Abstract
This is a review article on jaundice outbreak occurred in <i>Biratnagar</i> during April-July 2014. The study reviewed the reports on hepatitis outbreak presented by District Public Health Officer Morang during a seminar organized by Nepal Health Research Council (NHRC), District Disaster Management Committee (DDMC) meetings and HMIS (Health Management Information System) database. District Public Health Office (DPHO) recorded 2,789 Jaundice patients in Morang district including <i>Biratnagar</i> city. Most of the patients (80.67%) recorded from <i>Biratnagar</i>. In the outbreak sex ratio of female to male was 0.56:1. Hepatitis infection was highest among 15-29 age groups and noticed remarkable among 15 to 54 years age groups. District Disaster Management Committee declared the outbreak in <i>Biratnagar</i> on April 28 when 95 jaundice patients recorded in the hospitals. The number reached at peak level 176 patients on May 6 and the trend came downward to normal level on July 8, 2014. Total 12 deaths recorded in the outbreak. Of them 8 deaths recorded from <i>Biratnagar</i>, 3 deaths from <i>Morang</i> district and 1 death from <i>Saptari</i> district. In <i>Biratnagar</i> ward No. 11 listed 5 deaths, ward No. 8 listed 2 deaths and ward No. 3 listed 1 death. Case fatality rate in the <i>Biratnagar</i> outbreak calculated as 0.43%. The causes of hepatitis infection were hepatitis viruses E and A. The transmission of infection in <i>Biratnagar</i> was due to sewage contamination through leaking pipes in water distribution. The level of community awareness on taking safe water observed in the <i>Biratnagar</i>. Before the outbreak, people used to drink tap water without treatment. After the outbreak, people changed their behavior to boil or filter water to drink in houses. Many people started to purchase mineral water in jars and bottles from the market. However, government water supply system in <i>Biratnagar</i> is poor which demands an upgrade to meet WHO standard of drinking water.
Highlights
Hepatitis is inflammation of the liver caused by a variety of different viruses such as hepatitis A, B, C, D, E and G
This review study uncovers how far the Rapid Response Team (RRT) mobilized by District Public Health Office (DPHO) Morang in collaboration with municipality and other stakeholders had fulfilled the requirements set by World health organization (WHO) standard and guidelines
The number reached at peak level 176 patients on May 6 and that came down to the normal level on July 8, 2014
Summary
Hepatitis is inflammation of the liver caused by a variety of different viruses such as hepatitis A, B, C, D, E and G. Among them hepatitis E virus (HEV) is the agent responsible for the hepatitis outbreak in developing countries. The hepatitis outbreak of Hyderabad India in 2005 was caused by Hepatitis E virus through water contamination [1]. It is an estimate of hepatitis E infections is 20 million, symptomatic cases of hepatitis E is over 3 million, and hepatitis E-related deaths are 56,600 every year. Hepatitis has typical sign and symptoms of jaundice, fever, anorexia, and abdominal pain, nausea, vomiting, and enlarged with tender liver. It transmits through fecal-oral route via water and foods.
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