title: Investigation of suspected viral hepatitis outbreaks in North West India.
abstract: Hepatitis E (HEV) infection is diagnosed on the basis of serum anti-HEV IgM detection. In outbreaks, early diagnostic method is important for prompt control measures. This study compared 3 diagnostic methods in 60 serum samples collected in suspected HEV outbreaks. The suitability of saliva samples for antibody detection was also evaluated in 21 paired serum saliva samples. The anti-HEV IgM, HEV-Ag, and HEV-RNA were detected in serum samples of 52 (86.66%), 16 (26.66%), and 18 (30%) patients, respectively. The concordance between serum and saliva IgM was found to be 76.91%. The positivity of PCR and HEV-Ag detection was 100% within 1 week of illness which declined to 5-10% thereafter. The outbreak was attributed to HEV genotype 1, subtype 1a, and the clinical and environmental strains clustered together. HEV-antigen and RNA were an early diagnostic marker with 96.66% concordance. Saliva samples can be used as an alternative in outbreak setting.
authors: Department of Virology, Postgraduate Institute of Medical Education & Research, Chandigarh, India 160012. Electronic address: minipsingh@gmail.com.
authors: Mini P
authors: MP
authors: Singh
authors: Department of Virology, Postgraduate Institute of Medical Education & Research, Chandigarh, India 160012. Electronic address: manasivirol@gmail.com.
authors: Manasi
authors: M
authors: Majumdar
authors: Department of Virology, Postgraduate Institute of Medical Education & Research, Chandigarh, India 160012. Electronic address: kapilgoyalpgi@gmail.com.
authors: Kapil
authors: K
authors: Goyal
authors: School of Public Health, Postgraduate Institute of Medical Education & Research, Chandigarh, India 160012. Electronic address: lakshmi.pvm@pgimer.edu.in.
authors: P V M
authors: PV
authors: Lakshmi
authors: Integrated Disease Surveillance Project, Directorate of Health & Family Welfare, Punjab, Chandigarh, India. Electronic address: idspb@gmail.com.
authors: Deepak
authors: D
authors: Bhatia
authors: Department of Virology, Postgraduate Institute of Medical Education & Research, Chandigarh, India 160012. Electronic address: rathopgi@yahoo.com.
authors: R K
authors: RK
authors: Ratho
mesh_terms: D000293:Adolescent; D000328:Adult; D000956:Antigens, Viral / Q000097:blood; D019411:Clinical Laboratory Techniques / Q000379:methods*; D003955:Diagnostic Tests, Routine / Q000379:methods*; D004196:Disease Outbreaks; D005260:Female; D005838:Genotype; D006508:Hepatitis Antibodies / Q000032:analysis*; D016751:Hepatitis E / Q000175:diagnosis* / Q000453:epidemiology; D016752:Hepatitis E virus / Q000145:classification / Q000235:genetics / Q000276:immunology*; D006801:Humans; D007075:Immunoglobulin M / Q000032:analysis* / Q000097:blood; D007194:India / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012367:RNA, Viral / Q000097:blood / Q000235:genetics; D012189:Retrospective Studies; D012463:Saliva / Q000737:chemistry; D012680:Sensitivity and Specificity; D055815:Young Adult
chemical_list: D000956:Antigens, Viral; D006508:Hepatitis Antibodies; D007075:Immunoglobulin M; D012367:RNA, Viral
keywords: HEV-antigen; Hepatitis E virus; Outbreak; Phylogenetic analysis; Saliva