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Hepatitis A Outbreak Investigation: Steps and Measures for Control

This document outlines the steps taken during the investigation of a Hepatitis A outbreak. It details the identification of contacts related to initial cases and verifies diagnoses of affected individuals. A total of eight confirmed cases with symptoms, including jaundice, were documented. Key epidemiological links were established to understand transmission dynamics. Preventive measures were implemented, including public health messages about proper hand hygiene and advice for those exposed to seek medical guidance on immune globulin.

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Hepatitis A Outbreak Investigation: Steps and Measures for Control

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  1. Hepatitis A

  2. Step 2: Establish existence of an outbreak • Contacts • 1st case- 2 contacts • 2nd case- 3 contacts • 3rd case- Sexual contacts • 3 current boyfriends & fmr.boyfriend - Household contacts • Son • Mother & Father • A Gentleman and Lady & 2 Kids • Sister & Boyfriend & 2 Kids • 1 Contact

  3. 4/30/03 Mother 2/21 Child 2/21 StepFather S+ 1/15 Girlfriend Sister T + 2/13 Mother Girlfriend Sister Boyfriend M + 3/25 Hepatitis A Outbreak Fmr.Boyfriend Boyfriend M - J+ 3/21 F - Boyfriend Sister’s Boyfriend Boyfriend Sister Contact IG Given Child IgM + C Child GS JW J Household contact Child

  4. Step 3: Verify Diagnosis • 8 individuals with HAV-IgM + • All 8 showed signs and symptoms (i.e. jaundice)

  5. Step 4: Define & Identify Cases • Clinical case definition: • Discrete onset of symptoms and • Jaundice or elevated serum aminotransferase levels • Laboratory criteria • Immunoglobulin M (IgM) antibody to hepatitis A (anti-HAV) positive

  6. Step 4: Define & Identify Cases • Confirmed Case: A case that meetsthe clinical case definition and is laboratory confirmed or for hepatitis A, a case that meets the clinical case definition and occurs in a person who has an epidemiological link with a person who has laboratory-confirmed hepatitis A (i.e. household or sexual contact with an infected person during the 15-50 days before onset of symptoms) • 8 Cases of acute hepatitis A

  7. Step 5: Perform Descriptive Epidemiology

  8. Step 6: Develop Hypotheses • M was the index case • Did not seek medical care or treatment • S wanted to hide his sexual preference and did not expose M • Positive individuals did not reveal contacts to LHD thus number of cases increased

  9. Step 9: Implement Control/Preventive Measures • Letter was sent to students of school • Prevention messages • Always wash your hands after using the bathroom. • Always wash your hands after cleaning the toilet. • Always wash your hands after changing diapers. • Always wash your hands after handling soiled towels or linens. • Always wash your hands before fixing food or eating. • If exposed to hepatitis A, ask your doctor about immune globulin.

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