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Hepatitis E: intrafamilial transmission versus waterborne spread

R Aggarwal1, S R Naik

  • 1Department of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.

Journal of Hepatology
|November 1, 1994
PubMed
Summary

Water contamination, not family spread, was the primary driver of a large hepatitis E epidemic in India. Most cases resulted from contaminated water, with family transmission playing a minor role.

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Area of Science:

  • Epidemiology
  • Public Health
  • Infectious Diseases

Background:

  • Hepatitis E outbreaks pose significant public health challenges.
  • Understanding transmission routes is crucial for effective control strategies.
  • The relative contributions of waterborne vs. intrafamilial spread of hepatitis E were previously unclear.

Purpose of the Study:

  • To determine the primary source of hepatitis E transmission during a large epidemic in Kanpur, India.
  • To differentiate between waterborne contamination and intrafamilial spread as drivers of the outbreak.

Main Methods:

  • Two household surveys were conducted during a bimodal waterborne hepatitis E epidemic.
  • Data collected included case onset dates and family relationships.
  • Temporal analysis correlated case occurrence with water contamination control measures.

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Main Results:

  • Out of 111 hepatitis cases, 103 (92.8%) were attributed to primary waterborne infection.
  • Only 8 cases (7.2%) occurring 2-6 weeks after initial cases suggested potential intrafamilial spread.
  • New cases ceased 9 weeks after water contamination control measures were implemented.

Conclusions:

  • Water contamination was the predominant factor in the hepatitis E epidemic's spread.
  • Intrafamilial transmission played a minimal role in this specific outbreak.
  • Public health interventions should prioritize controlling water sources during hepatitis E epidemics.