title: An Outbreak of Acute Hepatitis Caused by Genotype IB Hepatitis A Viruses Contaminating the Water Supply in Thailand.
abstract: BACKGROUND
  In 2000, an outbreak of acute hepatitis A was reported in a province adjacent to Bangkok, Thailand.
  
  
  OBJECTIVE
  To investigate the cause of the 2000 hepatitis A outbreaks in Thailand using molecular epidemiological analysis.
  
  
  METHODS
  Serum and stool specimens were collected from patients who were clinically diagnosed with acute viral hepatitis. Water samples from drinking water and deep-drilled wells were also collected. These specimens were subjected to polymerase chain reaction (PCR) amplification and sequencing of the VP1/2A region of the hepatitis A virus (HAV) genome. The entire genome sequence of one of the fecal specimens was determined and phylogenetically analyzed with those of known HAV sequences.
  
  
  CONCLUSIONS
  Eleven of 24 fecal specimens collected from acute viral hepatitis patients were positive as determined by semi- nested reverse transcription PCR targeting the VP1/2A region of HAV. The nucleotide sequence of these samples had an identical genotype IB sequence, suggesting that the same causative agent was present. The complete nucleotide sequence derived from one of the samples indicated that the Thai genotype IB strain should be classified in a unique phylogenetic cluster. The analysis using an adjusted odds ratio showed that the consumption of groundwater was the most likely risk factor associated with the disease.
authors.affiliation: National Institute of Health, Ministry of Public Health, Nonthaburi, Thailand.
authors.forename: Kriangsak
authors.initials: K
authors.lastname: Ruchusatsawat
authors.forename: Jongkonnee
authors.initials: J
authors.lastname: Wongpiyabovorn
authors.forename: Chonthicha
authors.initials: C
authors.lastname: Kawidam
authors.forename: Laddawan
authors.initials: L
authors.lastname: Thiemsing
authors.forename: Somchai
authors.initials: S
authors.lastname: Sangkitporn
authors.forename: Sayaka
authors.initials: S
authors.lastname: Yoshizaki
authors.forename: Masashi
authors.initials: M
authors.lastname: Tatsumi
authors.forename: Naokazu
authors.initials: N
authors.lastname: Takeda
authors.forename: Koji
authors.initials: K
authors.lastname: Ishii
mesh_terms: D000208:Acute Disease / Q000453:epidemiology*; D004196:Disease Outbreaks; D060766:Drinking Water / Q000382:microbiology; D005243:Feces / Q000821:virology*; D005260:Female; D016679:Genome, Viral; D005838:Genotype; D006506:Hepatitis A / Q000097:blood* / Q000453:epidemiology* / Q000209:etiology / Q000821:virology; D017957:Hepatitis A Virus, Human / Q000235:genetics* / Q000302:isolation & purification; D006801:Humans; D008297:Male; D016017:Odds Ratio; D010802:Phylogeny; D016133:Polymerase Chain Reaction; D012367:RNA, Viral / Q000235:genetics; D013785:Thailand / Q000453:epidemiology; D014881:Water Supply
chemical_list: D060766:Drinking Water; D012367:RNA, Viral