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Investigating a community wide outbreak of hepatitis A in Kerala, India
BACKGROUND: There was an outbreak of acute hepatitis in Nellikuzhy panchayat of Kothamangalam taluk, Ernakulam district, Kerala, during November and early December 2016. Objective of this study is to describe the epidemiological features of the outbreak and to identify the probable source. MATERIALS...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Medknow Publications & Media Pvt Ltd
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6293930/ https://www.ncbi.nlm.nih.gov/pubmed/30613555 http://dx.doi.org/10.4103/jfmpc.jfmpc_127_18 |
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author | Rakesh, P. S. Mainu, T. T. Carmel Regeela Raj, Arun Babu, Devika Rajiv, Midhun Mohandas, K Sreelakshmi Das, Amrita Balasubramanian, Arjun |
author_facet | Rakesh, P. S. Mainu, T. T. Carmel Regeela Raj, Arun Babu, Devika Rajiv, Midhun Mohandas, K Sreelakshmi Das, Amrita Balasubramanian, Arjun |
author_sort | Rakesh, P. S. |
collection | PubMed |
description | BACKGROUND: There was an outbreak of acute hepatitis in Nellikuzhy panchayat of Kothamangalam taluk, Ernakulam district, Kerala, during November and early December 2016. Objective of this study is to describe the epidemiological features of the outbreak and to identify the probable source. MATERIALS AND METHODS: The outbreak was defined in terms of time, place, and person. A hypothesis was generated and tested using a case–control study. Cases were selected by simple random sampling from the line list and controls were age-matched neighborhood individuals without any history of jaundice. Chi-square test, univariate analysis, and multi-variate logistic regression analyses were done to identify the probable risk factors. RESULTS: Around 223 hepatitis A cases were identified. Attack rate was found to be highest among the age group of 16-30 years at 1.44% and was eight times higher among males. Epidemic curve suggested a point source outbreak possibly from exposure to food or water from a newly opened hotel in the area. The case–control study confirmed the hypothesis with a statistically significant association between cases and history of exposure to food from the hotel [OR 120; 95% CI 14.6–996.2; P value < 0.001]. CONCLUSION: Observations and results of the case–control study revealed that the probable source of the Hepatitis A outbreak at Nellikuzhy panchayat was a hotel. The study findings also add evidences to the changing epidemiological pattern of hepatitis A in Kerala, and warrant the necessity to enforce food safety rules in the State. |
format | Online Article Text |
id | pubmed-6293930 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Medknow Publications & Media Pvt Ltd |
record_format | MEDLINE/PubMed |
spelling | pubmed-62939302019-01-04 Investigating a community wide outbreak of hepatitis A in Kerala, India Rakesh, P. S. Mainu, T. T. Carmel Regeela Raj, Arun Babu, Devika Rajiv, Midhun Mohandas, K Sreelakshmi Das, Amrita Balasubramanian, Arjun J Family Med Prim Care Original Article BACKGROUND: There was an outbreak of acute hepatitis in Nellikuzhy panchayat of Kothamangalam taluk, Ernakulam district, Kerala, during November and early December 2016. Objective of this study is to describe the epidemiological features of the outbreak and to identify the probable source. MATERIALS AND METHODS: The outbreak was defined in terms of time, place, and person. A hypothesis was generated and tested using a case–control study. Cases were selected by simple random sampling from the line list and controls were age-matched neighborhood individuals without any history of jaundice. Chi-square test, univariate analysis, and multi-variate logistic regression analyses were done to identify the probable risk factors. RESULTS: Around 223 hepatitis A cases were identified. Attack rate was found to be highest among the age group of 16-30 years at 1.44% and was eight times higher among males. Epidemic curve suggested a point source outbreak possibly from exposure to food or water from a newly opened hotel in the area. The case–control study confirmed the hypothesis with a statistically significant association between cases and history of exposure to food from the hotel [OR 120; 95% CI 14.6–996.2; P value < 0.001]. CONCLUSION: Observations and results of the case–control study revealed that the probable source of the Hepatitis A outbreak at Nellikuzhy panchayat was a hotel. The study findings also add evidences to the changing epidemiological pattern of hepatitis A in Kerala, and warrant the necessity to enforce food safety rules in the State. Medknow Publications & Media Pvt Ltd 2018 /pmc/articles/PMC6293930/ /pubmed/30613555 http://dx.doi.org/10.4103/jfmpc.jfmpc_127_18 Text en Copyright: © 2018 Journal of Family Medicine and Primary Care http://creativecommons.org/licenses/by-nc-sa/4.0 This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms. |
spellingShingle | Original Article Rakesh, P. S. Mainu, T. T. Carmel Regeela Raj, Arun Babu, Devika Rajiv, Midhun Mohandas, K Sreelakshmi Das, Amrita Balasubramanian, Arjun Investigating a community wide outbreak of hepatitis A in Kerala, India |
title | Investigating a community wide outbreak of hepatitis A in Kerala, India |
title_full | Investigating a community wide outbreak of hepatitis A in Kerala, India |
title_fullStr | Investigating a community wide outbreak of hepatitis A in Kerala, India |
title_full_unstemmed | Investigating a community wide outbreak of hepatitis A in Kerala, India |
title_short | Investigating a community wide outbreak of hepatitis A in Kerala, India |
title_sort | investigating a community wide outbreak of hepatitis a in kerala, india |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6293930/ https://www.ncbi.nlm.nih.gov/pubmed/30613555 http://dx.doi.org/10.4103/jfmpc.jfmpc_127_18 |
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