Pregnant women in flood-hit areas under threat of Hepatitis E

• Women dying due to water-borne diseases, including Hepatitis E.
• Health officials, experts call for immediate inoculation in flood-hit areas.
• Around 42,000 pregnant women expected to give birth in next 3 months.

ISLAMABAD: Health officials and experts have urged to immediately initiate an inoculation drive for pregnant women and children in flood-hit areas as they are at risk of dying through several diseases — cholera, typhoid, Hepatitis E, and other preventable diseases — and can be saved through several vaccines available in the country.

“Women and children have started dying due to water-borne diseases, including cholera, typhoid, Hepatitis E and other vaccine-preventable diseases in the flood-affected areas. Fortunately, we have vaccines available in the country to prevent these diseases," Health Services Academy (HSA), Islamabad Vice Chancellor Dr Shahzad Ali Khan, told a group of health officials and stakeholders.

The vice-chancellor said that Hepatitis E is a water-borne endemic illness, which can cause acute liver failure, fetal loss and mortality among pregnant women.

Around 42,000 among 128,000 pregnant women are expected to give birth in the next three months in the flood-hit areas but due to Hepatitis E viral infection, which is an endemic water-borne disease, many of them are feared to lose their babies or even die themselves, experts warned.

Speaking at a dissemination meeting on Pakistan floods at the HSA — which was attended by officials from the National Institute of Health (NIH), Islamabad, infectious disease experts, gynaecologists, pharmacists and representatives from the pharmaceutical industry — Dr Khan said it was imperative to inoculate the flood-hit people.

“So, in addition to providing clean drinking water and food to people in the flood-hit areas, it is recommended that children and women be given vaccines to save them from cholera, typhoid and Hepatitis E outbreaks. It is also advisable to give Hepatitis E vaccine to thousands of pregnant women,” Dr Khan was reported as saying by The News.

Representatives of pharmaceutical firm Ferozsons, which has introduced the Hepatitis E vaccine in Pakistan, claimed the lives of pregnant mothers and their fetuses can be saved with the help of vaccines, including the Hepatitis E recombinant vaccine.

Stagnant flood waters, spreading over one-third of the country, may take up to six months to recede, increasing the risks of water-borne diseases such as Hepatitis E, malaria, dengue, and cholera.

The company representatives warned that lack of access to safe drinking, proper sanitation, resources and medical supplies, and overcrowding of camps of internally displaced persons (IDPs) increases the risks of outbreaks.

“Among all the potential outbreaks, Hepatitis E virus (HEV) outbreak is of great concern for pregnant women. HEV infection progresses to liver failure and ultimately causes death," said Dr Najeeb Muhammad, a representative of the pharmaceutical firm.

Miscarriages and neonatal deaths are common complications of HEV infection. The fatality rate among pregnant women may go as high as 15-20pc, whereas the fetal mortality rate can reach as high as 40pc,” he said.

Director ORIC at Health Services Academy, Prof Mubashir Hanif said all the available pharmaceutical and non-pharmaceutical interventions should be used to save lives.

Former surgeon general of Pakistan Army Lt Gen (retd) Dr Asif Mumtaz Sukhera, Dr Syed Batool Mazhar, Dr Mujeeb Ahmed from the Holy Family Hospital, Aamir Zafar from the Ferozsons, and other experts also spoke at the event.