Abstract
Objective Since 2005 there have been several reports of hepatitis B outbreak in the state of Kerala in southern India. Objective of this study was to analyze such outbreaks and to explore hypothesis pertaining the transmission mode. Methods Retrospective observational study involving cases of acute hepatitis B acquired between 1 January 2015 and 31 December 2015 and their family members residing in Mazhuvanoor village in Ernakulam district of Kerala State in southern India. Results 59 houses were included in the survey. The number of patients diagnosed to have acute viral hepatitis B was 59. Majority (66.10%) were over 50 years old. There were no cases below the age of 15 years. All 59 patients claimed to have been bitten frequently by a fly which was identified as “deer fly” belonging to the genus Chrysops. Conclusion Given the current understanding of mechanical transmission of pathogens in both humans and animals by insects belonging to the Tabanidae family which also includes Chrysops, it is plausible that the same mechanism may hold true for hepatitis B also. However this needs to be proven in further studies both at the laboratory level and at field studies.
Highlights
Hepatitis B infection is caused by a DNA virus, the hepatitis B virus (HBV)
Acute hepatitis B is marked by acute inflammation and hepatocellular necrosis, with a case fatality rate of 0.5–1% [2]
Chronic hepatitis B infection is defined as persistent HBV infection with or without associated active viral replication and indication of hepatocellular injury [2]
Summary
Hepatitis B infection is caused by a DNA (deoxyribonucleic acid) virus, the hepatitis B virus (HBV). HBV is the prototype member of the Hepadnaviridae family Members of this family of viruses have a narrow host range and predominantly infect hepatocytes in their respective hosts [1]. HBV infection can be either acute or chronic and may range from asymptomatic infection or mild disease to severe or rarely fulminant hepatitis [2]. Chronic hepatitis B infection is defined as persistent HBV infection with or without associated active viral replication and indication of hepatocellular injury [2]. Age plays an important role in chronic infection; risk of chronicity is more in neonates and young children than in infection that is acquired in adulthood. Risk of chronicity is 90% in neonates and 2060% in children under the age of 5 years while it is less than 5% when acquired in adulthood [3, 4]. Majority of people who have chronic hepatitis B acquired the infection at birth or in early childhood
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