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Outbreaks of hepatitis A among children in western India

M S Chadha1, K S Lole, M H Bora

  • 1National Institute of Virology, 20-A, Pune, 411001, Maharashtra, India. mscniv@hotmail.com

Transactions of the Royal Society of Tropical Medicine and Hygiene
|January 22, 2009
PubMed

Insights

Hepatitis A outbreaks in Indian children are increasingly common. Genotype IIIA of the Hepatitis A virus (HAV) was identified as the cause in a large 2004 Pune outbreak, highlighting the need for vaccination strategies.

Area of Science:

  • Hepatology
  • Virology
  • Public Health

Background:

  • Hepatitis A is typically a childhood disease in developing nations.
  • Focal outbreaks of Hepatitis A have recently been observed in children in India.
  • Investigated a large-scale hepatitis outbreak among children in Pune, India, during 2004.

Purpose of the Study:

  • To investigate the cause and characteristics of a large-scale hepatitis outbreak in Indian children.
  • To identify the etiological agent and its genetic profile.
  • To assess the public health implications for vaccination strategies.

Main Methods:

  • Epidemiological investigation of overt and sub-clinical cases.
  • Serological testing for IgM antibodies against Hepatitis A virus (HAV) and Hepatitis E virus (HEV).
  • Detection of HAV RNA in clinical and environmental samples.
  • Molecular characterization of HAV isolates to determine genotype.

Main Results:

  • Identified 123 overt and 56 sub-clinical cases of Hepatitis A.
  • Confirmed HAV as the etiological agent, with all patients negative for IgM anti-HEV.
  • Molecular analysis revealed the predominance of HAV genotype IIIA in the outbreak and other focal outbreaks in the region.

Conclusions:

  • Hepatitis A outbreaks caused by genotype IIIA are prevalent in this region of India.
  • The findings underscore the need for updated public health strategies, including vaccination, for countries transitioning in Hepatitis A endemicity.
  • Effective control measures are crucial to manage the increasing incidence of Hepatitis A in vulnerable populations.

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