1. An outbreak of fulminant hepatitis delta in the Waorani, an indigenous people of the Amazon basin of Ecuador.
- Author
-
Manock SR, Kelley PM, Hyams KC, Douce R, Smalligan RD, Watts DM, Sharp TW, Casey JL, Gerin JL, Engle R, Alava-Alprecht A, Martínez CM, Bravo NB, Guevara AG, Russell KL, Mendoza W, and Vimos C
- Subjects
- Adolescent, Adult, Child, Child, Preschool, Ecuador epidemiology, Ethnicity statistics & numerical data, Female, Hepatitis Antibodies blood, Hepatitis B Surface Antigens blood, Hepatitis D complications, Hepatitis Delta Virus genetics, Humans, Infant, Liver Failure etiology, Male, Middle Aged, RNA, Viral blood, Disease Outbreaks, Hepatitis D epidemiology, Hepatitis Delta Virus immunology, Liver Failure epidemiology
- Abstract
An outbreak of delta hepatitis occurred during 1998 among the Waorani of the Amazon basin of Ecuador. Among 58 people identified with jaundice, 79% lived in four of 22 Waorani communities. Serum hepatitis B surface antigen (HBsAg) was found in the sera of 54% of the jaundiced persons, and 14% of asymptomatic persons. Ninety-five percent of 105 asymptomatic Waorani had hepatitis B core (HBc) IgG antibody, versus 98% of 51 with jaundice. These data confirm that hepatitis B virus (HBV) infection is highly endemic among the Waorani. Sixteen of 23 (70%) HBsAg carriers identified at the onset of the epidemic had serologic markers for hepatitis D virus (HDV) infection. All 16 were jaundiced, where as only two of seven (29%) with negative HDV serology were jaundiced (P = .0006). The delta cases clustered in families, 69% were children and most involved superinfection of people chronically infected with HBV. The data suggest that HDV spread rapidly by a horizontal mode of transmission other than by the sexual route.
- Published
- 2000
- Full Text
- View/download PDF