Outbreak Investigation of Unusual Deaths in Cases of Acute Hepatitis Syndrome, in Makronia Municipal Area of Sagar Disitrict of Madhya Pradesh

Authors

  • Sunil Kant Guleri Bundelkhand Medical College, Sagar
  • Amarnath Gupta Bundelkhand Medical College, Sagar
  • Sunil Nandeshwar Bundelkhand Medical College, Sagar
  • Shraddha Mishra Bundelkhand Medical College, Sagar
  • Ramkumar Panika Bundelkhand Medical College, Sagar
  • Rupesh Sahu Bundelkhand Medical College, Sagar

Keywords:

Hepatitis B, leptospirosis, co-infection, super infection Hepatorenal Syndrome

Abstract

Introduction: Eleven (11) cases of sudden deaths were reported in patients suffering from jaundice in Sagar district of Madhya Pradesh during March-July 2018. All the cases were HBsAg posi- tive and died due to hepatic encephalopathy and or hepatorenal failure.

Methods: outbreak investigation was done using semi-structured profarma. The clinical history, investigation reports, death certifi- cates and other available documents were analysed and findings recorded. House to house survey and health camps were also or- ganised to find other cases with similar illnesses. The blood sam- ples family members and suspected cases with jaundice were sent to ICMR NIRTH Jabalpur for viral isolations.

Results: All the cases of deaths were localised within an area of about 10 Kms. About 72% cases recorded died within 3 days of ill- ness. Jaundice, abdominal pain and vomiting were the common symptoms. All cases were Hepatitis b surface antigen (HBSAg ) test

+ve, SGPT raised in 90.90 % cases, SGOT raised in 81.82 cases.

Conclusion: In ICMR NIRTH Jabalpur, reports leptospira positivity was found in 05 cases. There was no other underlying cause except Leptospira co-infection/super-infection which was responsible for such a high fatality in cases with acute Hepatitis.

References

K Park .Parks textbook of preventive and social medicine

,23rd edition, Jabalpur: Bhanot Publishers;2015. pages 210- 220.

Acute Hepatitis in the Emergency Department. Available at: https://www.reliasmedia.com/articles/137579-acute- hepatitis-in-the-emergency-department. Assessed September 12th, 2018.

Merle P, Trépo C, Zoulim F. Current management strategies for hepatitis B in the elderly. Drugs & Aging. 2001; 18:725– 735.

Kun Huang, Jin-Hua Hu. Survival and prognostic factors in hepatitis B virus-related acute-on-chronic liver failure.World J Gastroenterol. 2011; 17(29): 3448–3452.

Weissberg JI, Andres LL, Smith CI, Weick S, and et al. Sur- vival in chronic hepatitis B. An analysis of 379 patients. Ann Intern Med. 1984 Nov; 101(5):613-6.

Felix E. De Jongh, Harry L. A. Janssen, and et al. Survival and Prognostic Indicators in Hepatitis B Surface Antigen- Positive Cirrhosis of the Liver. Gastroenterology .1992; 103(5): 1630-1635.

Sagnelli E, Coppola N, Messina V, et al. HBV superinfection in hepatitis C virus chronic carriers, viral interaction, and clinical course. Hepatology. 2002; 36:1285.

Liaw YF, Chen YC, Sheen IS, et al. Impact of acute hepatitis C virus superinfection in patients with chronic hepatitis B vi- rus infection. Gastroenterology. 2004; 126:1024.

Subrat Kumar Acharya, Praveen Kumar Sharma, Rajbir Singh and et al. Hepatitis E virus (HEV) infection in patients with cirrhosis is associated with rapid decompensation and death. Journal of Hepatology. 2007; 46(3): 387-394

Yoto Y, Kudoh T , Haseyama K, Suzuki N, and et al . Parvo- virus B19 infection associated with acute hepatitis. Lancet. 1996; 347: 868-869

Krygier DS, Steinbrecher UP, Petric M, et al. Parvovirus B19 induced hepatic failure in an adult requiring liver transplan- tation. World J Gastroenterol. 2009; 15(32):4067-9.

Leonidas Christou, Georgios Kalambokis and Epameinondas V Tsianos. Weil ’s disease in a Patient with Chronic Viral Hepatitis and History of Alcohol Abuse. Internal Medi- cine.2008; 47: 933-937.

Bijayini Behera, Rama Chaudhry, Anubhav Pandey, Anant Mohan, and et al. Co-infections due to leptospira, dengue and hepatitis E: a diagnostic challenge. Journal of Infection in Developing Countries. 2010; 4(1):048-050.

M Rizvi, M Azam, M R Ajmal, I Shukla, and A Malik. Prevalence of leptospira in acute hepatitis syndrome and assessment of IL-8 and TNF-alpha level in leptospiral hepatitis. Annals of tropical medicine and parasitology. 2011; 105(7): 499–506.

Tandon BN, Gandhi BM, Joshi YK. Etiological spectrum of viral hepatitis and prevalence of markers of hepatitis A and B infection in north India. Bulletin of the World Health Organization. 1984; 62: 67- 73.

Naik SR et al. A large waterborne viral hepatitis E epidemic in Kanpur, India. Bulletin of the World Health Organization 1992; 70: 597-604.

Singh J et al. An outbreak of viral hepatitis E: role of com- munity practices. Journal of communicable diseases.1995; 27: 92-96

J. Singh, R. Bhatia, J.C. Gandhi, A.P. Kaswekar and et al.Outbreak of viral hepatitis B in a rural community in India linked to inadequately sterilized needles and syringes. Bulle- tin of the World Health Organization. 1998; 76 (1): 93-98

Disha A Patel, Praveg A Gupta, Deepa M Kinariwala, Hetal S Shah and et al . An Investigation of an Outbreak of Viral Hepatitis B in Modasa Town, Gujarat,India .J Glob Infect Dis. 2012; 4(1): 55–59.

Nihal Secil Bati, Mehmet Sait Tekerekoglu, Yucel Duman. Investigation of HBV DNA in HBsAg positive patients. Med- icine Science. 2017;6(4):706-9

Banker DD et al. Hepatitis delta virus infection in Bombay. Transactions of the Royal Society of Tropical Medicine and Hygiene. 1992; 86: 424-425

Hadler SC et al. Epidemiology and long-term consequences of hepatitis delta virus infection in the Yucpa Indians of Ven- ezuela. American journal of epidemiology.1992; 136: 1507- 1516.

Tina Damodar, Thomas Kuruvilla, Zevita Furtado, and Roopa Hegde .Co–Infection: Weil’s Syndrome with Hepatitis B Infection- A Diagnostic and Therapeutic Hitch. J Clin Diagn Res. 2013 ; 7(10): 2270–2271

Downloads

Published

2019-03-31

How to Cite

1.
Guleri SK, Gupta A, Nandeshwar S, Mishra S, Panika R, Sahu R. Outbreak Investigation of Unusual Deaths in Cases of Acute Hepatitis Syndrome, in Makronia Municipal Area of Sagar Disitrict of Madhya Pradesh. Natl J Community Med [Internet]. 2019 Mar. 31 [cited 2024 Mar. 29];10(03):135-9. Available from: https://njcmindia.com/index.php/file/article/view/472

Issue

Section

Original Research Articles