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Hepatitis ''A'' Outbreak in Dhulai?a Rasheed, Al Qassiem region, 2004.


An increase in the number of Hepatitis A cases was reported from scattered villages in Dhulai'a Rasheed, Qassiem region, up to 30 April 2006. 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 Dhulai'a Rasheed 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 14/9/1426 to 1/4/1427 (18 October 2005 to 30 Apr 2006). Two controls were 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.


105 Hepatitis A cases were reported from 20 villages; 210 controls met the criteria of selection interview. All were Saudis, males represented 59% of cases and females represented 41% (female: male ratio 1: 1.44). Cases had a mean (±sd) age of 5.4(±2.2) years. The epidemic curve showed occurrence of a peak every 4-6 weeks. The risk factors identified were contact with jaundice case (OR=2.46, 95% CI= 1.39-4.36) and this risk further increased when jaundice cases were relatives (OR=7.79, 95% CI =1.10-67.13).All the water sources in the area which represented by the shallow wells were chemically and biologically contaminated and incompatible for human use. Washing hands with water and soap before eating and after going to the toilet, or recent administration of immune globulin vaccine gave protection from acquiring infection.


This epidemic is an exacerbation of a person to person transmission as well as an extended common source. Future similar outbreaks could be prevented mainly by water source control. Following basic hygienic practices; 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.