Hepatitis - Bulgaria : HAV identified

International Society for Infectious Diseases
<http://www.isid.org>

Source: Sofia Echo [edited]
< http://www.sofiaecho.com/article/hepatitis-infection-in-bulgarias-plovdiv/id_17486/catid_5>


Hepatitis infection in Bulgaria's Plovdiv Region
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By 4 Sep [2006], a total of 607 people in the Plovdiv region were
reported as infected with the hepatitis A virus. Four hundred
seventy-seven of them came from the Stolipinovo and Sheker Mahala
Roma quarters of Plovdiv. Most of the infected were Roma children and
teenagers, according to Plovdiv Regional Inspectorate for Protection
and Control of Public Health (PRIPCPH) data.

Immunisation in the affected areas will probably start only in the
last 10 days of September [2006], even though vaccinations for about
12 400 Plovdiv children were provided on 9 Aug [2006]. The Health
Ministry has started a public procedure to choose an immunisation supplier.

The procedure would end soon after 11 Sep [2006], the ministry said.
Hepatitis has a 20- to 50-day incubation period. It takes about 15-20
days for a person to rebuild his or her immunity after immunisation.
This means that actual results would only take effect in mid-October,
the Health Ministry said.

The hepatitis infection broke out in July. Director of the PRIPCPH,
doctor Ani Eginlian, declared it an epidemic on 30 Aug [2006].

Scores of people have been coming to the Plovdiv hospital of Sveti
Georgi (Saint George) and hospitals in the surrounding towns every
day. On 4 Sep [2006], 29 were registered. The week of 20 Aug [2006],
258 people in the whole country became infected, as opposed to 169 in
the previous week, the Health Ministry said. 83 of the 258 came from
Stolipinovo.

On 7 or 8 Sep [2006], representatives of the Iztok and Sever
municipalities of Plovdiv (where Stolipinovo and Sheker Mahala are),
the PRIPCPH, surrounding villages and the Plovdiv branch of the
Bulgarian Red Cross (BRCP) were to meet to co-ordinate their efforts
to prevent a further outbreak of the disease, a BRCP official told
The Sofia Echo. At the moment, things were still at a stage when
precise needs were being evaluated, the official said.

All parents of Roma children have otherwise received invitations for
immunisation, the head of the Health Ministry department for
supervising infectious diseases, Angel Kunchev, told Bulgarian news
agency BTA. Children whose parents did not agree to vaccinations
would not be vaccinated, he said.

Immunisation has been dogged by doctor protests also. Doctors were
not refusing to vaccinate, according to an 31 Aug [2006] declaration
sent by doctors to the Health Ministry, Plovdiv municipal
institutions and state institutions. Rather, they wanted precise
immunisation schedules, corresponding payment arrangements and
separate immunisation rooms to prevent infecting other patients, BTA said.

The Health Ministry provided the schedules and was arranging
additional medical teams to aid the vaccination process. The teams
would come from the ministry, PRIPCPH and neighbouring regions.

On 1 Sep [2006], the PBRC committee gave 150kg of washing powder to
100 families in Plovdiv's Stolipinovo and Sheker Mahala.

The donation came from the Italian and Swiss Red Crosses. The Labour
and Social Policy Ministry also gave about 8 500 packs of soap and
wet wipes to Stolipinovo residents on 9 Aug [2006]. These cost about
10 000 leva, BTA said.

The Cabinet decided to give an additional one million leva [USD 649
182] to sanitise Stolipinovo, Health Minister Radoslav Gaidarski said
on 29 Aug [2006]. Stolipinovo had not been cleaned up for years. The
clearing of about 40 tons of refuse, which at places rose a metre
high, only started on 30 Aug [2006], but refuse was now being cleared
regularly. Shops and cafes in the two Roma quarters were also to be
regularly inspected, as were all affected areas in the region.

The areas between housing blocks in Stolipinovo should be drained and
asphalted, and their inhabitants should be brought out of there,
Gaidarski said. The municipality recently started demolishing illegal
wood and tin makeshift Roma houses as a measure to prevent infection.

The actual problem, however, was not illegal dwellings, but lack of a
sewerage system and running water, Stolipinovo inhabitants told
weekly paper Kapital. Refuse water had, so far, been poured into the
basements of surrounding housing complexes, and clean running water
would sometimes not reach beyond the second floor of housing complexes.

Health measures would not be enough to fight hepatitis, Gadiarski
said. Unless living conditions in the Roma quarters changed, the
epidemic would repeat itself in five years, Kunchev told BTA.