Singh V, Singh V, Raje M, Nain C K, Singh K
Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Trop Gastroenterol. 1998 Jul-Sep;19(3):107-9.
A large waterborne epidemic of hepatitis E occurred in the city of Saharanpur (Uttar Pradesh, India) between December 1992 and April 1993. A random survey was conducted in the affected area of Saharanpur. Source of water supply, number of family members, number and characteristics of affected persons were noted. Blood, stool and water samples were collected. The incidence of hepatitis was 14% in the affected area of the city. A total of 3682 individuals were affected with the disease. Attack rate for adults was significantly higher than the children aged < 15 years (17% vs 7%; p < 0.0001). Among the adults, the attack rate was higher for males than females (23% vs 12%; p < 0.0001). The incidence of hepatitis was greater in persons using the municipal water supply (17%) as compared to hand pump (0.9%) or tubewell water (0%). There was a single peak in the epidemic. Of the 56 fresh cases, 38 (64%) occurred within two weeks, 14 within 2-4 weeks and 4 within 4-6 weeks of index cases. Serologic markers for acute hepatitis A, B and C were absent. IgM anti-HEV was positive in 20 out of 24 sera tested. Immune electron microscopy detected 27-34 nm virus-like particles (VLPs) in 2 of 8 stool specimens and in 1 of 3 water samples. The epidemic occurred due to leakage of municipal water supply pipes passing through the sewerage holes. A large waterborne epidemic of hepatitis E resulted due to contaminated water supply. VLPs were detected in water. Adults and males were commonly affected. There was no person-to-person spread.
1992年12月至1993年4月期间，印度北方邦萨哈兰普尔市发生了一起大规模戊型肝炎水媒疫情。在萨哈兰普尔受影响地区进行了随机调查。记录了供水来源、家庭成员数量、受影响人员的数量和特征。采集了血液、粪便和水样。该市受影响地区的肝炎发病率为14%。共有3682人感染了该病。成年人的发病率显著高于15岁以下儿童（17%对7%；p<0.0001）。在成年人中，男性的发病率高于女性（23%对12%；p<0.0001）。使用市政供水的人群中肝炎发病率（17%）高于使用手压泵供水（0.9%）或管井水（0%）的人群。疫情有一个单一高峰。在56例新发病例中，38例（64%）在首例病例后的两周内发病，14例在2至4周内发病，4例在4至6周内发病。急性甲型、乙型和丙型肝炎的血清学标志物均为阴性。在检测的24份血清中，20份的IgM抗戊型肝炎病毒呈阳性。免疫电镜在8份粪便标本中的2份以及3份水样中的1份中检测到了27 - 34纳米的病毒样颗粒（VLP）。疫情是由于市政供水管穿过污水孔发生渗漏所致。受污染供水导致了大规模戊型肝炎水媒疫情。在水中检测到了病毒样颗粒。成年人和男性普遍受到影响。没有发生人传人传播。
