The Hindu Business Line : Hepatitis epidemic keeps Kerala Health Dept on its toes

The disease has spread to practically all parts of the State with the water-bound areas in Thrissur, Pathanamthitta and Alappuzha reporting the maximum incidence.

Thiruvananthapuram , Feb. 14

MARAUDING hepatitis A and E viruses have put the health infrastructure under severe stress with no less than 700 cases of affliction being reported from across the State during the last few months.

At least 10 patients have since died, mostly in the district of Kottayam, where ironically the Medical College and its vicinity are seemingly proving to be the breeding grounds for the deadly virus.

It has since spread its tentacles to practically all parts of the State with the water-bound areas in Thrissur, Pathanamthitta and Alappuzha reporting the maximum incidence. The Government has since swung into action by putting up a network of district-level cells headed at the apex level by State-level cell in the Capital to monitor and fight the spread of the disease.

Sources at the Kerala Government Medical College Teachers' Association reveal that 90 house surgeons, 165 medical students, and around 100 locals in Kottayam have contracted the disease in the last six months. The condition of six doctors became critical and two of them died subsequently. The Kottayam Medical College alone has treated more than 500 jaundice patients during the past six months.

Water-borne hepatitis in India has often been associated predominantly with sewage-contamination of water supplies. Not surprisingly, hepatitis A virus (a picornavirus or a very small virus) and hepatitis E virus (an unrelated enteric virus) have been responsible for water-borne outbreaks of jaundice. Hepatitis E virus is the more threatening, as women in the latter stages of pregnancy are at greater risk of serious disease.

Hepatitis A virus infection resolves without complication and protection can be achieved by vaccination. Since most doctors and hospital staff could be assumed to have received hepatitis vaccination, health activists are suggesting that hepatitis E virus could well be the culprit in Kottayam at the least.

On Sunday, 21 cases were reported from Thrissur district, raising the total number of the afflicted there to 312. Outbreak of the disease has been particularly severe in Kunnamkulam and Parappukkara areas of the district.

Officials in the Public Health Department believe contaminated water bodies are the main source for the spread of the disease. If it was the case of an infected water tank at the Medical College, Kottayam, polluted local ponds are thought to have spawned the virus in Thrissur and Alappuzha districts. The mushrooming of eateries, most of whose water sources are suspect, need to be restricted, say health activists.

Efforts are now on to isolate the sources of contamination. The Health Department has instructed all district medical officers to carry out inspections of the eateries and fruit juice vendors in their respective areas and intensify containment measures. They are being authorised to invoke provisions of the Public Health Act to raid outlets food vends of selling contaminated food.

The department has also notified a list of dos and don'ts for the attention of the public in its efforts to prevent a further outbreak of the disease. It directed the public to avoid cool drinks, buttermilk and ice cream for fear of having used infected water. Patients with hepatitis B, C, and D infections have been advised against donating blood.

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