Faudzi Ahmad Yusoff1, Rusdi Abdul Rahman2, Ling He May3, Suzana Binti Budart3, Lokman Hakim Sulaiman4. 1. Unit of Epidemiology and Biostatistics, Medical Research Resource Centre, Institute for Medical Research, Ministry of Health, Kuala Lumpur, Malaysia . 2. Melaka State Health Department (Public Health), Hang Tuah Jaya, Melaka, Malaysia . 3. Manjung Health District Department, Perak Darul Ridzuan, Malaysia . 4. Office of the Deputy Director General of Health (Public Health), Ministry of Health Malaysia, Putrajaya, Malaysia .
Abstract
BACKGROUND: In September 2012, 10 cases suspected to be hepatitis A were notified to the Manjung District Health Department. An investigation was conducted to identify the possible mode of transmission, source of the outbreak and to recommend prevention and control measures. METHODS: A case was a person with acute illness with discrete onset of symptoms and jaundice or elevated serum aminotransferase levels in September 2012 in the Manjung District. We conducted a case-control study and environmental assessments of processing plants and food premises. RESULTS: There were 78 confirmed cases of hepatitis A; an attack rate of 3.1 per 10,000 population. Multiple logistic regression showed that being male (odds ratio [OR]: 18.4 [5.13-65.9]; P < 0.001) and drinking toddy at processing place A (Adjusted OR: 2.70 [1.17-6.25]; P < 0.05) were associated with being a case. Environmental investigations of this and one other processing place found them to be unhygienic, and the pH of the toddy was at levels that encouraged growth of hepatitis A virus. CONCLUSION: Toddy was possibly the primary source of this outbreak based on both epidemiological and environmental results. Both toddy preparation places and several food premises were closed as a result of this investigation.
BACKGROUND: In September 2012, 10 cases suspected to be hepatitis A were notified to the Manjung District Health Department. An investigation was conducted to identify the possible mode of transmission, source of the outbreak and to recommend prevention and control measures. METHODS: A case was a person with acute illness with discrete onset of symptoms and jaundice or elevated serum aminotransferase levels in September 2012 in the Manjung District. We conducted a case-control study and environmental assessments of processing plants and food premises. RESULTS: There were 78 confirmed cases of hepatitis A; an attack rate of 3.1 per 10,000 population. Multiple logistic regression showed that being male (odds ratio [OR]: 18.4 [5.13-65.9]; P < 0.001) and drinking toddy at processing place A (Adjusted OR: 2.70 [1.17-6.25]; P < 0.05) were associated with being a case. Environmental investigations of this and one other processing place found them to be unhygienic, and the pH of the toddy was at levels that encouraged growth of hepatitis A virus. CONCLUSION: Toddy was possibly the primary source of this outbreak based on both epidemiological and environmental results. Both toddy preparation places and several food premises were closed as a result of this investigation.
Authors: Thuppal V Sowmyanarayanan; Ashis Mukhopadhya; B P Gladstone; Rajiv Sarkar; Gagandeep Kang Journal: Indian J Med Res Date: 2008-07 Impact factor: 2.375
Authors: Muhammad Jikal; Daisuke Mori; Ahmad Faudzi Yusoff; Sarawasthi Bina Rai; M Hafiz Mukhsam; Ismail Ali; Liza Abd Latif; Alfred A S Perianayagam; Esther Bernad; Cynthia C E Bailon; Lim Guan Lee; Vielerian Fredolin; Kamruddin Ahmed Journal: Am J Trop Med Hyg Date: 2021-07-12 Impact factor: 3.707