| Peer-Reviewed

Managing Hepatitis Outbreak in Biratnagar Nepal

Received: 26 September 2015     Accepted: 9 October 2015     Published: 22 October 2015
Views:       Downloads:
Abstract

This is a review article on jaundice outbreak occurred in Biratnagar during April-July 2014. The study reviewed the reports on hepatitis outbreak presented by District Public Health Officer Morang during a seminar organized by Nepal Health Research Council (NHRC), District Disaster Management Committee (DDMC) meetings and HMIS (Health Management Information System) database. District Public Health Office (DPHO) recorded 2,789 Jaundice patients in Morang district including Biratnagar city. Most of the patients (80.67%) recorded from Biratnagar. In the outbreak sex ratio of female to male was 0.56:1. Hepatitis infection was highest among 15-29 age groups and noticed remarkable among 15 to 54 years age groups. District Disaster Management Committee declared the outbreak in Biratnagar on April 28 when 95 jaundice patients recorded in the hospitals. The number reached at peak level 176 patients on May 6 and the trend came downward to normal level on July 8, 2014. Total 12 deaths recorded in the outbreak. Of them 8 deaths recorded from Biratnagar, 3 deaths from Morang district and 1 death from Saptari district. In Biratnagar ward No. 11 listed 5 deaths, ward No. 8 listed 2 deaths and ward No. 3 listed 1 death. Case fatality rate in the Biratnagar outbreak calculated as 0.43%. The causes of hepatitis infection were hepatitis viruses E and A. The transmission of infection in Biratnagar was due to sewage contamination through leaking pipes in water distribution. The level of community awareness on taking safe water observed in the Biratnagar. Before the outbreak, people used to drink tap water without treatment. After the outbreak, people changed their behavior to boil or filter water to drink in houses. Many people started to purchase mineral water in jars and bottles from the market. However, government water supply system in Biratnagar is poor which demands an upgrade to meet WHO standard of drinking water.

Published in Science Journal of Public Health (Volume 3, Issue 6)
DOI 10.11648/j.sjph.20150306.12
Page(s) 808-814
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2015. Published by Science Publishing Group

