Why in news?
Kerala recorded a surge of over 3,000 hepatitis A cases and more than a dozen deaths by mid‑April 2025, prompting health experts to urge the inclusion of the hepatitis A vaccine in India’s Universal Immunisation Programme. Contaminated drinking water and poor sanitation were identified as major causes of the outbreak.
Background
Hepatitis A is a viral infection that inflames the liver. It spreads when people ingest food or water contaminated with the faeces of an infected person. The incubation period ranges from 14 to 28 days. Many young children infected with the virus show few or no symptoms, but adults often experience fever, fatigue, nausea, abdominal pain, dark urine and jaundice. The illness usually resolves on its own within weeks, but severe cases can cause acute liver failure, especially in older patients or those with underlying liver disease. There is no specific antiviral treatment; management involves rest, adequate nutrition and hydration.
Recent developments
- Outbreak in Kerala: Health officials reported 3,227 confirmed cases and 16 deaths by April 2025, with clusters around Kozhikode and surrounding districts. Many victims were adults who lacked immunity because improved sanitation during childhood had reduced natural exposure to the virus.
- Public health response: Authorities chlorinated water sources, inspected restaurants and street vendors, and urged residents to boil drinking water. Awareness campaigns highlighted hygiene practices and the importance of vaccination for high‑risk groups.
- Calls for immunisation: Experts pointed out that India’s Universal Immunisation Programme covers vaccines against eleven diseases but not hepatitis A. They argued that including the vaccine could prevent similar outbreaks, particularly in urban areas with ageing infrastructure and rising adult susceptibility.
Understanding hepatitis A vaccination
- Vaccine efficacy: Inactivated hepatitis A vaccines provide long‑term protection with two doses given six months apart. They are safe for children over one year of age and adults of all ages.
- Global recommendations: The World Health Organization advises vaccination for travellers to areas with medium to high endemicity and for people at higher risk, such as men who have sex with men, drug users and those with chronic liver disease.
- Prevention through sanitation: Improved sewage disposal, safe water supply and food hygiene remain the cornerstone of prevention. Vaccination complements these measures by protecting individuals who may be exposed despite better infrastructure.
Significance
- Protecting adults and children: As hygiene improves, fewer children acquire natural immunity, leaving them susceptible as adults when the disease can be more severe. Vaccination closes this immunity gap.
- Reducing outbreaks: Incorporating hepatitis A vaccine into public health programmes could substantially reduce the incidence of future outbreaks and the associated economic burden of hospitalisation and lost productivity.
- Highlighting water quality issues: The Kerala outbreak underscores the need to upgrade water supply and sewage systems in many parts of India to prevent faecal contamination.
Conclusion
The hepatitis A outbreak serves as a wake‑up call for policymakers. Strengthening water and sanitation infrastructure, educating the public on hygiene and introducing hepatitis A vaccination into national programmes can together protect communities from this preventable disease.
Source: Business Standard · World Health Organization · National Health Mission