

At least three people have also reportedly died in that area following the recent outbreak.

A team from the Institute of Epidemiology, Disease Control, and Research (IEDCR) came to the port city from Dhaka on Wednesday to investigate the deaths.

The disease is a viral hepatitis (liver inflammation) caused by a viral infection of Hepatitis E, one of five known human hepatitis viruses. It’s a positive-sense, single-stranded, non-enveloped, and RNA icosahedral virus, and has a faecal-oral transmission route.

However, Dr Azizur told the Dhaka Tribune, “The infection rate has decreased. Earlier, 20-25 people were getting infected every day, but now it has come down to two to three.”

“But we are gravely concerned since three deaths from the outbreak have been reported. We are taking the matter seriously and trying to determine whether they actually died from Hepatitis E,” he said.

He added that they were collecting water samples from the affected area for tests. “Our investigation will parallel IEDCR’s,” Azizur said.

Measures taken

Regarding preventive measures, the civil surgeon said: “We have already distributed 300,000 water purifying pills among people of the affected area and distributed 50,000 leaflets warning against drinking unsafe water.”

“Apart from that, 50,000 sachets of oral saline have also been distributed among locals. We are also using loudspeakers to warn them of the outbreak,” he said.

He said they have also earmarked 100 beds at the Bangladesh Institute of Tropical and Infectious Diseases (BITID) at Fouzderhat to treat people affected by water-borne diseases.

Reason for the outbreak

Dr Azizur said water was the main cause behind this latest outbreak of Hepatitis E virus in the city.

“The Directorate General of Health Services (DGHS) is not tasked with supplying pure and safe water. We have already talked to Chittagong City Corporation Mayor AJM Nasir Uddin and he has assured us about taking all necessary steps in this regard,” he added.

The notice from the Chittagong Civil Surgeon's Office for the residents of Halishahar area on taking measures to protect themselves from water-borne diseases | Collected

The civil surgeon also said the viral disease was not life-threatening in every case, but in the case of pregnant women, the death to life ratio is considerably high at 5:1.

“We have directed all private and public hospitals in Chittagong to keep a record of people getting admitted with the Hepatitis E virus and then to report it to the Civil Surgeon’s office,” he added.

Meanwhile, while talking to the Dhaka Tribune, Chittagong Water Supply and Sewerage Authority’s (Wasa) Managing Director AKM Fazlullah assured citizens that the disease outbreak was not caused by the water supplied by them.

“However, we have already collected 38 water samples from different spots of the affected city areas and are testing them in our lab. We have also sent some water samples to the Bangladesh Council of Scientific and Industrial Research for testing,” he said.

Fazlullah said: “Halishahar is one of the low-lying areas of the city. The area is always inundated following heavy rains and tidal water intrusion. We think the stagnant polluted water has infected the underground water reservoirs in the area.”

“There is no chance of contamination of the water we supply as it gets purified in several stages. However, we are advising citizens to drink water after boiling, just to be safe,” he added.

Chittagong Wasa authorities in a post on its Facebook page Wednesday night also claimed that no trace of Hepatitis B or E viruses was found in the water they supply during tests.

‘Not a pandemic yet’

Civil surgeon Dr Azizur, however, was bombarded with questions by reporters over delayed response from the DGHS to the Hepatitis E outbreak at a press briefing in his office Wednesday evening.

Fending off the criticisms, he said a five-member IEDCR team had collected samples of blood from the patients and water from the affected Halishahar area when the disease first broke out two months ago.

He hinted that those samples had contained Hepatitis E virus. “At that time, Hepatitis E virus was found in the blood samples. But the higher authorities did not provide me with the test results of the water samples.

“I was asked not to meddle with those results as it could put the DGHS and Chittagong Wasa on a collision course,” Azizur said.

Urging the Wasa authorities to visit the affected area, he said the overhead and underground water reservoirs there should be cleaned up on a regular basis.

IEDCR team member Dr Abdullah Hil Maruf Faruqui and Dr Selim Akter Chowdhury, the chief medical officer of Chittagong City Corporation (CCC), were also present at the press briefing.

Selim claimed the disease was yet to turn into an epidemic. “A CCC medical team has been monitoring the outbreak and there is nothing to feel panicked about.”