Outbreak of Hepatitis B in Sabarkantha District of Gujarat: A Case-Control Study

Background: An outbreak of jaundice syndrome was reported from Sabarkantha district of Gujarat in February 2009. Initial investigation of serum specimens collected from the patients was positive for hepatitis B. The outbreak was investigated thoroughly. Materials and Methods: A confirmed case definition was made as a person residing in Sabarkantha district who developed jaundice symptoms with SGPT >400 IU and tested positive for HBsAg. A case-control study was conducted to identify the source of infection and to recommend public health measures. Results: Five-hundred and twenty-eight cases were reported of which, 93 died (Case fatality rate = 17.6%). Majority (61%) were males, and more than 77% were in the age group of 12-45 years. Eighty-four percent reported history of taking injections/needle prick in the last 6 months. In the case-control study there was strong association between cases and history of injection/needle prick (OR = 42.17). Hepatitis B mass vaccination was carried out to control the outbreak. Conclusion: This outbreak of hepatitis-B was associated with unsafe injection practices in private clinics of Sabarkantha district. Sensitization workshop for safe injection practices and waste management held among doctors. Legal actions were taken against the private practitioners involved in these unsafe injection practices.