Outbreak Investigation of Unusual Deaths in Cases of Acute Hepatitis Syndrome, in Makronia Municipal Area of Sagar Disitrict of Madhya Pradesh
Keywords:
Hepatitis B, leptospirosis, co-infection, super infection Hepatorenal SyndromeAbstract
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
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