A severe and explosive outbreak of hepatitis B in a rural population in Sirsa district, Haryana, India: unnecessary therapeutic injections were a major risk factor

Epidemiol Infect. 2000 Dec;125(3):693-9. doi: 10.1017/s0950268800004684.


Most outbreaks of viral hepatitis in India are caused by hepatitis E. This report describes an outbreak of hepatitis B in a rural population in Haryana state in 1997. At least 54 cases of jaundice occurred in Dhottar village (population 3096) during a period of 8 months; 18 (33.3%) of them died. Virtually all fatal cases were adults and tested positive for HBsAg (other markers not done). About 88% (21/24) of surviving cases had acute or persistent HBV/HCV infections; 54% (13/24) had acute hepatitis B. Many other villages reported sporadic cases and deaths. Data were pooled from these villages for analysis of risk factors. Acute hepatitis B cases had received injections before illness more frequently (11/19) than those found negative for acute or persistent HBV/HCV infections (3/17) (P = 0.01). Although a few cases had other risk factors, these were equally prevalent in two groups. The results linked the outbreak to the use of unnecessary therapeutic injections.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Child
  • Child, Preschool
  • Disease Outbreaks*
  • Equipment Contamination*
  • Female
  • Hepatitis B / mortality
  • Hepatitis B / transmission*
  • Hepatitis B Surface Antigens / analysis
  • Hepatitis C
  • Humans
  • India / epidemiology
  • Infant
  • Infant, Newborn
  • Injections, Intravenous
  • Jaundice / etiology
  • Jaundice / virology
  • Male
  • Middle Aged
  • Needles / virology
  • Risk Factors
  • Rural Population


  • Hepatitis B Surface Antigens