ABSTRACT
Following a report of a confirmed case of Hepatitis A in a child, a cross sectional epidemiological and an environmental survey were done on the total population ( about 90 households) of a village adjacent to the Arima river from April to September, 1989. The residents had no legal claim to the land and there was no pipe-bourne water supply or scavenging service to the area. Cases of Hepatitis A were identified based on clinical signs and symptoms, and a case control analysis was done using affected and non-affected households. Based on case definition criteria, the attack rate was 22 per cent and 30 cases were found. The age distribution was typical of Hepatitis A, and an epidemic curve had some features of both a common source and a propagated source epidemic. Highly significant were exposures related to using the river as a water source, using a spring and a household size > 4. It was concluded that there was an Hepatitis A outbreak, and the initial source was a river which collected waste from the nearby town and the effluent from a water treatment plant. This outbreak serves as a useful indicator of declining socio-economic conditions and deteriorating environmental standards (AU)