An unusually large number of Hepatitis A cases were reported from a rural community in Jizan in year 2002. As a result, the Saudi Ministry of Health requested an investigation to suggest measures for its control and prevent recurrence.
Methodology
After an initial review of all the existing record in regional health directorate and local Primary Health Care centre; interview of the patients admitted in the hospital with review of their medical record; visit of the local community for environmental assessment a case control study was designed to identify the risk factors associated with the occurrence and transmission of disease.
Results
A total of 63 children reported the usual symptoms and signs of Hepatitis A, among who 41% were males. The outbreak started in village Mehlia (AR 42.9/1000 pop) and gradually expanded to physically contiguous villages Khradla (AR 24.3/1000 pop) and Omeriah (AR 2.5/1000 pop) in a pattern suggestive of person to person transmission. Among the risk factors studied exposure to a known case of jaundice (OR 11.86, 95% CI 3.0-48.0), being a student (OR 0.16, 95% CI 0.16-0.64) and usually washing hands with soap before eating meal (OR 0.11, 95% CI 0.03-0.44) were found statistically significantly associated. No significant association was found with any of the food items or source of water supply studied.
Conclusion
The outbreak studied is an exacerbation of the endemic person to person feco-oral transmission of Hepatitis A, which can be prevented by improved water quality and personal/food hygiene practices.