Seroprevalence of hepatitis E virus (HEV) among united nations mission in haiti (UNMIH) peacekeepers, 1995

Information about the prevalence of HEV infection is sparse in many countries. Following the identification of four cases of acute HEV infection with jaundice among Bangladeshi soldiers whose battalion had recently deployed to Haiti as peacekeepers, a cross-sectional survey to determine the level of Ig to HEV was conducted to assess the prevalence of past infection with HEV among other UNMIH personnel and Haitian civilians. The ELISA antigen was HEV (Burma) capsid protein expressed in the baculovirus system. Of the 981 participants in the survey, 876 were soldiers from 8 UNMIH-participating countries representing Asia, Africa, and the Americas. The remaining 105 participants were Haitian civilians who had applied for local hire by the United Nations. The prevalence of HEV infection by country ( from highest to lowest) included Pakistan (66%), India (39%), Nepal (39%), Bangladesh (30%), Djibouti (16%), Guatemala (8%), Honduras (8%), Haiti (6%), and the United States (3%). The wide range of prevalences of HEV infection that we observed were remarkably consistent with those published from those countries in which HEV has been studied. Safe water and sanitation practices will help prevent HEV transmission among military and civilian travelers, and local populations alike as other countermeasures are being developed. Future multinational missions like the UNMIH present unique opportunities to study health threats of widespread interest.