Viral Hepatitis Surveillance — India, 2011–2013

Abstract

© 2015, Department of Health and Human Services. All rights reserved.What is already known on this topic? Hepatitis A and hepatitis E are endemic in India, and although hepatitis B and hepatitis C are thought to be common, national data are lacking on all forms of viral hepatitis. What is added by this report? The National Integrated Disease Surveillance Program, established in India in 2009, collects data on cases and outbreaks of jaundice, and supports outbreak investigations and laboratory testing for hepatitis A and hepatitis E. During 2011–2013, large numbers of hepatitis A and hepatitis E cases and frequent outbreaks occurred each year. Hepatitis A and hepatitis E outbreaks were reported throughout the country, associated with poor water quality and lack of sanitation. Cases of hepatitis A appeared to follow a seasonal pattern associated with the monsoon season. What are the implications for public health practice? Epidemiologic and laboratory strengthening of the Integrated Disease Surveillance Program might improve understanding of the hepatitis disease burden in India because most cases were not laboratory-confirmed. Further, the large numbers of cases and outbreaks underscore the need for improvements in water quality and sanitation. Finally, collection of additional demographic and epidemiologic data on hepatitis A can inform consideration of including hepatitis A vaccine in routine immunization programs.