Figure 1.

Gulmarg Kashmir Epidemic, 1978–1979. (A) Upper panel. The epidemic curve with the weekly occurrence of hepatitis E cases. The region had an open-source water supply from a canal (Ningli Nallah) which originates from the Alpather Lake situated at the foot of Apharwat Peaks, Gulmarg. After passing through mountains as the world-famous Sharanz waterfall, the stream crosses the valley to join the Wular lake. The canal along its route is used for multiple purposes including drinking water, linen washing, swimming, fishing, and sewage and garbage disposal, and thus stays highly polluted. Lower panel. The data on incidence and severity of viral hepatitis in men (15–45 years), NPF (nonpregnant females; 15–45 years) and PF (pregnant females) were collected by four door-to-door surveys done at 4 to 6 week intervals during the epidemic. (B) Kashmir strain of HEV (Pinglina epidemic, 1993–94, Kashmir, India [20].). Unrooted phylogenetic tree generated by Maximum Likelihood method using MEGA software (version 10.1.8), on the basis of 326 bp sequences of HEV ORF1 genomic. Reference sequences of different HEV genotypes from GenBank are shown in gray filled circles, while country specific HEV sequences are shown in color filled circles. Kashmir strain of HEV was of genotype 1 with 94.6% homology with the Burmese isolates of HEV (Courtesy Saleem Kamili & Xia, Guo-Liang, both at CDC, Atlanta, Georgia). α = 6 pregnant women died.