Going into the general elections, Narendra Modi will fight not his rivals, but a virus. A Hepatitis B outbreak in the northern district of Modasa and nearby villages has claimed 61 lives since February and infected more than 185 people. The virus attacks the liver and can cause death from cirrhosis or cancer. A case of culpable homicide has been registered against Dr Govind Patel, a private practitioner who, authorities said, reused syringes, leading to the outbreak. He was practising in front of Public Health Centre in Modasa. The authorities found tonnes of bio-medical waste, which apparently was kept for reuse. Twenty doctors in Modasa have been booked for improper disposal of medical waste. A couple of small clinics have been served closure notice. Sixteen medical shops selling medicines without prescription have been sealed. Teams from the National Institute of Virology, Pune, and National Institute of Communicable Diseases, Delhi, said it was prima facie a case of unsafe injection practices. Most Hepatitis B cases are perinatal. The virus also spreads through childhood infections, unsafe injections practices, blood transfusions and sexual contact. Experts say the toll could rise since the virus has mutated. Dr Vidya Arankale of National Institute of Virology said the gravity of the outbreak was unprecedented. As a precautionary measure, the government vaccinated 60,000 people. Said Health Minister Jaynarayan Vyas: "It was one of the biggest vaccination drives of its kind in the world." One lakh syringes, 60,000 adult vaccines and30,000paediatric doses were flown in from Hyderabad. In 1984, about 150 people had died of Hepatitis B in Civil Hospital, Ahmedabad. Experts say that the mortality rate is already high, and out of three lakh people surveyed, about 700 are suspected carriers of the virus. The government has issued advisories in the form of advertisements and hoardings, asking people not to get injections or intravenous drips, unless absolutely necessary. Vyas said the government would come out with the Gujarat Public Health Management Act in six weeks. Dispensaries, clinics and hospitals would then be strictly supervised.