2009 Gujarat hepatitis outbreak

Last updated
2009 Gujarat hepatitis outbreak
Modasa-Gujrat.png
Location of Modasa in Gujarat
Dateearly 2009
Location Modasa, Gujarat, India
Casualties
49 dead [1]
125+ infected [2]

The 2009 Gujarat hepatitis B outbreak was a cluster of hepatitis B cases that appeared in Modasa, northern Gujarat, India in 2009. Over 125 people were infected and up to 49 people died. [1] [2] Several doctors were investigated and arrested after the outbreaks.[ citation needed ]

Contents

Hepatitis B

The hepatitis B virus infects the liver and causes an inflammation called hepatitis. It is a DNA virus and one of many unrelated viruses that cause viral hepatitis. The disease, originally known as "serum hepatitis", [3] has caused epidemics in parts of Asia and Africa, and it is endemic in China. [4] About a third of the world's population, more than 2 billion people, have been infected with the hepatitis B virus. [5] This includes 350 million chronic carriers of the virus. [6] The acute illness causes liver inflammation, vomiting and jaundice. The infection is preventable by vaccination. [7]

Transmission of hepatitis B results from exposure to infectious blood or body fluids containing blood. Possible forms of transmission include (but are not limited to) unprotected sexual contact, blood transfusions, re-use of contaminated needles & syringes, and vertical transmission from mother to child during childbirth. HBV can be transmitted between family members within households, possibly by contact of nonintact skin or mucous membrane with secretions or saliva containing HBV. [8] [9] However, at least 30% of reported cases of hepatitis B among adults cannot be associated with an identifiable risk factor. [10]

Arrests

The doctors were accused of re-using syringes, which had been contaminated with hepatitis B virus, to treat other patients. Eight medical practitioners, including doctors Govind and Chintal Patel, were arrested under the Indian Penal Code for culpable homicide not amounting to murder after allegedly re-using infected syringes. [11] One of them was also charged with attempted murder. [2] Most of the people affected had received medical treatment from Dr. Patel in the last six months. Medical officials conducted a raid on Patel's clinic and found several used syringes and other medical waste. [2] [12]

Reaction

The Government of Gujarat started a mass immunization drive under strict medical supervision in Modasa, which set up 60 booths in Modasa and nearby cities. [13] 224 medical teams, including some from All Indian Institute of Medical Sciences and National Institute of Virology set up camps in Modasa and remained there for about a month. [1] [14] According to the officials 25,000 vaccines were sent to the most affected area and 600,000 more vaccines was arranged from Hyderabad. [15] In addition, the government distributed 30,000 pamphlets and mounted a campaign to inform residents about the disease. [14] The Health Department of the Gujarat government have sent 600,000 doses of vaccine to the area. [16]

See also

Related Research Articles

<span class="mw-page-title-main">Hepatitis</span> Inflammation of the liver

Hepatitis is inflammation of the liver tissue. Some people or animals with hepatitis have no symptoms, whereas others develop yellow discoloration of the skin and whites of the eyes (jaundice), poor appetite, vomiting, tiredness, abdominal pain, and diarrhea. Hepatitis is acute if it resolves within six months, and chronic if it lasts longer than six months. Acute hepatitis can resolve on its own, progress to chronic hepatitis, or (rarely) result in acute liver failure. Chronic hepatitis may progress to scarring of the liver (cirrhosis), liver failure, and liver cancer.

<span class="mw-page-title-main">Hepatitis C</span> Human viral infection

Hepatitis C is an infectious disease caused by the hepatitis C virus (HCV) that primarily affects the liver; it is a type of viral hepatitis. During the initial infection period, people often have mild or no symptoms. Early symptoms can include fever, dark urine, abdominal pain, and yellow tinged skin. The virus persists in the liver, becoming chronic, in about 70% of those initially infected. Early on, chronic infection typically has no symptoms. Over many years however, it often leads to liver disease and occasionally cirrhosis. In some cases, those with cirrhosis will develop serious complications such as liver failure, liver cancer, or dilated blood vessels in the esophagus and stomach.

Hepatitis D is a type of viral hepatitis caused by the hepatitis delta virus (HDV). HDV is one of five known hepatitis viruses: A, B, C, D, and E. HDV is considered to be a satellite because it can propagate only in the presence of the hepatitis B virus (HBV). Transmission of HDV can occur either via simultaneous infection with HBV (coinfection) or superimposed on chronic hepatitis B or hepatitis B carrier state (superinfection).

