Gurugram, Feb. 17 -- Authorities in Haryana's Palwal have declared a health emergency in Chayansa village after at least six deaths were reported due to liver-related complications over the past month amid what officials suspect is a hepatitis outbreak, which they have not yet been able to identify the source of. Official records show of the 15 deaths reported between January 6 and February 11, six deaths were clinically attributed to acute Hepatitis B, jaundice, or acute liver failure with hepatic encephalopathy. Four among those who died from liver-related complications, including children as young as 12 years old, tested positive for Hepatitis B. To be sure, not all 15 fatalities were linked to hepatitis, with several others being reported due to old age, accidents or other conditions. Several other recent deaths are still under medical review. Preliminary screening indicates that liver-related complications are at the centre of the crisis. Of nearly 1,500 residents screened between January 2 and February 16, including close contacts of the deceased, 37 have tested positive for Hepatitis C, 10 for Hepatitis B and one for HIV, said Dr Devender Jakhad, in-charge of PHC Chhaisa and the health official overseeing the probe. However, officials are yet to determine how the infection, typically spread through contact with infected blood or bodily fluids, appears to have affected so many people. "Blood samples have tested negative for Hepatitis A and E, which are commonly water-borne," Dr Jakhad said. Given that Hepatitis B and C are blood-borne, investigators said they don't have a clear transmission route. Jakhad said multiple possible routes are being looked into, including unsafe sexual contact, injection drug use with shared needles, reuse of syringes by unqualified practitioners, and barbers using the same blade on multiple customers. He said rapid viral tests conducted on 180 patients on Monday found eight positive for Hepatitis B or C. A day earlier, 12 Hepatitis C cases and one case each of Hepatitis B and HIV were detected. "So far, we have not found any instance of water-borne hepatitis A or E," he said, adding that water contamination has not been ruled out. In response, Haryana health minister Arti Singh Rao said the state and district administration have taken all steps to curb the spread. "The health and safety of villagers is the government's and district administration's highest priority," Rao said, urging residents to avoid unsafe injections and seek treatment only from registered doctors. Deputy commissioner Dr Harish Kumar Vashishth, who visited the village on Monday, said officials were camping in the area and that detailed investigations are underway. Since February 1, rapid response teams have been holding daily medical camps, conducting door-to-door surveys and offering blood tests, consultations and medicines at three locations in the village. Screening includes tests for Hepatitis B, C, HIV and liver function. Palwal chief medical officer Dr Satinder Vashisth said surveillance would continue until the situation stabilises. Authorities have also warned against the reuse of syringes, treatment by unqualified practitioners and shared blades at barber shops. Youth have been advised to avoid injectable drugs. Veterinary inspections have ruled out animal-linked transmission, and leptospirosis tests have returned negative. Officials said efforts are now focused on identifying transmission chains and strengthening water safety measures. Mohammad Ismail, the village sarpanch, said fear has spread since the first reported case on January 14. "Since then, the village has been living in fear. One after another, 15 people have died," he said. "Initially, many people had diarrhoea and doctors suspected food poisoning or water contamination, but no report confirmed this. Now, we are being told the deaths are due to blood-borne diseases like Hepatitis B, C and even HIV," Ismail said....