Keywords

Jaundice, Hepatitis E, Fecal Contaminated Water, Biratnagar, Nepal

References
[1] Sarguna P, Rao A, Sudha Ramana KN. Outbreak of acute viral hepatitis due to hepatitis E virus in Hyderabad. Indian Journal of Medical Microbiology. 2007 Oct; 25(4): 378-82.
[2] WHO. Hepatitis E. Fact sheet N°280, Updated July 2015.website browsed on Sept. 23, 2015. www.who.int.
[3] Clayson ET, Shrestha, MP, Vaughn DW, Snitbhan, R, Shrestha KB, Longer CF. Rates of Hepatitis E Virus Infection and Disease among Adolescents and Adults in Kathmandu, Nepal. Journal of Infectious Diseases 1997;176 (September).
[4] Chauhan, NT, Prajapati P, Trivedi AV, Bhagyalaxmi A. Epidemic Investigation of the Jaundice Outbreak in Girdharnagar, Ahmedabad, Gujarat, India, 2008. Indian Journal Community Medicine. 2010 Apr; 35(2): 294–297.
[5] Awsathi S, Rawat V, Rawat C, Semwal V, Bartwal S. Epidemiological Investigation of the Jaundice Outbreak in Lalkuan, Nainital District, Uttarakhand. Indian Journal of Community Medicine. 2014 Apr-Jun; 39(2): 94–97. doi: 10.4103/0970-0218. 132725.
[6] CDC. Hepatitis A outbreak associated with green onions at a restaurant--Monaca, Pennsylvania, 2003.Centers for Disease Control and Prevention (CDC).MMWR Morb Mortal Weekly Report. 2003 Nov 28; 52(47): 1155-7.
[7] CDC. Hepatitis A outbreak associated with green onions at a restaurant--Monaca, Pennsylvania, 2003.Centers for Disease Control and Prevention (CDC).MMWR Morbidity Mortality Weekly Report. 2003 Nov 28; 52(47): 1155-7.
[8] Guthmann J, Klovstad H, Boccia D, Hamid N,, Pinoges L, Nizou J, et al. A Large Outbreak of Hepatitis E among a Displaced Population in Darfur, Sudan, 2004: The Role of Water Treatment Methods. Oxford Journals of Clinical Infectious Diseases, Volume 42, Issue 12Pp. 1685-1691.
[9] Hlady WG, Islam MN, Wahab MA, et al. Enterically trans- mitted non-A, non-B hepatitis associated with an outbreak in Dhaka: epidemiology and public health implications. Tropical Doctor 1990; 20: 15-17.
[10] Kainer M. Hepatitis E study in Nepal. Travellers Medical and Vaccination Centre Pry. Ltd. and the Victorian Infectious Diseases Service, Royal Melbourne Hospital, Melbourne, Victoria, Australia, 1998. (http://www.tmvc.com.au/ref3.html).
[11] Margolis HS, Alter MJ, Hadler SC. Viral hepatitis. In: Evans AS, Kaslow RA, eds. Viral infections of humans: epidemiol- ogy and control. 4th ed. New York, NY: Plenum Medical Book Company, 1997: 400-6..
[12] Mast EE, Krawczynski K. Hepatitis E: an overview. Annual Review Medicine 1996; 47: 257-66.
[13] Ouvea V, Snellings N, Popek MJ, Longer CF, Innis BL. 1998. Hepatitis E virus: complete genome sequence and phylogenetic analysis of a Nepali isolate. Virus Res 57: 21–26.
[14] Shrestha SM. Hepatitis E in Nepal. Kathmandu University Medical Journal (2006), Vol. 4, No. 4, Issue 16, 530-544.
[15] Okorondu S. I., Anyadoh-Nwadike S. O., Bacteriological and Physiochemical Analysis of Oguta Lake Water, Imo State, Nigeria, Science Journal of Public Health. Special Issue: Who Is Afraid of the Microbes. Vol. 3, No. 5-1, 2015, pp. 14-19. doi: 10.11648/j.sjph.S.2015030501.13.
Cite This Article
  • APA Style

    Nawa Raj Subba. (2015). Managing Hepatitis Outbreak in Biratnagar Nepal. Science Journal of Public Health, 3(6), 808-814. https://doi.org/10.11648/j.sjph.20150306.12

    Copy | Download

    ACS Style

    Nawa Raj Subba. Managing Hepatitis Outbreak in Biratnagar Nepal. Sci. J. Public Health 2015, 3(6), 808-814. doi: 10.11648/j.sjph.20150306.12

    Copy | Download

    AMA Style

    Nawa Raj Subba. Managing Hepatitis Outbreak in Biratnagar Nepal. Sci J Public Health. 2015;3(6):808-814. doi: 10.11648/j.sjph.20150306.12

