Hepatitis E is the most common cause of life-threatening acute hepatitis, causing approximately 20 million infections and 44,000 deaths each year.Since 2012, there is a vaccine (Hecolin) to prevent it.And, since 2015, the World Health Organization (WHO) recommends considering its use to respond to epidemic outbreaks of this disease, which is particularly deadly for pregnant women.However, this 2022 has been the first time that it has been used, when the South Sudanese authorities, together with Doctors Without Borders (MSF), have carried out the first global immunization campaign in response to an outbreak of this disease. .Thus, 25,000 people, including pregnant women, have received, between March and April, the first two doses in the Bentiu displaced persons camp, the largest in the country, the medical and humanitarian organization reported last Thursday.The third and final round will take place in October.All the experts consulted agree that this is good news.Researcher Antonio Rivero, a pioneer in the study of hepatitis E, explains that, until now, Hecolin had only been used individually in China, the only place where it is produced and marketed and where it is used to vaccinate travelers.“For me, it makes sense to use it in the Bentiu field.Especially in the most vulnerable people, such as children, the elderly, cirrhotic or immunocompromised patients, and pregnant women.Those with a higher mortality rate.We have a vaccine that is safe, let's use it!” declares Rivero.The researcher recognizes, however, that, although it is advisable to get immunized, the cases would decrease a lot with a correct treatment of the water, since they are the genotypes 1 and 2 of the hepatitis E virus, transmitted by this means (HEV), the causing epidemics in Africa and Asia.As the infection is spread through faecal contamination of water and food, hatches often result from situations where sanitation conditions are inadequate.Robin Nesbitt, MSF Switzerland epidemiologist and coordinator of the vaccination campaign in the Bentiu camp, defines the symptoms (fever, nausea and vomiting, loss of appetite, pain in the upper abdomen over the liver, darker colored urine , lighter colored stools, and a key feature: yellowish eyes and skin, which is called jaundice) and also the consequences.In most cases, she says, the body can fight off the infection and the virus goes away, but in some it can be severe, leading to fulminant hepatitis that can be fatal.In addition, she points out: “If the vaccine has not been injected so far, it is due to lack of interest.Hepatitis E is a disease of very poor people, who live in very unfavorable conditions.It is not interesting to study it, or treat it...”.For María Buti, a hepatologist, the data from the campaign is “very good news”.At the moment, she explains, people between 16 and 45 years old have been vaccinated.The new cases collected are in children, which, in the absence of the new figures – which will be analyzed after the third dose – means that it does protect.Buti insists on the importance of inoculating pregnant women, whose mortality rate is 25%.Almost 1,000 have already been immunized in this campaign, and it is expected to reach up to 3,000.Bentiu is the largest camp for displaced people in South Sudan, and was created in 2014 at the height of the war.Approximately 112,000 people currently live there, many of them having fled recent outbreaks of violence and flooding.MSF has been present since its inception and has seen hepatitis E epidemics since 2015, stemming from dire living conditions, including lack of adequate access to water, sanitation and hygiene.In 2021, extreme flooding and new arrivals of displaced people exacerbated already dire circumstances, also increasing the spread of waterborne diseases, including hepatitis E. Since July 2021, MSF has seen 759 patients with confirmed cases in its hospital in Bentiu, 17 of whom died.Nyemal is 22 years old, lives in Bentiu with his family, and is positive for hepatitis E. For him, improving water and sanitation services is just as important as vaccination.“The environment here is not clean at all, the bathrooms are full and not well covered.I would like them to be emptied before they are completely full or a new one dug.Because the flies go from the toilets to the homes, and if they are dirty, it is not safe for them to land on our food and drinking water, ”he laments in a testimony collected by MSF.Nyasunday, 19, has also lived in the camp since 2014, and is also positive for hepatitis E. Like Nyemal, she complains about the water and sanitation conditions in the camp: “The toilets are not good because people use them. use very poorly.If you go to the bathroom and don't watch where you're stepping, you might step on urine or feces."Although other control measures, including improving water and sanitation services, are also needed, health authorities believe that this vaccination campaign is a fundamental step towards reducing the burden of hepatitis E in the future.The Director General of Preventive Health Services at the South Sudan Ministry of Health, John Rumino, sees it as a role model: “Given the successful implementation and enthusiastic community response in the first two rounds, this innovative campaign of Vaccination can serve as an example and be replicated in similar contexts to control hepatitis E epidemics.”All the experts consulted agree.“I hope that this will serve so that, in the event of outbreaks of this disease, countries act sooner.In this way, unnecessary infections and deaths would be avoided,” adds Nesbitt, from MSF Switzerland.You can follow PLANETA FUTURO on Twitter, Facebook and Instagram, and subscribe to our 'newsletter' here.Or subscribe to read without limitsSubscribe and read without limits