The source of hepatitis B virus (HBV) infection at Ooramana has been found to be unsafe injections that the people received in 2011.

A study conducted by Manipal Virus Research Centre said that inadequate hygiene and infection control practices at barbershops also led to the spread of the disease. An inspection of instruments collected from barber shops showed presence of HBV. It also said that endoscopic examinations in hospitals are also risk factors for acquiring HBV infection.