Molecular confirmation of hepatitis A virus from well water: Epidemiology and public health implications

An outbreak of hepatitis A in a rural river-island community was found to b e associated with consumption of contaminated well water, Specimens from ca se-patients, the implicated well, and a cesspool suspected to be the source of contamination were all positive for hepatitis 4 virus (HAV) RNA by immu nocapture reverse-transcription polymerase chain reaction. All isolates wer e identical over about 400 bases from two capsid-encoding regions of the ge nome, identifying the chain of transmission. Other wells up to 60 m from th e cesspool also contained HAV RNA. In addition, HAV RNA was detected in the contamination source well 6 months after the initial contamination, when f ecal coliform bacteria were no longer present. These findings demonstrate t he utility of viral detection techniques to evaluate contaminated ground wa ter.