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Kumbal Choi 1 Article
Epidemiological Investigation of an Outbreak of Hepatitis A at a Residential Facility for the Disabled, 2011
Hyun-Sul Lim, Kumbal Choi, Saerom Lee
J Prev Med Public Health. 2013;46(2):62-73.   Published online March 28, 2013
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AbstractAbstract PDF

An outbreak of hepatitis A occurred at a residential facility for the disabled in July 10, 2011. This investigation was carried out to develop a response plan, and to find the infection source of the disease.


A field epidemiologist investigated the symptoms, vaccination histories, living environments, and probable infection sources with 51 residents and 31 teachers and staff members. In July 25, 81 subjects were tested for the hepatitis A virus antibody, and specimens of the initial 3 cases and the last case were genetically tested.


Three cases occurred July 10 to 14, twelve cases August 3 to 9, and the last case on August 29. Among the teachers and staff, no one was IgM positive (on July 25). The base sequences of the initial 3 and of the last case were identical. The vehicle of the outbreak was believed to be a single person. The initial 3 patients were exposed at the same time and they might have disseminated the infection among the patients who developed symptoms in early August, and the last patient might have, in turn, been infected by the early August cases.


The initial source of infection is not clear, but volunteers could freely come into contact with residents, and an infected volunteer might have been the common infection source of the initial patients. Volunteers' washing their hands only after their activity might be the cause of this outbreak. Although there may be other possible causes, it would be reasonable to ask volunteers to wash their hands both before and after their activities.



Citations to this article as recorded by  
  • Prevention of Hepatitis A Virus Infection in the United States: Recommendations of the Advisory Committee on Immunization Practices, 2020
    Noele P. Nelson, Mark K. Weng, Megan G. Hofmeister, Kelly L. Moore, Mona Doshani, Saleem Kamili, Alaya Koneru, Penina Haber, Liesl Hagan, José R. Romero, Sarah Schillie, Aaron M. Harris
    MMWR. Recommendations and Reports.2020; 69(5): 1.     CrossRef
  • Outbreak of Hepatitis A Virus Infection Among Adult Patients of a Mental Hospital — Los Angeles County, 2017
    Curtis Croker, Susan Hathaway, Amy Marutani, Margilane Hernandez, Crystal Cadavid, Shobita Rajagopalan, Bessie Hwang, Moon Kim
    Infection Control & Hospital Epidemiology.2018; 39(07): 881.     CrossRef
  • Estimating human-to-human transmissibility of hepatitis A virus in an outbreak at an elementary school in China, 2011
    Xu-Sheng Zhang, Giovanni Lo Iacono, Eric HY Lau
    PLOS ONE.2018; 13(9): e0204201.     CrossRef
  • Source identification through social networks in an epidemiological investigation of a hepatitis A outbreak at an elementary school in Anhui province, China
    J. B. WU, X. L. LI, J. ZHANG, D. XU, J. J. ZHU, B. S. ZHOU
    Epidemiology and Infection.2014; 142(7): 1450.     CrossRef

JPMPH : Journal of Preventive Medicine and Public Health