The death toll in the Hepatitis D outbreak in Modasa in north Gujarat reached 19, with two more deaths reported on Monday, even as expert teams from the National Institute of Communicable Diseases (NICD) and the National Institute of Virology in Pune visited the place today.

Earlier, eight doctors were booked under Section 30 of the Medical Practitioners Act on Saturday, as most were not found to be registered allopath practitioners. But state Health Secretary Rita Teotia said on Sunday that the deaths could possibly be due to the use of infected needles.

“From the preliminary investigation, it looks like a case of use of infected syringes. We have filed FIRs against the eight doctors, and our officials who are in Modasa since the past two days, are doing a door-to-door search for further cases. Whoever is being detected is being moved to the hospitals immediately. We will draw our final conclusions on the exact reason only after the two national teams submit their reports,” she said.

She said their findings are based on the primary investigations of two rapid rescue teams from the B J Medical College in Ahmedabad and the Civil Hospital in Himmatnagar, which had collected blood samples last week.

So far, the total number of Hepatitis D cases has reached 54, with patients admitted across hospitals in Ahmedabad, Himmatnagar, Modasa, Bayad and Shamlaji.

On Sunday, health officials collected a total of 91 samples from Modasa and the peripheral villages for investigations.

H S Patel, the CDHO of Sabarkantha said: “The cases were first reported from Modasa, but now they are also pouring in from neighbouring places like Himmatnagar, Bayad, Shamlaji and even Vartak. The incubation period of Hepatitis D is six days to six months, which means that patients will keep pouring in for the next six months. Other neighbouring areas could also come in its grip as the virus spreads within a short period.”

He added: “When affected by the virus, a patient can die within seven days. We have started door-to-door surveys and printed pamphlets for spreading awareness among the masses. We are also trying to tabulate the exact places of occurrence.”

The department is now awaiting the conclusions of the two national level teams to initiate further action.