Outbreak Investigation of Unusual Deaths in Cases of Acute Hepatitis Syndrome, in Makronia Municipal Area of Sagar Disitrict of Madhya Pradesh
Sunil Kant Guleri, Amarnath Gupta, Sunil Nandeshwar, Shraddha Mishra, Ramkumar Panika, Rupesh Sahu.
Introduction: Eleven (11) cases of sudden deaths were reported in patients suffering from jaundice in Sagar district of Madhya Pradesh during March-July 2018. All the cases were HBsAg positive and died due to hepatic encephalopathy and or hepatorenal failure.
Methods: outbreak investigation was done using semi-structured profarma. The clinical history, investigation reports, death certifi-cates and other available documents were analysed and findings recorded. House to house survey and health camps were also organised to find other cases with similar illnesses. The blood samples family members and suspected cases with jaundice were sent to ICMR NIRTH Jabalpur for viral isolations.
Results: All the cases of deaths were localised within an area of about 10 Kms. About 72% cases recorded died within 3 days of illness. Jaundice, abdominal pain and vomiting were the common symptoms. All cases were Hepatitis b surface antigen (HBSAg ) test +ve, SGPT raised in 90.90 % cases, SGOT raised in 81.82 cases.
Conclusion: In ICMR NIRTH Jabalpur, reports leptospira posi-tivity was found in 05 cases. There was no other underlying cause except Leptospira co-infection/super-infection which was responsible for such a high fatality in cases with acute Hepatitis.
Key words: Hepatitis B, leptospirosis, co-infection, super infection Hepatorenal Syndrome.