Research Article © ADR Journals 2017. All Rights Reserved. Seroepidemiology of a recent outbreak of Hepatitis E in urban Shimla, Himachal Pradesh, India Sunite A Ganju 1 , Neha Gautam 2 , Sohini Walia 3 , Anil Kanga 4 Abstract Hepatitis E, a major public health problem, continues to cause epidemics in different geographic areas in India and poses multi-sectoral challenges. The aim of the study was to determine the seroepidemiology of the hepatitis outbreak in the urban areas of district Shimla, Himachal Pradesh. Patients presenting with clinical features of acute viral hepatitis during and after the epidemic period were tested for seromarkers; IgM anti-HEV and IgM anti-HAV by enzyme linked immunosorbant assay. The weekly reporting under Integrated Disease and Surveillance Programme (IDSP) for cases of jaundice from Shimla from December 2015 to April 2016 was reviewed. The outbreak of hepatitis due to contamination of drinking water supply in urban Shimla beginning December 12, 2015 was confirmed by IDSP. A total of 425 serum samples (males: 292; females: 133) were tested for IgM anti-HAV and IgM anti-HEV by ELISA. Liver enzymes where deranged in all cases. Serological evidence of infection with HAV and/or HEV was seen in 64%. HEV infection alone was detected in 62.13%. All ages were affected, with one case of HEV infection below ten years. HEV infection alone was 5 times more common than HAV infection and co-infection was detected in 69 cases (m: 47; f:22). Six antenatal mothers were anti-HEV positive and the maternal mortality of 50% (n=3) due to fulminant hepatitis. Since HAV and HEV have a similar faecal-oral route of transmission, this study highlights periodic surveillance of HAV/HEV exposure pattern to improve levels of personal and food hygiene and inter-sectoral collaboration for provision of safe water supply and safe sewage disposal. Keywords: Acute viral hepatitis, Hepatitis E, Hepatitis A, Co-infection, Outbreak, Shimla Introduction HAV and HEV are enterically transmitted viruses that cause source-originated epidemics of acute viral disease in areas with poor sanitation and weak public health infrastructures. HEV has four genotypes of which genotypes 1 and 2 are implicated in human infections. There is one serotype of HAV with seven genotypes I-VII; genotypes I and III most commonly affect the humans. An estimated 20 million HEV infections occur worldwide annually, of which 3.3 million are symptomatic hepatitis E cases leading to approximately 56,600 deaths. 1 In the South-East Asian countries, prevalence of HEV is high, accounting for 60% of global incidence and 65% of global deaths of HEV. 2 1 Assistant Professor, 2 Research Scientist II, 3 Research Scientist I, Viral Research and Diagnostic laboratory, 4 Professor and Head, Department of Microbiology, Indira Gandhi Medical College, Simla. Correspondence: Dr. Sunite A Ganju, Indira Gandhi Medical College, Simla. E-mail Id: sunite01@gmail.com Orcid Id: http://orcid.org/0000-0002-4000-1257 How to cite this article: Ganju SA, Gautam N, Walia S et al. Seroepidemiology of a recent outbreak of Hepatitis E in urban Shimla, Himachal Pradesh, India. J Commun Dis 2017; 49(2): 17-22. Digital Object Identifier (DOI): https://doi.org/10.24321/0019.5138.201709 E ISSN: 0019-5138 I P ISSN: 2394-7047