Hepatitis A has become almost endemic to the State, bringing to focus the poor hygiene and sanitation prevailing here.
As per a study published in the National Journal of Research in Community Medicine, there were 84 outbreaks of hepatitis A in the past five years. In the past two years, the State had reported 22 deaths from hepatitis A.
According to principal investigator Rakesh P.S., assistant professor, Community Medicine, Amrita Institute of Medical Sciences, hepatitis A is generally a self-limiting viral disease, but it causes significant morbidity.
Those affected take a few months to recuperate and may need hospitalisation. The average medical expenditure incurred if a person is affected by hepatitis A is over ₹24,000.
The study says that on an average 8,268 cases of hepatitis A are reported in the State.
The State’s surveillance system mainly depends on a telephone-based reporting system from government institutions. As 70% of people depend on the private sector for their health-care needs, the real figure would be perhaps thrice the official figure, said Dr. Rakesh.
Water quality
Epidemiologist A. Sukumaran said the higher incidence of hepatitis A indicated the poor quality of water in the State. Faecal contamination of water is the root cause of the disease and people living in congested areas, where they depend more on well water or borewells, are more at risk of hepatitis A. Even piped water supply had become suspect in many cases of hepatitis A, he added.
According to Dr. Rakesh’s study, only 29.3% of houses in the State have piped water supply and only 23.4% get treated water. Intermittent water supply, closely running pipelines and drainage networks, frequent breaks in pipelines, and lack of chlorination of contaminated water sources are among the various reasons for hepatitis A, said Dr. Rakesh.
Waste and septage getting dumped in water sources is a prime reason for the poor quality of piped water, said Dr. Sukumaran. Superchlorination, not ordinary chlorination, is required to remove the virus from water in such cases, he added.
Quite a few studies in the State have revealed that most wells in the State are contaminated.
Absence of a full-fledged sewerage network has resulted in an increase in the number of septic tanks, leading to contamination of soil. The mandated minimum distance of 20 metres between a septic tank and a water source seems to be inadequate in controlling the spread of coliform bacteria through the soil into the water source, he added.
