Viral Hepatitis A and E Outbreaks in Kumaon Region of Uttarakhand

Abstract

From July 2012 to August 2013 a total of 124 serum samples were received in the Department of Microbiology Govt Medical College, Haldwani from suspected water borne viral hepatitis outbreaks from different area of Kumaon region, Uttarakhand. All sera were screened for IgM Hepatitis A Virus and Hepatitis E virus (HAV & HEV) by enzyme immune assay. Water samples from two outbreaks were analysed by multiple tube method. Of the total of 124 samples 82 (66.1 %) were reactive to at least one seromarker of hepatitis A or E. Hepatitis A was the major cause of outbreak in 41.5 % (34/82). However, in Haldwani town HEV was detected in higher number. Co infection of HAV and HEV was detected in 28 % and it was significantly higher in female. Serology results showed that over all adults outnumbered children (79 vs. 21 %), which was statistically significant. Point source contamination of water supply with sewerage was identified. In Kumaon region HAV is predominant except in Haldwani town where hepatitis E is the major cause of waterborne hepatitis. HAV–HEV co-infection was higher in female. Significantly higher rates of infection in adults suggest an epidemiological shift in this region.