Hepatitis A outbreak in Panbang kills one

Lack of sanitation likely cause

13 May, 2010 - Medical doctors in Panbang dungkhag, Zhemgang, suspect poor sanitation may have caused the outbreak of hepatitis A in four villages of Bjoka gewog, which claimed the life of a man and left seven people sick.

The first case occurred in Alongtey village about three weeks ago, when the village health worker (VHW) died from fever and diarrhoea, according to Dr Yeshi Dorji of Panbang BHU grade I.

The deceased did not avail any medical facilities, but health personnel said that relatives told them that his eyes had turned yellowish before he died.

The gewog basic health unit (BHU) is a two-day walk from the Alongtey village.

Hepatitis A is one of five human hepatitis viruses that primarily infect the human liver and cause illness. The disease is usually mild and characterised by jaundice (yellow discolouration of the skin), fatigue, abdominal pain, loss of appetite, nausea, diarrhoea and fever. It can occasionally be severe, especially in people with liver disease.

Dr Yeshi Dorji said that, a few days after the man died, his nine-year-old son came to Panbang hospital, complaining of fever and diarrhoea. “We referred him to Gelephu regional hospital and he was diagnosed with viral hepatitis,” he said.

The deceased’s daughter also suffered from similar symptoms and visited Panbang hospital a few days later.

A medical team, comprising the dungkhag assistant health officer, medical officer, laboratory technicians, basic health worker and a brother went to the village last week to investigate.

The team concluded that the outbreak was caused by poor sanitation, as the people live in huts raised slightly on stilts with pigs reared under.

In the villages of Alongtey, Chapdempa, Ligshipong and Wangphu, about seven people were infected with hepatitis. “Three of them got jaundice too,” Dr Yeshi Dorji said.

“Usually hepatitis A is caused through faeco-oral transmission, where a contaminated water source by the faeces of an infected person spreads the disease,” Dr Yeshi Dorji said. “We checked all the water source and it was not contaminated.”

Health officials said that vitamin B-complex was given to patients and villagers were advised to wash their hands before cooking and eating, drink boiled water and to remove the pigs from under the huts.

By Tashi Dema