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Outbreak Investigation of Hepatitis A Boarding school South Sulawesi Province, Indonesia
muammar taha kotu

Last modified: 2018-08-20


Outbreak Investigation  of Hepatitis A Boarding school South Sulawesi Province, Indonesia



Muammar1, Ansariadi1, Ni Wayan Deisy Arisanti1, A. Jusmawati1, Indra Dwinata1 , Debsy Pattilima2

1 Department Epidemiologi, Hasanuddin University, Makassar, Indonesia

2 South Sulawesi Provincial Health Office



* Corresponding Author: Muammar, alebaba29@yahoo.co.id, 085340205347



Background. Hepatitis A, the fecal-oral disease, is often reported as outbreak locally in several low income population. In September 2017, a community health service in one district reported 6 cases of Hepatitis A suspect from a boarding school . This investigations aimed to identify the source of outbreak, sources of transmission and provide recommending for control measures.

Materials and methods. A case control study was employed in this investigation. Cases were all patients with clinical symptoms of Hepatitis A. Serological test, IgM and IgG were performed to confirmed several suspects. A controls was those who did not have hepatitis A symptoms in the selected from same boarding school. Univariate and bivariate analysis at SPSS software were used to identify significant risk factor.

Results The school have 510 students and a total of  47 cases meet with case definition (IR = 9.2%). A total of eleven cases were selected for further Laboratory Tests using IgG and IgM and all were confirmed positive. The first case occurred in week five (5) In July 2017, outbreaks peak at week 5 five months of September and stopped at the beginning of October 2017.Age twelve has the highest attack rate (24.4%) followed by age fourteen ( AR=11.2%) and thirteen years (AR=9.5%). This study also found that AR among female age twelve was higher among female that that of among male. In contrat, at aged forteen yeard old, the attact rate among male was higher than that off among female. Hand washing without soap appear the most significant risk factors (OR = 3,226). Environmental lab results water examination on water drinking facilities indicated that water drinking has been contaminated with E. Coli which has similar mode of transmission with Hepatitis A virus.


Conclusions This investigation reveals that the unhygienic practices and drinking water  would the source of hepatitis A outbreak. Hand washing practices has been suggested to reduce the risk of hepatitis A exposure.  Chlorination or source of drinking water and replacement of UV equipment’s for drinking water treatment have been to reduce contamination from E.Coli and Hepatitis A.


Keywords Hepatitis A, outbreak, pesantren.