Three epidemics of acute viral hepatitis which occurred in different areas of Pakistan, namely Quetta, Mardan and Rawalpindi were studied. All the cases presented with jaundice, anorexia and nausea. The liver function tests showed raised serum bilirubin, alkaline phosphatase and ALT levels. In all the patients except one, the serology was consistent with non-A, non-B (NANB) hepatitis, which was most likely waterborne. This study shows that, as in some other parts of Asia and North Africa, epidemics of waterborne NANB hepatitis, clinically resembling hepatitis A, also occur in Pakistan. These epidemics are probably due to faecal contamination of the water supply systems in some areas of Pakistan.
Get full access to this article
View all access options for this article.
References
1.
PrinceAMGradyGFHazziC. Long incubation post-transfusion hepatitis without serological evidence of exposure to hepatitis B virus. Lancet1974;ii:241–6.
FrancisDPHadlerSCPrendergastTJ. Occurrence of hepatitis A, B and non-A/non-B in the United States: CDC sentinel county hepatitis study I. Am J Med1984;76: 69–74.
4.
TandonBNGandhiBMJoshiYKIrshadMGuptaH.Hepatitis virus non-A, non-B: The cause of a major public health problem in India. Bull WHO1985;63:931–4.
5.
MalikIALuqmanMAhmedA. A clinicopathological study of viral hepatitis. Pakistan J Med Res1987; 26:4–11.
6.
BradleyDWMaynardJEPopperH. Post-transfusion non-A, non-B hepatitis: Physicochemical properties of two distinct agents. J Infect Dis1983;148: 254–65.
7.
WongDCPurcelRHSreenivasanMAPrasadSRPavriKM.Epidemic and endemic hepatitis in India: Evidence for a non-A, non-B hepatitis virus aetiology. Lancet1980;ii:876–9.
8.
KhurooMS.Study of an epidemic of non-A, non-B hepatitis: Possibility of another human hepatitis virus distinct from post-transfusion non-A, non-B type. Am J Med1980; 68:818–24.
9.
BelabbesHBenatallahMIlloulGBouguermouthA.Study of an outbreak of non-A, non-B hepatitis in Algeria. Proceedings of VIII International Congress of Infections and Parasitic Disease, Stockholm, 1982;14b:3 (abstract).
10.
ViswanathanR.Epidemiology. Indian J Med Res1975;45 (Suppl):1–29.
11.
SreenivasanMABanerjeeKPandyaPG. Epidemiological investigation of an outbreak of infectious hepatitis in Ahmedabad city during 1975–76. Indian J Med Res1978;67:197–206.
12.
SreenivasanMASehgalAPrasadSRDhorjeS.A seroepidemiologic study of a waterborne epidemic of viral hepatitis in Kolhapur city. Indian J Hyg1984;93:113–22.
13.
KaneMABradleyDWShresthaSMEpidemic non-A, non-B hepatitis in Nepal: Recovery of possible etiologic agent and transmission studies in marmosets. JAMA1984;252:3140–5.
14.
FavorovMOKhukhlovichPAZairovGKListovskaiaEKArakelovSA.Clinical and epidemiological features and diagnosis of viral non-A, non-B hepatitis with faecal-oral transmission mechanism. Vopr Virusol1986;1:65–9 (English abstract).
15.
BalayanMSAndjparidzeAGSavinskayaSSEvidence for a virus in non-A, non-B hepatitis transmitted via the faecal-oral route. Intervirology1983;20:23–31.
16.
SreenivasanMAArankalleVASehgalAPavriKM.Non-A, non-B epidemic hepatitis: Visualization of virus-like particles in the stool by immune electron microscopy. J Gen Virol1984;65:1005–7.
