Diarrheal Epidemic Grips Ghallour Sub-centre, Jawalamukhi Block, Kangra District, Himachal Pradesh, India

Abstract

Background: On 31st August, 2014, eighty cases of the gastroenteritis were reported in Ghallour sub-centre area. We investigated the outbreak to identify the source, propose control and preventive measures. Materials and methods: We defined a case as occurrence of three or more watery stools with or without vomiting, w.e.f 27 January, till 2nd Feb2014 in residents of Ghallour sub-centre area of Jawalamukhi Block. We hypothesized it as a water borne outbreak. We determined age and sex specific attack rate. We collected information about personal history on age, sex, residence, and date of onset of symptom from case patient and established line list. We collected 9 stool samples/rectal swabs from the cases; 3 pre and 4 post chlorination water samples and sent them for microbiological testing. We mapped water supply pipelines of the area and reviewed water chlorination record. Results: We identified 390 cases. The overall attack rate was 8% with range of 1.3% to 36%. The cases patients were reported from all age groups and both the genders with the youngest student; 1 year old to the oldest one as 88 years. Two thirds of the cases reported vomiting with some complaining of pain abdomen. Villages like Jathman, Khattni, Rajol Patta, Kohara has 100% case patients of loose motions while villages like Dhroli, (100%), Sasan (63%) and Ghallour (50%) etc have combined symptoms of loose motions and vomiting. No fatality was reported. Escherichia coli was detected in the samples from water samples. Records of chlorination were not properly maintained. Conclusion/recommendation: The outbreak was caused due to contamination of water at the source in Jolly Khad. Regular treatment of the water needs to be done right at the source before being lifted.