title: Outbreak of viral hepatitis B in a rural community in India linked to inadequately sterilized needles and syringes.
abstract: In India, virtually all outbreaks of viral hepatitis are considered to be due to faeco-orally transmitted hepatitis E virus. Recently, a cluster of 15 cases of viral hepatitis B was found in three villages in Gujarat State. The cases were epidemiologically linked to the use of inadequately sterilized needles and syringes by a local unqualified medical practitioner. The outbreak evolved slowly over a period of 3 months and was marked by a high case fatality rate (46.7%), probably because of concurrent infection with hepatitis D virus (HDV) or sexually transmitted infections. But for the many fatalities within 2-3 weeks of the onset of illness, the outbreak would have gone unnoticed. The findings emphasize the importance of inadequately sterilized needles and syringes in the transmission of viral hepatitis B in India, the need to strengthen the routine surveillance system, and to organize an education campaign targeting all health care workers including private practitioners, especially those working in rural areas, as well as the public at large, to take all possible measures to prevent this often fatal infection.
authors.affiliation: National Institute of Communicable Diseases (NICD), Delhi, India.
authors.forename: J
authors.initials: J
authors.lastname: Singh
authors.forename: R
authors.initials: R
authors.lastname: Bhatia
authors.forename: J C
authors.initials: JC
authors.lastname: Gandhi
authors.forename: A P
authors.initials: AP
authors.lastname: Kaswekar
authors.forename: S
authors.initials: S
authors.lastname: Khare
authors.forename: S B
authors.initials: SB
authors.lastname: Patel
authors.forename: V B
authors.initials: VB
authors.lastname: Oza
authors.forename: D C
authors.initials: DC
authors.lastname: Jain
authors.forename: J
authors.initials: J
authors.lastname: Sokhey
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016000:Cluster Analysis; D004196:Disease Outbreaks / Q000706:statistics & numerical data*; D004866:Equipment Contamination / Q000706:statistics & numerical data*; D005260:Female; D006509:Hepatitis B / Q000453:epidemiology* / Q000209:etiology*; D003699:Hepatitis D / Q000150:complications; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009339:Needles / Q000009:adverse effects*; D011159:Population Surveillance; D012423:Rural Health; D012749:Sexually Transmitted Diseases / Q000150:complications; D013242:Sterilization / Q000592:standards*; D013594:Syringes / Q000009:adverse effects*