Community-wide Outbreak of Hepatitis A Among an Indian Population in Oklahoma

Gildon, B; Makintubee, S; Gr, Istre

doi:10.1097/00007611-199201000-00004

Cited by 9 publications

(3 citation statements)

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“…Usually they persist for 6-18 months, until the pool of susceptible persons is exhausted. [293031] Control measures were intensified from the next day of reporting the current outbreak which included daily chlorination of wells for a week followed by weekly chlorination. The chlorination in pipeline was restarted on March 23 rd after interference from District Collector.…”

Section: Discussionmentioning

confidence: 99%

Investigating a community-wide outbreak of hepatitis A in India

Rakesh¹,

Sherin²,

Sankar³

et al. 2014

J Global Infect Dis

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Background:There was an outbreak of acute hepatitis in Mylapore village, Kollam district, Kerala, southern India during February to June 2013. An outbreak investigation was initiated with the objective of describing the epidemiological features of the hepatitis outbreak.Materials and Methods:House-to-house visits were undertaken to identify symptomatic cases. The outbreak was described in terms of person, place and time. Hypothesis was generated based on findings from descriptive study, laboratory investigation of water samples, and environmental observations. A case-control study was designed to test the hypothesis. Chi-square test, univariate analysis, and logistic regression to identify the risk factors associated with hepatitis A infection were done.Results:Line list generated consisted of 45 cases. Attack rate was the highest among the age group 15-24 years (4.6%) followed by 5-14 years (3.1%). The geographical distribution of the cases suggested a clustering around the water supply through the pipeline and epidemic curve showed a sharp rise in cases suggestive of a common source outbreak. Water samples collected form pipeline showed evidence of fecal contamination and absence of residual chlorine. In the case-control study, having consumed water from the pipeline (odds ratio: 9.01 [95% confidence interval: 2.16-37.61]) was associated with the hepatitis A cases.Conclusion:The time frame of disease occurrence, environmental observations, anecdotal evidences, laboratory results and results of the analytical study indicated the possibility of occurrence of hepatitis A outbreak as a result of pipe water contamination supplied from a bore well. The study warrants establishment of an efficient water quality surveillance system.

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Section: Discussionmentioning

confidence: 99%

Investigating a community-wide outbreak of hepatitis A in India

Rakesh¹,

Sherin²,

Sankar³

et al. 2014

J Global Infect Dis

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“…In many instances, the outbreaks of hepatitis A are cyclic, occurring approximately every 10 years. This cyclic pattern is thought to result from socioeconomic factors that promote transmission of disease and the periodic build-up of enough susceptible persons to maintain an epidemic [Gildon et al, 1992;Sorinson, 1996]. In Estonia, larger hepatitis A outbreaks occur roughly every 10 to 15 years.…”

Section: Discussionmentioning

confidence: 99%

Sequential changes in hepatitis A virus genotype distribution in Estonia during 1994 to 2001

Tallo

Nordér

Tefanova³

et al. 2003

Journal of Medical Virology

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Hepatitis A virus (HAV) isolates from a large outbreak and from non-outbreak cases in Estonia were characterized by sequencing the aminoterminal VP1 region. From January 1998 to December 1999, a total of 1084 cases of hepatitis A were reported to the Harjumaa-Tallinn and Ida-Virumaa Health Protection Services in Estonia. The attack rate was highest among males aged 15-29. Initial cases were noted to be associated with injecting drug use. IgM anti-HAV positive sera were available from 107 hospitalized outbreak cases and from 68 patients sampled during 1994 to 2001. HAV RNA was detected in 42% of sera from 1994-1996 and in 88% of sera from 1998-2001. It was possible to obtain HAV sequences from 83 outbreak and 29 background cases. The outbreak strain was represented by five different sequences, all belonging to subtype IIIA. During the outbreak, this IIIA strain also spread into the general population. All available non-outbreak isolates from 1994 to 2001 but one belonged to genotype IA and formed distinct clusters as compared to isolates from other parts of the world. One subtype IIIA isolate from 1995 was unrelated to the outbreak strain. Subtype IA had been dominating in Estonia during 1994-2001, but the outbreak strain from 1998 to 1999 was IIIA. This subtype was encountered previously in addicts in Sweden during the 1980s and in Norway at the end of the 1990s. This study supports the use of limited sequencing within the aminoterminal VP1 region for studying the molecular epidemiology of hepatitis A.

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“…Hepatitis A virus (HAV) infection is spread by fecaloral transmission and most disease occurs in the context of community-wide outbreaks [Shaw et al, 1986;Gildon et al, 1992;Desenclos and MacLafferty 1992;Henning et al, 1995;Smith et al, 1997 ]. Disease rates generally increase among all age groups, and although cases may occur among persons with selected risk factors (e.g., injecting drug use, men who have sex with men, children who attend day care), these risk groups generally do not account for the majority of cases [Bell et al, 1998].…”

Section: Introductionmentioning

confidence: 99%

Genetic relatedness of hepatitis A virus isolates during a community‐wide outbreak

et al. 2000

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In 1993-94, a community-wide outbreak of hepatitis A occurred in Stanislaus County, California. Stool specimens collected from a sample of 33 case patients were used to evaluate the duration of hepatitis A virus (HAV) excretion and the genetic relatedness of HAV isolates. Twenty-four percent of the patients had a stool sample positive for HAV antigen by enzyme immunoassay, whereas 91% had at least one stool positive for HAV RNA by RT-PCR amplification. Children were found to excrete low levels of HAV RNA for up to 10 weeks after the onset of symptoms. Analysis of the HAV VP1 amino terminus and VP1/P2A regions showed that a limited number of HAV isolates circulated during the epidemic and the majority of the cases were infected with the same strain.

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Community-wide Outbreak of Hepatitis A Among an Indian Population in Oklahoma

Cited by 9 publications

References 0 publications

Investigating a community-wide outbreak of hepatitis A in India

Investigating a community-wide outbreak of hepatitis A in India

Sequential changes in hepatitis A virus genotype distribution in Estonia during 1994 to 2001

Genetic relatedness of hepatitis A virus isolates during a community‐wide outbreak

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