Hepatitis A outbreak in Ba Subdivision, Fiji, October–December 2013

Abstract

Objective: A cluster of suspected hepatitis A cases from Balevuto medical area of Ba subdivision was notified to the Fiji Ministry of Health on the 22^nd of October, 2013. An outbreak investigation team was mobilized to collect and review evidence and confirm the existence of an outbreak of hepatitis A in order to advise appropriate public health interventions.

Methods: A case definition for outbreak investigation was established. Standardized data collection tools were used to collect information on clinical presentation and risk factors. An environmental risk assessment was also carried out.

Results: There were 160 patients who fulfilled the case definition criteria for hepatitis A, with 18 confirmed with Hepatitis A viral infection and 142 suspected clinical cases. The incidence of hepatitis A was 246 and 349 per 10,000 population in Balevuto medical area and in Nukuloa nursing zone, respectively. There was no reported case of fulminant hepatitis or death. Residents of Nukuloa settlements were close to seven times more likely to present with symptomatic hepatitis A infection (RR = 6.6, 95% CI= 3.8-12.6) compared with residents of other villages in the Balevuto area.

Discussion: This is the first significant hepatitis A outbreak documented in Ba subdivision and possibly in Fiji. An enhanced surveillance of the disease may reveal other clusters in the country. The basic change with improving the primary water source dramatically reduced the incidence of disease in the affected community and adjacent areas.

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