Outbreak of waterborne hepatitis E, Pune, Maharashtra, India, 2013

Abstract

Introduction: Following the report of clustering of jaundice cases from Kolvan village in Pune district, Maharashtra on 16th June, 2013, we investigated the outbreak with objectives to confirm the diagnosis, to describe it and to make recommendations for the control of outbreak. Methods: We defined a suspected case of acute hepatitis as an individual presenting with acute onset of yellow eyes or dark urine with or without fever and other constitutional symptoms in a resident of Kolvan village from 28 May 2013 onwards. Following house to house survey, we prepared a line list of suspected cases. We prepared epi-curve and spot maps of cases and determined the attack rates. We tested blood and water samples and conducted environmental survey. Results: Overall attack rate was 3.3% (n=37); highest in Gavthan area of Kolvan village (14.5%) and in the age group of41-60 years (4.9%). It was more in males (4.3%) than females (2.3%). Hepatitis E IgM antibody was found in 16/ 20 (80%) case patients. Water samples from river, common water source (well) and water storage tanks confirmed presence of coliform bacteria suggesting contamination of drinking water source with faecal matter through newly constructed trench between a well and the river. Conclusions: The continuing common source outbreak occurred possibly due to drinking of faecally contaminated water from the trench. We recommended closure of the trench, temporary alternate water supply arrangement and regular chlorination of drinking water source.We focused on community education regarding safe drinking water and improving sanitation in the village.

Keywords

• outbreak
• hepatitis e
• pune