Abstract
On 20 June 2015, a cholera outbreak affecting more than 30 people was reported in a fishing village, Katwe, in Kasese District, south-western Uganda. We investigated this outbreak to identify the mode of transmission and to recommend control measures. We defined a suspected case as onset of acute watery diarrhoea between 1 June and 15 July 2015 in a resident of Katwe village; a confirmed case was a suspected case with Vibrio cholerae cultured from stool. For case finding, we reviewed medical records and actively searched for cases in the community. In a case-control investigation we compared exposure histories of 32 suspected case-persons and 128 age-matched controls. We also conducted an environmental assessment on how the exposures had occurred. We found 61 suspected cases (attack rate = 4.9/1000) during this outbreak, of which eight were confirmed. The primary case-person had onset on 16 June; afterwards cases sharply increased, peaked on 19 June, and rapidly declined afterwards. After 22 June, eight scattered cases occurred. The case-control investigation showed that 97% (31/32) of cases and 62% (79/128) of controls usually collected water from inside a water-collection site “X” (ORM-H = 16; 95% CI = 2.4–107). The primary case-person who developed symptoms while fishing, reportedly came ashore in the early morning hours on 17 June, and defecated “near” water-collection site X. We concluded that this cholera outbreak was caused by drinking lake water collected from inside the lakeshore water-collection site X. At our recommendations, the village administration provided water chlorination tablets to the villagers, issued water boiling advisory to the villagers, rigorously disinfected all patients’ faeces and, three weeks later, fixed the tap-water system.
Highlights
Cholera is a diarrhoeal disease caused by the bacterium Vibrio cholerae
20% of those infected with V. cholerae develop acute, watery diarrhoea and 10–20% of those infected develop severe diarrhoea and vomiting [1]
Individuals who did not treatment drinking water had less odds of being cholera cases (ORM-H = 0.29, 95% confidence intervals (CI): 0.099–0.82) (Table 2)
Summary
Cholera is a diarrhoeal disease caused by the bacterium Vibrio cholerae. 20% of those infected with V. cholerae develop acute, watery diarrhoea and 10–20% of those infected develop severe diarrhoea and vomiting [1]. The incubation period for cholera is short (a few hours–5 days for most subtypes) [2]. Cholera can spread quickly in places with poor water and sanitation conditions once the organism is introduced[3]. Outbreaks are usually caused by consumption of contaminated water or food [2, 3]. Since cholera has a relatively high infectious dose (104 organisms [4]), it often requires heavy contamination of drinking water or multiplication of the pathogen in the contaminated food to cause outbreaks
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