title: Hepatitis E virus: A leading cause of waterborne viral hepatitis in Northwest Districts of Punjab, India.
abstract: BACKGROUND
  Acute viral hepatitis (AVH) caused by enterically transmitted hepatitis A virus (HAV) and hepatitis E virus (HEV) poses a major health problem in developing countries such as India. Despite improving sanitation, heath awareness, and socioeconomic conditions, these infections continue to occur both in sporadic as well as in epidemic forms in different parts of India.
  
  
  OBJECTIVE
  The aim of this study is to determine the total as well as age-specific prevalence rates of HAV and HEV in the outbreaks of waterborne hepatitis in districts surrounding Amritsar region of Punjab.
  
  
  METHODS
  The study was conducted in the Virology Research and Diagnostic Laboratory, Government Medical College, Amritsar, during the study period of January 2015-March 2016. Samples from suspected outbreaks of AVH occurring in various districts around Amritsar were included as a part of the study. A total of 95 sera were tested for IgM antibody to HEV and HAV using IgM capture ELISA kit.
  
  
  RESULTS
  Out of the total 95 samples received, 73 samples (76.84%) were positive for HAV/HEV. Out of the total positive cases, 65 (68.42%) had HEV infection, 2 (2.1%) had HAV, and 6 cases (6.31%) were coinfected with both HAV and HEV. The 21-30 years age group (25 cases) was identified as the most susceptible group for HEV infection. The coinfected subjects presented a wider range of age distribution (1-10 years: 1; 11-20 years: 3; 21-30 years: 1; 31-40 years: 1). Seasonal distribution of data revealed bimodal peaks for HEV infection.
  
  
  CONCLUSIONS
  There should be some surveillance system to regularly monitor the portability of drinking water from time to time to avoid such preventable outbreaks in future.
authors.affiliation: Department of Microbiology, Government Medical College, Amritsar, Punjab, India.
authors.forename: Maninder
authors.initials: M
authors.lastname: Kaur
authors.affiliation: Department of Microbiology, Government Medical College, Amritsar, Punjab, India.
authors.forename: Shailpreet K
authors.initials: SK
authors.lastname: Sidhu
authors.affiliation: Department of Microbiology, Government Medical College, Amritsar, Punjab, India.
authors.forename: Kanwardeep
authors.initials: K
authors.lastname: Singh
authors.affiliation: Department of Microbiology, Government Medical College, Amritsar, Punjab, India.
authors.forename: Pushpa
authors.initials: P
authors.lastname: Devi
authors.affiliation: Department of Microbiology, Government Medical College, Amritsar, Punjab, India.
authors.forename: Manpreet
authors.initials: M
authors.lastname: Kaur
authors.affiliation: Department of Microbiology, Government Medical College, Amritsar, Punjab, India.
authors.forename: Nachhatar Jit
authors.initials: NJ
authors.lastname: Singh
keywords: Acute viral hepatitis; hepatitis A virus; hepatitis E virus; outbreaks