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Hepatitis ''A'' Outbreak in Rania, Al-Taif region, 2009


An increase in the number of hepatitis A cases was reported from scattered villages in Rania, Al Taif region, up to 10 February 2009. 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 Rania 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 14/1/1430 to 15/2/1430 (10 January 2009 to 10 February 2009). Three 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.


25 hepatitis A cases were reported from 8 villages; 75 controls met the criteria of selection interview. Saudis represented 92% of the cases and controls, males represented 68% of cases and females represented 32% (female: male ratio 1: 2.12). Cases had a mean (±sd) age 11.2 (± 2.2) years. The epidemic curve showed occurrence of a peak every 1-2 weeks. The risk factors identified were contact with jaundice case (OR=3.27, 95% CI= 1.22-9.21) and this risk further increased when jaundice cases are school peer (OR=16, 95% CI =2.82-103).All the water sources in the area which represented by the shallow wells were chemically and biologically incompatible to human use. All 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 a common source as well as a person to person transmission. Future similar outbreaks could be prevented mainly by water source control. Although, 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.