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Hepatitis E outbreak in Jaipur due to Genotype IA.
Indian Journal of Medical Microbiology ( IF 1.6 ) Pub Date : 2020-01-01 , DOI: 10.4103/ijmm.ijmm_19_433 Bharti Malhotra 1 , Farah Deba 2 , Pratibha Sharma 1 , Khushbu Trivedi 1 , Jitendra Tiwari 3 , Aradhana Chouhan 1 , Ruchi Singh 4 , Deepa Meena 4 , H N Verma 5
Purpose: Suddenly, many cases of fever with jaundice were reported from Sodala area at Jaipur. This outbreak of acute hepatitis at Jaipur Rajasthan was investigated for aetiology and subsequent phylogenetic analysis. Methods: Blood samples were collected from 106 symptomatic patients of acute hepatitis and 39 pregnant females (with or without symptoms of hepatitis) during an outbreak at Jaipur. The samples were tested for hepatitis A virus (HAV) and hepatitis E virus (HEV) by serological and molecular methods (polymerase chain reaction [PCR]). Sequencing of nested PCR product was done for phylogenetic analysis. Hepatitis B surface antigen (HBs antigen), anti-hepatitis C virus (HCV), anti-Leptospira and anti-scrub typhus IgM enzyme-linked immunosorbent assay (ELISA) was done for patients negative for HEV and HAV. Results: Among 106 symptomatic patients, HEV IgM was positive in 84/106 (79.2%) patients and HEV RNA in 72/106 (67.9%) patients. Among pregnant women, 6/39 (15.4%) were HEV IgM positive and 5/39 (12.8%) for HEV RNA. One (2.5%) pregnant woman died due to hepatitis. All the isolates belonged to genotype 1A of HEV. All HAV, HEV-negative samples were negative for HBs antigen, HCV antibody, Leptospira and scrub typhus IgM ELISA. Conclusion: The outbreak was due to HEV genotype 1A. The municipal water supply was contaminated and sanitary conditions and waste disposal were poor in the area. Boiling of drinking water, fixing the water supply pipes and frequent hand washing helped in controlling the outbreak.
中文翻译:
斋浦尔因基因型IA引起的戊型肝炎暴发。
目的:突然之间,斋浦尔的Sodala地区报告了许多黄疸热病例。斋浦尔拉贾斯坦邦爆发的这例急性肝炎已进行了病因学调查和随后的系统发育分析。方法:在斋浦尔爆发期间,从106例有症状的急性肝炎患者和39例怀孕的女性(有或没有肝炎症状)中收集了血液样本。通过血清学和分子方法(聚合酶链反应[PCR])对样品进行甲型肝炎病毒(HAV)和戊型肝炎病毒(HEV)的检测。巢式PCR产物的测序用于系统发育分析。对HEV和HAV阴性的患者进行了乙型肝炎表面抗原(HBs抗原),抗丙型肝炎病毒(HCV),抗钩端螺旋体和抗擦伤性斑疹病IgM酶联免疫吸附测定(ELISA)。结果:在106例有症状的患者中,HEV IgM阳性的患者为84/106(79.2%),HEV RNA的阳性患者为72/106(67.9%)。在孕妇中,HEV IgM阳性率为6/39(15.4%),HEV RNA为5/39(12.8%)。一名孕妇(2.5%)死于肝炎。所有分离株均属于HEV基因型1A。所有HAV,HEV阴性样品的HBs抗原,HCV抗体,钩端螺旋体和斑疹伤寒IgM ELISA均为阴性。结论:爆发是由于HEV基因型1A。该地区的市政供水受到污染,卫生条件和废物处理不佳。煮沸饮用水,固定供水管道和经常洗手有助于控制疫情。
更新日期:2020-01-01
Indian Journal of Medical Microbiology ( IF 1.6 ) Pub Date : 2020-01-01 , DOI: 10.4103/ijmm.ijmm_19_433 Bharti Malhotra 1 , Farah Deba 2 , Pratibha Sharma 1 , Khushbu Trivedi 1 , Jitendra Tiwari 3 , Aradhana Chouhan 1 , Ruchi Singh 4 , Deepa Meena 4 , H N Verma 5
Affiliation
Purpose: Suddenly, many cases of fever with jaundice were reported from Sodala area at Jaipur. This outbreak of acute hepatitis at Jaipur Rajasthan was investigated for aetiology and subsequent phylogenetic analysis. Methods: Blood samples were collected from 106 symptomatic patients of acute hepatitis and 39 pregnant females (with or without symptoms of hepatitis) during an outbreak at Jaipur. The samples were tested for hepatitis A virus (HAV) and hepatitis E virus (HEV) by serological and molecular methods (polymerase chain reaction [PCR]). Sequencing of nested PCR product was done for phylogenetic analysis. Hepatitis B surface antigen (HBs antigen), anti-hepatitis C virus (HCV), anti-Leptospira and anti-scrub typhus IgM enzyme-linked immunosorbent assay (ELISA) was done for patients negative for HEV and HAV. Results: Among 106 symptomatic patients, HEV IgM was positive in 84/106 (79.2%) patients and HEV RNA in 72/106 (67.9%) patients. Among pregnant women, 6/39 (15.4%) were HEV IgM positive and 5/39 (12.8%) for HEV RNA. One (2.5%) pregnant woman died due to hepatitis. All the isolates belonged to genotype 1A of HEV. All HAV, HEV-negative samples were negative for HBs antigen, HCV antibody, Leptospira and scrub typhus IgM ELISA. Conclusion: The outbreak was due to HEV genotype 1A. The municipal water supply was contaminated and sanitary conditions and waste disposal were poor in the area. Boiling of drinking water, fixing the water supply pipes and frequent hand washing helped in controlling the outbreak.
中文翻译:
斋浦尔因基因型IA引起的戊型肝炎暴发。
目的:突然之间,斋浦尔的Sodala地区报告了许多黄疸热病例。斋浦尔拉贾斯坦邦爆发的这例急性肝炎已进行了病因学调查和随后的系统发育分析。方法:在斋浦尔爆发期间,从106例有症状的急性肝炎患者和39例怀孕的女性(有或没有肝炎症状)中收集了血液样本。通过血清学和分子方法(聚合酶链反应[PCR])对样品进行甲型肝炎病毒(HAV)和戊型肝炎病毒(HEV)的检测。巢式PCR产物的测序用于系统发育分析。对HEV和HAV阴性的患者进行了乙型肝炎表面抗原(HBs抗原),抗丙型肝炎病毒(HCV),抗钩端螺旋体和抗擦伤性斑疹病IgM酶联免疫吸附测定(ELISA)。结果:在106例有症状的患者中,HEV IgM阳性的患者为84/106(79.2%),HEV RNA的阳性患者为72/106(67.9%)。在孕妇中,HEV IgM阳性率为6/39(15.4%),HEV RNA为5/39(12.8%)。一名孕妇(2.5%)死于肝炎。所有分离株均属于HEV基因型1A。所有HAV,HEV阴性样品的HBs抗原,HCV抗体,钩端螺旋体和斑疹伤寒IgM ELISA均为阴性。结论:爆发是由于HEV基因型1A。该地区的市政供水受到污染,卫生条件和废物处理不佳。煮沸饮用水,固定供水管道和经常洗手有助于控制疫情。