The burden of viral
hepatitis in India is not well characterized. In 2009, the national Integrated Disease Surveillance Programme (IDSP) began conducting surveillance across all Indian states for epidemic-prone diseases, including foodborne and waterborne forms of viral
hepatitis (e.g.,
hepatitis A and E). Information on outbreaks of all forms of viral
hepatitis, including A, B, C, and E, also is collected. This report summarizes viral
hepatitis surveillance and outbreak data reported to IDSP during 2011-2013. During this period, 804,782
hepatitis cases and 291 outbreaks were reported; the virus type was unspecified in 92% of cases. Among 599,605 cases tested for
hepatitis A, 44,663 (7.4%) were positive, and among 187,040 tested for
hepatitis E, 19,508 (10.4%) were positive. At least one
hepatitis outbreak report was received from 23 (66%) of 35 Indian states. Two-thirds of outbreaks were reported from rural areas. Among 163 (56%) outbreaks with known etiology, 78 (48%) were caused by
hepatitis E, 54 (33%) by
hepatitis A, 19 (12%) by both
hepatitis A and E, and 12 (7%) by
hepatitis B or
hepatitis C. Contaminated
drinking water was the source of most outbreaks. Improvements in water quality and sanitation as well as inclusion of
hepatitis A vaccine in childhood immunization programs should be considered to reduce the public health burden of
hepatitis in India. Efforts to decrease the proportion of cases for which the etiology is unspecified, including expanding the IDSP to support
hepatitis B and C testing, might help further elucidate the epidemiology of these diseases.