Diarrheal disease outbreak in Gaidatar village of Rautahat District, Nepal

Kul Raj Rai,Phanu Maya Thapa,Shiba Kumar Rai,Prasha Shrestha,Santosh Thapa,Ganesh Rai,Sabina Kc,Reena Kiran Mukhiya

doi:10.1186/s13104-019-4156-9

Abstract

ObjectiveDiarrheal diseases, including cholera, remain a major public health concern in developing countries like Nepal. This study investigated a diarrheal outbreak that affected over 1500 people in Gaidatar village of Rautahat district in central Nepal and sought to identify the source and causation of the disease. Stool samples were collected from individuals with acute diarrheal illness (n = 16) and healthy non-diarrheal children (n = 39), along with samples from local drinking water sources (n = 8) and their sewage system (n = 10). None of the individuals were sampled multiple times. Diarrheic stool and sewage samples were analysed for the presence of Vibrio cholerae, while coliforms were tested in drinking water samples following standard microbiological protocols. Enteric parasites were tested in both diarrheic and non-diarrheic stool samples.ResultsVibrio cholerae O1 Ogawa serotype was isolated in 18.7% of the diarrheic stool and 20.0% of the sewage. Coliforms were found in all drinking water samples, with 87.5% testing positive for fecal coliform. Additionally, 43.6% of the stool samples (n = 55) had at least one of the intestinal parasites tested, primarily Giardia lamblia (21.8%). However, almost all parasites were found in non-diarrheal stool. Taken together, our results provide evidence that the diarrheal outbreak was associated with V. cholerae O1 Ogawa serotype, possibly transmitted through the drinking water sources contaminated with fecal matters from their sewage (drainage) system. These findings warrant regular surveillance of drinking water sources to help prevent future outbreaks.

Highlights

Diarrheal diseases still remain a major public health threat for developing countries and is attributed to poor sanitation, unhygienic practices and inadequate supply of purified drinking water [1]
Our results provide evidence that the diarrheal outbreak was associated with V. cholerae O1 Ogawa serotype, possibly transmitted through the drinking water sources contaminated with fecal matters from their sewage system
The present study reports the findings of a diarrheal outbreak (June 2014) investigated in Gaidatar village of Rautahat District in central Nepal

Summary

Results

V. cholerae in stool and sewage Among the total 16 stool samples collected from 16 individuals (one sample/person) with acute diarrheic illness and 10 environmental (sewage) samples, 18.7% (3/16) and 20.0% (2/10) yielded V. cholerae, respectively (Table 1). The 3 V. cholerae positive diarrheal samples were from 3 different individuals. 19.2% of the samples (fecal and sewage) subjected for alkaline peptone water enrichment showed growth of V. cholerae. Enteric parasites in fecal samples Of the total 55 formal-saline fixed stool samples (both diarrheal and non-diarrheal), 43.6% (24/55) were positive for at least one of enteric parasites tested (Table 2). Parasite positive rate was significantly higher among school children when compared to the patients with acute diarrheal illness (p = 0.013). Giardia lamblia was the most dominant, followed by Entamoeba coli and E. histolytica and others

Introduction

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Discussion

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