epidemiological investigation of an outbreak of hepatitis a in rural china

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2015
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Abstract
Objectives: This investigation was a response to an outbreak of hepatitis A in rural China in 2013. The objectives were to identify the pattern of transmission and the risk factors. Methods: A probable case was defined as an individual in/nearby the village of the outbreak with jaundice and/or an elevation of serum alanine aminotransferase (at or above 80 IU/l) plus at least three of the following symptoms: fever (axillary temperature ≥37 °C), headache, nausea, vomiting, anorexia, or abdominal pain in the upper right quadrant, during the outbreak period (from June 1 to August 11, 2013). Using a case–control study design, we compared exposures to suspected food items, water, and close contact with a patient or case with asymptomatic infection between 22 cases and 32 controls. Results: We identified 22 cases, including 15 symptomatic cases and seven with asymptomatic infections. All cases were aged <15 years. Household clustering was apparent (Chi-square = 4.69, p < 0.05). Contact with symptomatic cases or cases with an asymptomatic infection was a major risk factor (59.09% in cases and 25.00% in the controls: odds ratio (OR) 4.33, 95% confidence interval (CI) 1.17–16.68). A good hand-washing habit (at least once per day) was found in 45.45% of cases vs. 78.13% of controls (OR 0.23, 95% CI 0.06–0.88). The dose–response analysis showed that the daily frequency of hand-washing was inversely associated with infection (trend Chi-square = 5.35, p = 0.021). Person-to-person transmission was deduced from the epidemic curves and the transmission chain of symptomatic cases. Conclusion: The pattern of transmission in this outbreak was person-to-person, and the transmission route was indicated to be fecal–oral. In addition to close contact, insufficient hand-washing was a risk factor. Strengthening the management of the rural environmental sanitation services and enhancing awareness in the household are key to preventing outbreaks of hepatitis A in the future.
Reference Key
yu2015internationalepidemiological Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors Ping Yu, Lihong Huang, Hui Li, Mingbin Liu, Jun Zong, Chao Li, Feng Chen
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Journal israel journal of chemistry
Year 2015
DOI
10.1016/j.ijid.2015.02.006
URL
http://www.sciencedirect.com/science/article/pii/S120197121500034X
Keywords
outbreak hepatitis a

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