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A hepatitis E outbreak caused by a temporary interruption in a municipal water treatment system, Baripada, Orissa,

Susanta K Swain1, Prameela Baral, Yvan J Hutin

  • 1Field Epidemiology Training Programme, Master of Applied Epidemiology, National Institute of Epidemiology, Indian Council of Medical Research, Chennai, Tamil Nadu, India.

Transactions of the Royal Society of Tropical Medicine and Hygiene
|September 1, 2009
PubMed

Insights

A large hepatitis E outbreak in India was caused by drinking untreated river water. Public health measures are needed to ensure safe water supplies, especially during service disruptions.

Area of Science:

  • Public Health
  • Epidemiology
  • Infectious Diseases

Background:

  • A significant outbreak of acute hepatitis occurred in Baripada, Orissa, India, in early 2004.
  • The outbreak involved 538 reported cases with a notable attack rate and a small number of fatalities.

Purpose of the Study:

  • To investigate the cause of the acute hepatitis cluster in Baripada.
  • To identify the source of infection and risk factors associated with the outbreak.

Main Methods:

  • Case definition: fever with loss of appetite and jaundice.
  • Serological testing for IgM antibodies to hepatitis E virus.
  • Case-control study comparing water sources of affected and unaffected individuals.

Main Results:

  • 47 out of 48 sera tested positive for hepatitis E virus IgM antibodies.
  • A strong association was found between drinking water from a specific untreated river source and illness (OR 31).
  • The outbreak coincided with a 10-day period of untreated water supply due to a strike at the treatment plant.

Conclusions:

  • The hepatitis E outbreak was strongly linked to the consumption of untreated raw river water.
  • Ensuring the quality of municipal water supplies and maintaining essential services during strikes are critical public health interventions.

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