41 cases of Hepatitis A were reported from Alhysoniah village in Eqlat Sqoor, AlQassiem Region, during the period 5-24/2/1431H (20 Jan, 2010 to 8 Feb, 2010). This study aims to describe this outbreak, identify the possible risk factors associated with its occurrence and provide recommendations for disease control and prevention.
Methodology
A case control study was conducted. A case was defined as any person living in Alhysoniah village and presenting at one of the health institutes with jaundice and/or confirmed by laboratory tests during the period of 5/2/1431 to 24/2/1431H. A control was defined as any person lived in the same area who never had any jaundice symptoms (did not suffer from hepatitis A clinically) before 24/2/1431 H (08 Feb 2010). One control was selected for each case. Data was collected by face to face interviews and documented on a structured data collection instrument. Odds ratios and 95% confidence intervals were calculated to investigate associated risk factors.
Results
30 Hepatitis A cases were selected for this study. 30 controls met the criteria of selection interview. All cases were Saudis, males represented 83.3% of cases and females represented 16.7% (Female : Male ratio 1:4.99). Cases had a mean (+ sd) age of 13.6 (+ 4.1) years. The epidemic curve showed occurrence of single peak which suggest point source epidemic. The risk factors identified were attending Alhysoniah School (OR = 6.88, 95% CI = 1.71 - 27.75), drinking water from school cooler (OR = 3.60, 95% CI = 1.22 - 10.64) and contact with jaundice case (OR = 3.5, 95% CI = 1.20 - 10.19) Sample from water tank in Alhysoniah School showed positive E-coli test.
Conclusion
This outbreak is an example of community point source epidemic, which is the school water tank exacerbated by person to person transmission. Future similar outbreaks could be prevented mainly by water source control. Following basic hygienic practices; hand washing with water and soap among school tank cleaners and students can help in epidemic control. Health Education campaigns among school children and cleaners is highly recommended.