Epidemiological and clinical analysis of hepatitis virus A infections during three successive outbreaks in Sfax (Tunisia) between 2007 and 2010.

to describe the epidemiological and clinical characteristics of HAV infection during three successive outbreaks occurring between 2007 and 2010 in the governorate of Sfax. epidemiological and clinical characteristics were retrospectively analyzed from the outbreak investigations. The diagnosis of acute hepatitis A was confirmed by ELISA detection of immunoglobulin M serum antibodies to HAV. 443 patients were identified and 159 of them investigated. Their mean age was 12.2 years and the M/F ratio was 0.9. The most affected age groups were 6-10 years (35%) and 11-15 years (33%). The most likely sources of contamination were drinking water from wells or tanks and direct transmission. The most frequent symptoms included asthenia, digestive disorders, and jaundice. Two cases of fulminant hepatitis were reported, one lethal. our results show that HAV endemicity in the governorate of Sfax has dropped from high to intermediate as demonstrated by the increasing age at primary HAV infection. Strengthening health education and improving access to drinking water would reduce the transmission risk of HAV in our regions.