<span class="mw-page-title-main">Hepatitis A</span> Acute infectious disease of the liver

Hepatitis A is an infectious disease of the liver caused by Hepatovirus A (HAV); it is a type of viral hepatitis. Many cases have few or no symptoms, especially in the young. The time between infection and symptoms, in those who develop them, is 2–6 weeks. When symptoms occur, they typically last 8 weeks and may include nausea, vomiting, diarrhea, jaundice, fever, and abdominal pain. Around 10–15% of people experience a recurrence of symptoms during the 6 months after the initial infection. Acute liver failure may rarely occur, with this being more common in the elderly.

<span class="mw-page-title-main">Hepatitis E</span> Human disease caused by Orthohepevirus A

Hepatitis E is inflammation of the liver caused by infection with the hepatitis E virus (HEV); it is a type of viral hepatitis. Hepatitis E has mainly a fecal-oral transmission route that is similar to hepatitis A, although the viruses are unrelated. In retrospect, the earliest known epidemic of hepatitis E occurred in 1955 in New Delhi, but the virus was not isolated until 1983 by Russian scientists investigating an outbreak in Afghanistan. HEV is a positive-sense, single-stranded, nonenveloped, RNA icosahedral virus and one of five known human hepatitis viruses: A, B, C, D, and E.

<i>Hepadnaviridae</i> Family of viruses

Hepadnaviridae is a family of viruses. Humans, apes, and birds serve as natural hosts. There are currently 18 species in this family, divided among 5 genera. Its best-known member is hepatitis B virus. Diseases associated with this family include: liver infections, such as hepatitis, hepatocellular carcinomas, and cirrhosis. It is the sole accepted family in the order Blubervirales.

<span class="mw-page-title-main">Viral hepatitis</span> Liver inflammation from a viral infection

Viral hepatitis is liver inflammation due to a viral infection. It may present in acute form as a recent infection with relatively rapid onset, or in chronic form.

Post-exposure prophylaxis, also known as post-exposure prevention (PEP), is any preventive medical treatment started after exposure to a pathogen in order to prevent the infection from occurring.

The Jade Ribbon Campaign (JRC) also known as JoinJade, was launched by the Asian Liver Center (ALC) at Stanford University in May 2001 during Asian Pacific American Heritage Month to help spread awareness internationally about hepatitis B (HBV) and liver cancer in Asian and Pacific Islander (API) communities.

Hepatitis B is endemic in China. Of the 350 million individuals worldwide infected with the hepatitis B virus (HBV), one-third reside in China. As of 2006 China has immunized 11.1 million children in its poorest provinces as part of several programs initiated by the Chinese government and as part of the Global Alliance for Vaccines and Immunization (GAVI). However, the effects of these programs have yet to reach levels of immunization that would limit the spread of hepatitis B effectively.

<span class="mw-page-title-main">HBsAg</span> Surface antigen of the hepatitis B virus

HBsAg is the surface antigen of the hepatitis B virus (HBV). Its presence in blood indicates current hepatitis B infection.

<span class="mw-page-title-main">Hepatitis B vaccine</span> Vaccine against hepatitis B

Hepatitis B vaccine is a vaccine that prevents hepatitis B. The first dose is recommended within 24 hours of birth with either two or three more doses given after that. This includes those with poor immune function such as from HIV/AIDS and those born premature. It is also recommended that health-care workers be vaccinated. In healthy people, routine immunization results in more than 95% of people being protected.

<span class="mw-page-title-main">Hepatitis B</span> Human viral infection

Hepatitis B is an infectious disease caused by the Hepatitis B virus (HBV) that affects the liver; it is a type of viral hepatitis. It can cause both acute and chronic infection.

<i>Hepatitis B virus</i> Species of the genus Orthohepadnavirus

Hepatitis B virus (HBV) is a partially double-stranded DNA virus, a species of the genus Orthohepadnavirus and a member of the Hepadnaviridae family of viruses. This virus causes the disease hepatitis B.

cccDNA is a special DNA structure that arises during the propagation of some viruses in the cell nucleus and may remain permanently there. It is a double-stranded DNA that originates in a linear form that is ligated by means of DNA ligase to a covalently closed ring. In most cases, transcription of viral DNA can occur from the circular form only. The cccDNA of viruses is also known as episomal DNA or occasionally as a minichromosome.

The transmission of hepadnaviruses between their natural hosts, humans, non-human primates, and birds, including intra-species host transmission and cross-species transmission, is a topic of study in virology.

<span class="mw-page-title-main">Hepatitis B virus precore mutant</span>

A precore mutant is a variety of hepatitis B virus that does not produce hepatitis B virus e antigen (HBeAg). These mutants are important because infections caused by these viruses are difficult to treat, and can cause infections of prolonged duration and with a higher risk of liver cirrhosis. The mutations are changes in DNA bases from guanine to adenine at base position 1896 (G1896A), and from cytosine to thymine at position 1858 (C1858T) in the precore region of the viral genome.

