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Hepatitis E genotype 1 outbreak in Jharkhand, India: A descriptive analysis.

INTRODUCTION
A waterborne outbreak of hepatitis E virus occurred in the Jamshedpur city of Jharkhand from March 2018 to October2018. In the present study, we attempt to study the hepatitis E virus outbreak clinically, serologically and etiologically.


METHODS
Five hundredand eighty four clinically and biochemically documented cases were screened for the hepatotropic viral markers (HepatitisA, B, C, and E) by the ELISA. Demographic data such as gender, age,clinical diagnosis, location, the outcome, time of admission were extracted from the online hospital management system.Water samples from affected area were tested for HEV RNA detection. Genotyping of HEV virus was carried out by sequencing and phylogenetic analysis.


RESULT
Hepatitis E genotype 1 was confirmed as the major etiological agent inthis outbreak due to faecal contamination of drinking water supply while establishing illegal water connections. Mixed infection of HEV-HAV (5.31%) or HEV-HBV (0.91%) was also detected in the present series of acute viral hepatitis.


CONCLUSIONS
The study highlights the importance of screening forboth enterically transmitted hepatotropic viral markers as well as the parenterally transmitted hepatotropic viral markersduring outbreaks of acute viral hepatitis.