The highest number of hepatitis B cases have been detected in Spiti area of Himachal Pradesh, state Health Minister Kaul Singh said on Tuesday.

In a written reply in the state assembly, Singh said 4,231 people were screened from May 2015 to April 2016 and 963 cases (22 per cent) of hepatitis B and 39 cases (0.93 per cent) of hepatitis C cases were detected.

According to the minister, 200 hepatitis B cases were reported in the Indian Gandhi Medical College and Hospital in Shimla from Spiti in Lahaul-Spiti district before 2014.

The Himachal Pradesh government has launched universal hepatitis B vaccination for prevention and spread of the disease, he said. Two doses of vaccination, covering a population of 19,000 across the district, have already been given and the third dose of vaccination will be administered in April.

In addition, mandatory screening of all pregnant women for hepatitis B infection and provision of immunoglobulin and vaccination at all delivery points in the district has been ensured. Lahaul-Spiti district is populated mainly by tribals. The climatic conditions are harsh as much of the land forms part of a cold desert where the mercury drops below minus 20 degrees Celsius during winter.

The Buddhist-dominated district in the Himalayan terrain at elevations ranging from 15,000 to 20,000 feet above the sea level attracts globe-trotters not only for nature-based activities but also to ancient monasteries like Tabo and Dhankar.

The district has no town, the population is rural and spread across 521 villages.