<i>Ground squirrel hepatitis virus</i> Species of virus

Ground squirrel hepatitis virus, abbreviated GSHV, is a partially double-stranded DNA virus that is closely related to human Hepatitis B virus (HBV) and Woodchuck hepatitis virus (WHV). It is a member of the family of viruses Hepadnaviridae and the genus Orthohepadnavirus. Like the other members of its family, GSHV has high degree of species and tissue specificity. It was discovered in Beechey ground squirrels, Spermophilus beecheyi, but also infects Arctic ground squirrels, Spermophilus parryi. Commonalities between GSHV and HBV include morphology, DNA polymerase activity in genome repair, cross-reacting viral antigens, and the resulting persistent infection with viral antigen in the blood (antigenemia). As a result, GSHV is used as an experimental model for HBV.

<i>Woolly monkey hepatitis B virus</i> Species of virus

The woolly monkey hepatitis B virus (WMHBV) is a viral species of the Orthohepadnavirus genus of the Hepadnaviridae family. Its natural host is the woolly monkey (Lagothrix), an inhabitant of South America categorized as a New World primate. WMHBV, like other hepatitis viruses, infects the hepatocytes, or liver cells, of its host organism. It can cause hepatitis, liver necrosis, cirrhosis, and hepatocellular carcinoma. Because nearly all species of Lagothrix are threatened or endangered, researching and developing a vaccine and/or treatment for WMHBV is important for the protection of the whole woolly monkey genus.

<span class="mw-page-title-main">Epidemiology of Hepatitis D</span> Instance, distribution, and control of Hepatitis D

The epidemiology of hepatitis D occurs worldwide. Although the figures are disputed, a recent systematic review suggests that up to 60 million individuals could be infected. The major victims are the carriers of the hepatitis B surface antigen (HBsAg), who become superinfected by the HDV, and intravenous drug users who are the group at highest risk. The infection usually results in liver damage ; this is most often a chronic and severe hepatitis rapidly conducive to cirrhosis.

References

  1. 1 2 3 "Doctor arrested in Gujarat Hepatitis-B outbreak case". NDTV. 2009-02-22. Retrieved 2009-02-22.
  2. 1 2 3 4 "India hepatitis death toll reaches 38". CNN. 2009-02-22. Archived from the original on 26 February 2009. Retrieved 22 February 2009.
  3. Barker LF, Shulman NR, Murray R, et al. (1996). "Transmission of serum hepatitis. 1970". JAMA. 276 (10): 841–4. doi:10.1001/jama.276.10.841. PMID   8769597.
  4. Williams R (2006). "Global challenges in liver disease". Hepatology. 44 (3): 521–6. doi: 10.1002/hep.21347 . PMID   16941687.
  5. WHO | Hepatitis B
  6. FAQ about Hepatitis B Archived 2009-02-09 at the Wayback Machine , Stanford University School of Medicine
  7. Pungpapong S, Kim WR, Poterucha JJ (2007). "Natural history of hepatitis B virus infection: an update for clinicians". Mayo Clin. Proc. 82 (8): 967–75. doi: 10.4065/82.8.967 . PMID   17673066.
  8. Petersen NJ, Barrett DH, Bond WW, Berquist KR, Favero MS, Bender TR, Maynard JE (1976). "Hepatitis B surface antigen in saliva, impetiginous lesions, and the environment in two remote Alaskan villages". Appl. Environ. Microbiol. 32 (4): 572–574. doi:10.1128/AEM.32.4.572-574.1976. PMC   170308 . PMID   791124.
  9. "Hepatitis B - the facts: IDEAS - Victorian Government Health Information, Australia". Health.vic.gov.au. Archived from the original on 28 February 2009. Retrieved 2009-02-23.
  10. Shapiro CN (1993). "Epidemiology of hepatitis B". Pediatr. Infect. Dis. J. 12 (5): 433–7. doi:10.1097/00006454-199305000-00036. PMID   8392167.
  11. "Doctors held over hepatitis deaths". Press Association. 2009-02-22. Retrieved 2009-02-22.
  12. "Hepatitis outbreak: 2 doctors booked for culpable homicide". Press Trust of India. 2009-02-22. Archived from the original on 25 February 2009. Retrieved 2009-02-22.
  13. "Hepatitis-B toll up to 35". Times of India. 2009-02-22. Retrieved 2009-02-22.
  14. 1 2 "Modassa residents blame Gujarat govt for spread of Hepatitis B". Sify News. 2008-02-22. Archived from the original on 2009-05-08. Retrieved 2009-02-22.
  15. "State govt opts for mass immunisation drive to counter Hepatitis B outbreak". Archived from the original on 2009-05-07. Retrieved 2009-02-22.
  16. "NDTV Report". Archived from the original on 2009-02-25. Retrieved 2009-02-23.