Food Safety, Sanitation and Hygiene: Lessons from a Hepatitis-A Outbreak in Rural India

Abstract

Introduction: Hepatitis-A is a vaccine-preventable viral infection primarily transmitted through the faecal-oral route. In October 2023, a Hepatitis-A outbreak was investigated in South West Khasi Hills District, Meghalaya. Objective: The study was carried out to identify risk factors of the disease. Methodology: A descriptive epidemiological study was conducted using surveillance data, household surveys, laboratory testing, and environmental assessments. Results: Fifteen suspected cases were identified, with five (33%) laboratory-confirmed, predominantly affecting young children (median age: 5 years). The outbreak was linked to multiple risk factors, including consumption of contaminated drinking water, inadequate sanitation, poor hand hygiene (85.6% of affected individuals did not use soap), open defecation (13.3%), and consumption of unregulated packaged fruit juice. Water samples from the village’s main drinking source revealed coliform contamination, confirming unsafe water supply as a key contributor. Despite a 13.3% hospitalization rate, all cases fully recovered, and no fatalities were recorded. Conclusion: The findings of the study highlight the critical role of water sanitation, hand hygiene, and implementation of food safety regulation. Study emphasizes on enhancing water quality monitoring at least twice in a year (pre & post monsoon) and whenever needed by public health engineering department in coordination with health authorities, Mass awareness about hand hygiene and strict implementation of FSSAI regulations to prevent future outbreaks.