    Copy | Download

  • @article{10.11648/j.sjph.20150306.12,
      author = {Nawa Raj Subba},
      title = {Managing Hepatitis Outbreak in Biratnagar Nepal},
      journal = {Science Journal of Public Health},
      volume = {3},
      number = {6},
      pages = {808-814},
      doi = {10.11648/j.sjph.20150306.12},
      url = {https://doi.org/10.11648/j.sjph.20150306.12},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.sjph.20150306.12},
      abstract = {This is a review article on jaundice outbreak occurred in Biratnagar during April-July 2014. The study reviewed the reports on hepatitis outbreak presented by District Public Health Officer Morang during a seminar organized by Nepal Health Research Council (NHRC), District Disaster Management Committee (DDMC) meetings and HMIS (Health Management Information System) database. District Public Health Office (DPHO) recorded 2,789 Jaundice patients in Morang district including Biratnagar city. Most of the patients (80.67%) recorded from Biratnagar. In the outbreak sex ratio of female to male was 0.56:1. Hepatitis infection was highest among 15-29 age groups and noticed remarkable among 15 to 54 years age groups. District Disaster Management Committee declared the outbreak in Biratnagar on April 28 when 95 jaundice patients recorded in the hospitals. The number reached at peak level 176 patients on May 6 and the trend came downward to normal level on July 8, 2014. Total 12 deaths recorded in the outbreak. Of them 8 deaths recorded from Biratnagar, 3 deaths from Morang district and 1 death from Saptari district. In Biratnagar ward No. 11 listed 5 deaths, ward No. 8 listed 2 deaths and ward No. 3 listed 1 death. Case fatality rate in the Biratnagar outbreak calculated as 0.43%. The causes of hepatitis infection were hepatitis viruses E and A. The transmission of infection in Biratnagar was due to sewage contamination through leaking pipes in water distribution. The level of community awareness on taking safe water observed in the Biratnagar. Before the outbreak, people used to drink tap water without treatment. After the outbreak, people changed their behavior to boil or filter water to drink in houses. Many people started to purchase mineral water in jars and bottles from the market. However, government water supply system in Biratnagar is poor which demands an upgrade to meet WHO standard of drinking water.},
     year = {2015}
    }
    

    Copy | Download

  • TY  - JOUR
    T1  - Managing Hepatitis Outbreak in Biratnagar Nepal
    AU  - Nawa Raj Subba
    Y1  - 2015/10/22
    PY  - 2015
    N1  - https://doi.org/10.11648/j.sjph.20150306.12
    DO  - 10.11648/j.sjph.20150306.12
    T2  - Science Journal of Public Health
    JF  - Science Journal of Public Health
    JO  - Science Journal of Public Health
    SP  - 808
    EP  - 814
    PB  - Science Publishing Group
    SN  - 2328-7950
    UR  - https://doi.org/10.11648/j.sjph.20150306.12
    AB  - This is a review article on jaundice outbreak occurred in Biratnagar during April-July 2014. The study reviewed the reports on hepatitis outbreak presented by District Public Health Officer Morang during a seminar organized by Nepal Health Research Council (NHRC), District Disaster Management Committee (DDMC) meetings and HMIS (Health Management Information System) database. District Public Health Office (DPHO) recorded 2,789 Jaundice patients in Morang district including Biratnagar city. Most of the patients (80.67%) recorded from Biratnagar. In the outbreak sex ratio of female to male was 0.56:1. Hepatitis infection was highest among 15-29 age groups and noticed remarkable among 15 to 54 years age groups. District Disaster Management Committee declared the outbreak in Biratnagar on April 28 when 95 jaundice patients recorded in the hospitals. The number reached at peak level 176 patients on May 6 and the trend came downward to normal level on July 8, 2014. Total 12 deaths recorded in the outbreak. Of them 8 deaths recorded from Biratnagar, 3 deaths from Morang district and 1 death from Saptari district. In Biratnagar ward No. 11 listed 5 deaths, ward No. 8 listed 2 deaths and ward No. 3 listed 1 death. Case fatality rate in the Biratnagar outbreak calculated as 0.43%. The causes of hepatitis infection were hepatitis viruses E and A. The transmission of infection in Biratnagar was due to sewage contamination through leaking pipes in water distribution. The level of community awareness on taking safe water observed in the Biratnagar. Before the outbreak, people used to drink tap water without treatment. After the outbreak, people changed their behavior to boil or filter water to drink in houses. Many people started to purchase mineral water in jars and bottles from the market. However, government water supply system in Biratnagar is poor which demands an upgrade to meet WHO standard of drinking water.
    VL  - 3
    IS  - 6
    ER  - 

    Copy | Download

Author Information
  • Tribhuvan University, Department of Psychology, Kathmandu, Nepal

  • Sections