A large outbreak of hepatitis E occurred in 2005 in Hyderabad, Andhra Pradesh, India. A total of 1611 cases were reported between 1 March and 31 December 2005 (attack rate 40/100 000). The epidemic curve suggested a continuing common source outbreak. Cases were centred around open sewage drains that crossed the old city. The attack rate was significantly higher in neighbourhood blocks supplied by water supply lines that crossed open drains (203/100 000) than in blocks supplied by non-crossing water pipes with a linear trend (38/100 000, P<0·00001). Crossing water pipelines were repaired and the attack rates declined.

Leptospirosis is an important public health problem in the Andaman Islands. The disease is being increasingly reported among children and adolescents in recent times. An attempt was made to find out the level of exposure to leptospires, to estimate the incidence of infection and to identity the risk factors for acquiring infection among children. A sample of 1544 schoolchildren was selected. Presence of anti-leptospiral antibodies was tested using the microscopic agglutination test (MAT). Students were interviewed for behavioural factors. In total, 341 (221 seronegative and 120 seropositive) students were followed up clinically and serologically during a subsequent outbreak. An overall seropositivity rate of 23·6% (95% CI 21·54–25·81) was observed. Infection rate was 33·5% among seronegatives whereas re-infection rate was 16·7% among seropositives during the outbreak that occurred 1 month after the first sample collection. Morbidity and mortality were found to be higher among seronegative individuals than serpositives, More than 90% of leptospiral infections were found to be subclinical or unnoticed. The high level of exposure among the children results in high infection rates and because they have less previous exposure than adults, they do not have sufficient protection to resist clinical illness during outbreaks.

Andaman and Nicobar Islands, Union Territory of India, is home to six primitive tribes. Preliminary serological studies carried out earlier among the four accessible tribes revealed that hepatitis B virus (HBV) infection is hyper-endemic among them. The present study was carried out to understand important modes of transmission and to identify possible risk factors associated with HBV infection among the Nicobarese tribe. The epidemiology of HBV infection in these islands appears to be distinct with a high prevalence of the chronic carrier state (22·2%) associated with a comparable proportion of the population being anti-HBs positive (26·3%). More than half of the HBsAg and anti-HBs negative individuals have anti-HBc antibodies. Age, past history of hospital admission, intramuscular injections and number of carriers in the tuhet were found to be significantly associated with exposure to hepatitis B virus. Horizontal transmission through close contact with carriers and perinatal route appears to be an important mode of transmission of HBV in this community. Besides this, use of unsafe injections represents an independent risk factor for acquiring HBV infection in this population. Introducing HBV vaccine in the infant immunization programme and improving injection safety would help to control the infection in the tribal community of these islands.

The Andaman islands were known to be endemic for leptospirosis during the early part of the century. Later, for about six decades no information about the status of the disease in these islands was available. In the late 1980s leptospirosis reappeared among the settler population and several outbreaks have been reported with high case fatality rates. Besides settlers, these islands are the home of six primitive tribes of which two are still hostile. These tribes have ample exposure to environment conducive for transmission of leptospirosis. Since no information about the level of endemicity of the disease among the tribes is available, a seroprevalence study was carried out among all the accessible tribes of the islands. A total of 1557 serum samples from four of the tribes were collected and examined for presence of antileptospiral antibodies using Microscopic Agglutination Test (MAT) employing 10 serogroups as antigens. An overall seropositivity rate of 19·1% was observed with the highest rate of 53·5% among the Shompens. The seropositivity rates in the other tribes were 16·4% among Nicobarese, 22·2% among the Onges and 14·8% among the Great Andamanese. All of the tribes except the Onges showed a similar pattern of change in the seroprevalence rates with age. The prevalence rates were rising from low values among children to reach a peak in those aged 21–40 years and then declined. Among Onges the seroprevalence rates continued to rise beyond 40 years. In all the tribes, seroprevalence rates were found to be significantly higher among the males. The commonest serogroups encountered were Australis followed by Grippotyphosa, Icterohaemorrhagiae, Pomona and Canicola.