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Suspected spread of hepatitis A virus from a restaurant among adults in rural area of the Kerala state, India

  • Y. K. Gurav (a1), G. Retheesh Babu (a1), K. P. Vinu (a2) and K. S. Lole (a1)

Abstract

India is experiencing a substantial decrease in early childhood exposure to hepatitis A virus (HAV). Kerala has experienced several hepatitis A outbreaks in young adults/adults in the recent past. The current hepatitis outbreak occurred in Nellikuzhi, Kerala state, India in December 2016. Investigation was carried by preparing a line list of suspected hepatitis cases. The blood and stool samples collected from patients were tested for anti-HAV/anti-Hepatitis E virus (HEV) immunoglobulin (IgM) antibodies and RNA respectively. A total of 562 suspected hepatitis cases were reported during the outbreak. Along with the first case (35 years, male), 86.1% (484/562) of the cases gave history of consuming food/water/cold drinks from one restaurant. Anti-HAV IgM positivity was 74.5% (73/98) in tested samples and amongst the positives, 81% were adults/young adults and adolescents. None of the samples tested positive for anti-HEV IgM. There were three HAV associated deaths without any co-morbidity. Sequence analysis of HAV RNA positive stool samples showed the presence of genotype IIIA HAV. The suspected source of the infection was a private well situated in the premise of a restaurant. Considering increasing HAV naive population in Kerala, there is a need to introduce hepatitis A vaccine in high-risk age groups.

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Copyright

This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.

Corresponding author

Author for correspondence: K. S. Lole, E-mail: lolekavita37@yahoo.com

References

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1.Koff, RS (1992) Clinical manifestations and diagnosis of hepatitis A virus infection. Vaccine 10(Suppl 1), S15S17.
2.Arankalle, VA et al. (2006) Molecular characterization of hepatitis A virus from a large outbreak from Kerala, India. The Indian Journal of Medical Research 123, 760769.
3.Kumar, T et al. (2015) Viral hepatitis surveillance-India, 2011–2013. Morbidity and Mortality Weekly Report 64, 758762.
4.Rakesh, PS and Sreelakshmi, MK (2017) 84 outbreaks of Hepatitis A in last five years in Kerala state-are we resigning to fate? National Journal of Research in Community Medicine 6, 267270.
5.Rakesh, PS et al. (2014) Investigating a community-wide outbreak of hepatitis A in India. Journal of Global Infectious Diseases 6, 5964.
6.Raveendran, S et al. (2016) Investigation of an outbreak of hepatitis A in a coastal area, Kerala, Southern India. Journal of Primary Care & Community Health 7, 288290.
7.Arankalle, V et al. (2007) Evaluation of human (genotype 1) and swine (genotype 4)-ORF2-based ELISAs for anti-HEV IgM and IgG detection in an endemic country and search for type 4 human HEV infections. Journal of Viral Hepatitis 14, 435445.
8.Rakesh, PS et al. (2018) Investigating a community wide outbreak of hepatitis A in Kerala, India. Journal of Family Medicine and Primary Care 7, 15371541.
9.Rakesh, PS et al. (2017) Do we need to consider universalising the hepatitis A vaccine in Kerala, India? Journal of Health Systems 2, 12.
10.Rakesh, PS et al. (2017) Out-of-pocket expenditure due to hepatitis A disease: a study from Kollam district, Kerala, India. The Indian Journal of Medical Research 146, 426429.
11.Arankalle, VA (2004) Hepatitis A vaccine strategies and relevance in the present scenario. The Indian Journal of Medical Research 119, iiivi.
12.Mathur, P and Arora, N (2008) Epidemiological transition of hepatitis A in India: issues for vaccination in developing countries. The Indian Journal of Medical Research 128, 600704.
13.Minutes of the meeting of the National Technical Advisory Group on Immunization, India, Ministry of health and Family Welfare, Government of India, Nirman Bhavan, New Delhi, December 9, 2016.
14.Parashar, D, Khalkar, P and Arankalle, V (2011) Survival of hepatitis A and E viruses in soil samples. Clinical Microbiology and Infection 17, E1E4.
15.Barde, P et al. (2014) Circulation of hepatitis A genotype IIIA virus in paediatric patients in central India. The Indian Journal of Medical Research 139, 940944.
16.Chobe, L and Arankalle, V (2009) Investigation of a hepatitis A outbreak from Shimla, Himachal Pradesh. The Indian Journal of Medical Research 130, 179184.
17.Gurav, YK et al. (2015) Outbreak of hepatitis A in an orphanage in Pune city, India. International Journal of Tropical Medicine and Public Health 5, 14.
18.Chadha, M et al. (2009) Outbreaks of hepatitis A among children in western India. Transactions of the Royal Society of Tropical Medicine & Hygiene 103, 911916.
19.Acharya, S et al. (2006) Viral hepatitis in India. The National Medical Journal of India 19, 203217.
20.Hussain, Z et al. (2006) Increasing trend of acute hepatitis A in north India: need for identification of high-risk population for vaccination. Journal of Gastroenterology and Hepatology 21, 689693.
21.Sharma, A et al. (2016) Upsurge in vaccine preventable hepatitis A virus infection in adult patients from a tertiary care hospital of North India. International Journal of Infectious Diseases 45, 457.
22.Das, K et al. (2000) The changing epidemiological pattern of hepatitis A in an urban population of India: emergence of a trend similar to the European countries. European Journal of Epidemiology 16, 507510.
23.Andre, F (2006) Universal mass vaccination against hepatitis A. In: Mass Vaccination: Global Aspects-Progress and Obstacles. Current Topics in Microbiology and Immunology 304, 95114.

Keywords

Suspected spread of hepatitis A virus from a restaurant among adults in rural area of the Kerala state, India

  • Y. K. Gurav (a1), G. Retheesh Babu (a1), K. P. Vinu (a2) and K. S. Lole (a1)

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