title: Two years' investigation of epidemic hepatitis E virus transmission in West Kalimantan (Borneo), Indonesia.
abstract: Two years' follow-up investigation of a hepatitis E virus (HEV) outbreak in West Kalimantan, Indonesia in 1991 was carried out to investigate the epidemiology of epidemic HEV transmission and the persistence of the immunoglobulin G (IgG) antibody response. Sixty cases identified as anti-HEV IgG positive during the outbreak in 1991 were matched with 67 controls and examined, together with 318 members of their families. Overall, the prevalence of anti-HEV IgG among the 445 subjects (representing 127 households) was 59%. There was no significant difference in anti-HEV prevalence between cases (72%) and controls (61%). Loss of detectable anti-HEV IgG after 2 years was demonstrated in 17 of 60 subjects (28%) who were originally positive for anti-HEV in 1991. The mean number of anti-HEV positive subjects per household was 2.04. Cross-sectional prevalence of anti-HEV IgG increased significantly with age (P = 0.01). When communities were grouped into areas of low (< 40%), medium (40-59%) and high (> or = 60%) anti-HEV prevalence, use of river water for drinking and cooking (P < 0.001), personal washing (P < 0.0001), and human excreta disposal (P < 0.001) were associated with high prevalence communities. Conversely, boiling drinking water was negatively associated with increased prevalence (P = 0.02). Subnormal rainfall during the month (August) leading up to the 1991 outbreak (19 cm compared to the monthly mean of 209 cm in 1985-1993) may have contributed to favourable epidemic conditions.
authors.affiliation: US Naval Medical Research Unit No. 2, Fakarta, Indonesia.
authors.forename: A
authors.initials: A
authors.lastname: Corwin
authors.forename: K
authors.initials: K
authors.lastname: Jarot
authors.forename: I
authors.initials: I
authors.lastname: Lubis
authors.forename: K
authors.initials: K
authors.lastname: Nasution
authors.forename: S
authors.initials: S
authors.lastname: Suparmawo
authors.forename: A
authors.initials: A
authors.lastname: Sumardiati
authors.forename: S
authors.initials: S
authors.lastname: Widodo
authors.forename: S
authors.initials: S
authors.lastname: Nazir
authors.forename: G
authors.initials: G
authors.lastname: Orndorff
authors.forename: Y
authors.initials: Y
authors.lastname: Choi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000914:Antibodies, Viral / Q000097:blood; D001893:Borneo / Q000453:epidemiology; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D004196:Disease Outbreaks; D005192:Family Health; D005260:Female; D005500:Follow-Up Studies; D006506:Hepatitis A / Q000175:diagnosis; D016751:Hepatitis E / Q000175:diagnosis / Q000453:epidemiology / Q000276:immunology / Q000635:transmission*; D016752:Hepatitis E virus; D006507:Hepatovirus; D006801:Humans; D006920:Hygiene; D007074:Immunoglobulin G / Q000097:blood; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D016036:Seroepidemiologic Studies; D014881:Water Supply
chemical_list: D000914:Antibodies, Viral; D007074:Immunoglobulin G