Epidemiological Investigation of Hepatitis E outbreak in a Northern city of India
Journal Title: Journal of Advanced Medical and Dental Sciences Research - Year 2017, Vol 5, Issue 8
Abstract
Background: Shimla city has been observing outbreak of hepatitis A/E every year since 2007. An unusual rise in the number of jaundice cases was reported in the first fortnight of December 2015. Objectives: To study the distribution and determinants of hepatitis cases, to find the source of infection, and to initiate the control measures in the affected area. Materials and Methods: A case of acute hepatitis was defined as a person who had acute jaundice with at least one of the following symptom: dark urine, anorexia, malaise, fatigue and right upper quadrant tenderness between December 2015 and March 2016. Line listing of cases was done and analyzed according to time, place, and person distribution. Blood samples were tested for IgM antibody for hepatitis A & E virus. Water samples were also collected for the bacteriological examination and residual chlorine. Results: A total of 6080 cases (attack rate 35.9/1000) were reported in this outbreak. 1132 serum sample were found positive for HEV IgM antibodies out of 1988 samples tested randomly, which confirmed a hepatitis E outbreak. The attack rate was significantly higher in males (P < 0.05) and in age groups 25-34 years (P < 0.001). Case fatality rate was found to be 0.4% among general population and 21% among pregnant females. Extensive IEC was done through electronic and print media. More than one lakh chlorine tablets were distributed. Environmental investigation confirmed sewage contamination of drinking water. All 6 STP were found to be working sub optimally. Ineffective chlorination was found at all 4 WTP. The relative risk of developing hepatitis E among people using contaminated water supply against those using other sources was 5.68 (95% CI 4.81 , 7.14). Conclusion: HEV was confirmed as the major etiological agent in this outbreak which was transmitted by contaminated drinking water.
Authors and Affiliations
Anita Thakur, Ranjana Rao, Amit Sachdeva
Keywords
Related Articles
- EP ID EP560976
- DOI -
- Views 131
- Downloads 0
UNILATERAL MASSETER HYPERTROPHY WITH UNUSUAL TWITCHING – A CASE REPORT
Masseteric Hypertrophy is a relatively uncommon condition that can occur unilaterally or bilaterally. Pain may be a symptom, but most frequently a clinician is consulted for cosmetic reasons. In some cases prominent exos...
DISPLACED FRACTURES OF GREATER TUBEROSITY OF HUMERUS: OUTCOMES AND COMPLICATIONS AFTER OPEN REDUCTION AND INTERNAL FIXATION
Background: Humerus fractures account for 5% to 8% of total fractures. Non-union and delayed union of Greater Tuberosity (GT) fractures though uncommon but presents a challenge to the orthopedic surgeons. Substantial dis...
Evaluation of Retention of Different Attachment System used in Implant Retained Overdenture
Background: Dental implants are widely used nowadays. The most common problem associated with the management of edentulous patients is the severely resorbed mandibular ridge, especially in older age when adaptive capacit...
Comparative Study Evaluating the Action of MTA and Calcium Hydroxide in Endodontic Treatment
Background: An inappropriate filling while obturation results in re-entry and re-invasion of microorganisms into the root canal system that irritates the periapical area and compromises the success of treatme...
Outcome of Intracapsular Humerus Fracture Fixation Using Triceps Sparing Paratricipital Approach
Background: Fractures of the proximal humerus represent 4% to 5% of all fractures. Various methods of stabilization are reported in the literature.Hence; we planned the present study to assess the outcome of Intracapsula...