Abstract
BackgroundCholera continues to remain endemic in over 50 countries and has caused large epidemics with around 3–5 million cases occurring every year in Asia alone. In India, cholera is endemic in many states. However, etiological information and age-specific incidence related to cholera outbreaks is limited. In November 2013, district authorities reported a cluster of diarrheal disease among residents of Medipally to the state surveillance unit. We investigated this cluster to confirm its etiology, describe its magnitude, identify potential risk factors, and make recommendations for control.FindingsA house-to-house active search was conducted to identify cases of acute diarrhea and collect information on drinking water source. Drinking water samples were collected from common water sources and sampled households to test for bacteriological quality. Ten stool samples were collected for culture. A matched case–control study was conducted to identify the risk factors. A total of 138 case-patients of diarrhea (Attack rate: 11.5/100; Population: 15 1,200) and 1 death (Case Fatality Ratio: 0.72/100) were identified. Five of the 10 stool samples were culture positive for V. cholerae, serogroup O1 El Tor. Drinking water from the overhead tank [Adjusted OR (AOR): 31.94, 95 % CI: 7.3-139.5] was associated with risk of developing illness.ConclusionsThis outbreak affected nearly 11% of the village population and was due to contamination of the main drinking water source. Outbreaks such as this can be prevented by constructing the drain away from the water pipelines and by monitoring regular chlorination of drinking water source and inspection of pipelines for damage.
Highlights
This outbreak affected nearly 11% of the village population and was due to contamination of the main drinking water source. Outbreaks such as this can be prevented by constructing the drain away from the water pipelines and by monitoring regular chlorination of drinking water source and inspection of pipelines for damage
Diarrheal diseases constitute an important cause of morbidity and mortality globally, especially in the developing economies [1]
Andhra Pradesh is a rapidly urbanizing state in southern India with a population of over 84 million people; sporadic outbreaks of acute diarrheal disease are a common phenomenon in this region
Summary
Diarrheal diseases constitute an important cause of morbidity and mortality globally, especially in the developing economies [1]. Cholera continues to remain endemic in over 50 countries and has caused large epidemics [5]. Etiological information and age-specific incidence related to such outbreak in this region is limited. Cholera continues to remain endemic in over 50 countries and has caused large epidemics with around 3–5 million cases occurring every year in Asia alone. Etiological information and age-specific incidence related to cholera outbreaks is limited. In November 2013, district authorities reported a cluster of diarrheal disease among residents of Medipally to the state surveillance unit. We investigated this cluster to confirm its etiology, describe its magnitude, identify potential risk factors, and make recommendations for control
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