What question did this study set out to answer?

The aim was to identify the causes and sources of a hepatitis A outbreak in Madurai.

February 5, 2026Indian Journal of Public Health0 citationsOpen Access

Investigating an Outbreak of Hepatitis A in an Urban Area of Madurai, Tamil Nadu, 2023

VSVallikavitha SubramanianNational Institute of Epidemiology KPKartik PalaniappanGovernment of Tamil Nadu SRSrinivasan RamalingamNational Institute of Epidemiology

Key Points

The aim was to identify the causes and sources of a hepatitis A outbreak in Madurai.
Conducted a door-to-door survey to identify cases.
Performed an environmental investigation to trace contamination sources.
Executed a matched case-control study to confirm associations between water sources and infection rates.
Identified 119 cases with an attack rate of 8.3 per 1000.
Contaminated urban local body water linked to 33% of cases (OR 9.9).
Drinking unboiled water accounted for 81% of cases (OR 15.1).

Abstract

Summary In July 2023, we investigated a cluster of jaundice cases in Madurai district, Tamil Nadu, to identify outbreaks, etiology, and source and to propose control measures. A door-to-door survey identified 119 cases, with an attack rate of 8.3 per 1000. An environmental investigation and matched case–control study confirmed that the outbreak was linked to contaminated urban local body (ULB) water. Consuming ULB piped water caused 33% of cases (odds ratio OR 9.9, 95% confidence interval CI: 2.5–38.6), whereas drinking unboiled water caused 81% (OR 15.1, 95% CI: 5.4–42.3). The outbreak highlighted the need for improved water and sewage management in the district.

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