A questionnaire regarding the onset of acute jaundice among expatriate staff while working in eastern Sudan refugee camps during 1985 has been distributed to 17 agencies involved. In addition, epidemiologic and clinical data are still being collected. N Aziz, MBBS, Sudan Commission on Refugees Health Unit. Frequently, large outbreaks have been linked to a fecally contaminated water source or have occurred after heavy rains in areas without systems for adequate sewage disposal. Clinical disease is common among adults, but infrequent among children.
Pregnant women have a dramatically high mortality rate.
The majority of patients who are not pregnant recover completely, and there is no evidence of chronic liver disease as a long-term sequela. In an outbreak situation, emphasis must be placed on preventing transmission. Water sources should be examined for fecal contamination. If the water supply is contaminated, all water should be boiled or chlorinated before consumption. The efficacy of IG from endemic areas is unknown.