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Hepatitis ''A'' Outbreak in Al-Berk, Asir region, 2004.


An increase in the number of hepatitis A cases was reported from scattered villages in Al-berk, Asir region, up to 19 May 2004. This study aims to describe this outbreak, identify possible risk factors and provide recommendations for control and prevention of its recurrence.


A case control study was conducted. A case was defined as any person living in Alberk governorate and presenting at one of the health institutes with jaundice and/or diagnosed as suffering from hepatitis A clinically and/or confirmed by laboratory tests during the period of 30/11/1424 to 30/3/1425 (1 January to 19 May 2004). 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.


110 hepatitis A cases were reported from 19 villages; 110 controls met the criteria of selection interview. All were Saudis, males represented 49.1% of cases and females represented 50.9% (male: female ratio 1: 1.04). Cases had a mean (±sd) age 9.1(±5.6) years. The epidemic curve showed occurrence of a peak every 3-5 weeks. The risk factors identified were contact with jaundice case (OR=3.2, 95% CI= 1.8-5.56) and this risk further increased when jaundice cases lived in the same household (OR=11.70, 95% CI =4.47-31.85). Washing hands with water and soap before eating and after going to the toilet, as well as recent administration of immune globulin vaccine gave protection from acquiring infection.


This epidemic is an exacerbation of person to person transmission. Future similar outbreaks could be prevented by following basic hygienic practices; mainly hand washing with water and soap. Immune Globulin vaccine helped in epidemic control. It is recommended to start health education campaigns especially among school children, particularly in endemic areas in Saudi Arabia.