title: A severe and explosive outbreak of hepatitis B in a rural population in Sirsa district, Haryana, India: unnecessary therapeutic injections were a major risk factor.
abstract: Most outbreaks of viral hepatitis in India are caused by hepatitis E. This report describes an outbreak of hepatitis B in a rural population in Haryana state in 1997. At least 54 cases of jaundice occurred in Dhottar village (population 3096) during a period of 8 months; 18 (33.3%) of them died. Virtually all fatal cases were adults and tested positive for HBsAg (other markers not done). About 88% (21/24) of surviving cases had acute or persistent HBV/HCV infections; 54% (13/24) had acute hepatitis B. Many other villages reported sporadic cases and deaths. Data were pooled from these villages for analysis of risk factors. Acute hepatitis B cases had received injections before illness more frequently (11/19) than those found negative for acute or persistent HBV/HCV infections (3/17) (P = 0.01). Although a few cases had other risk factors, these were equally prevalent in two groups. The results linked the outbreak to the use of unnecessary therapeutic injections.
authors.affiliation: National Institute of Communicable Diseases, Delhi, India.
authors.forename: J
authors.initials: J
authors.lastname: Singh
authors.forename: S
authors.initials: S
authors.lastname: Gupta
authors.forename: S
authors.initials: S
authors.lastname: Khare
authors.forename: R
authors.initials: R
authors.lastname: Bhatia
authors.forename: D C
authors.initials: DC
authors.lastname: Jain
authors.forename: J
authors.initials: J
authors.lastname: Sokhey
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D004196:Disease Outbreaks; D004866:Equipment Contamination; D005260:Female; D006509:Hepatitis B / Q000401:mortality / Q000635:transmission*; D006514:Hepatitis B Surface Antigens / Q000032:analysis; D006526:Hepatitis C; D006801:Humans; D007194:India / Q000453:epidemiology; D007223:Infant; D007231:Infant, Newborn; D007275:Injections, Intravenous; D007565:Jaundice / Q000209:etiology / Q000821:virology; D008297:Male; D008875:Middle Aged; D009339:Needles / Q000821:virology; D012307:Risk Factors; D012424:Rural Population
chemical_list: D006514:Hepatitis B Surface Antigens