Epidemiology Division, National Centre for Disease Control, Delhi-110054, India.
Divison of Global Health and Protection, US Centers for Disease Control and Prevention, New Delhi-110021, India.
Trans R Soc Trop Med Hyg. 2020 Oct 5;114(10):762-769. doi: 10.1093/trstmh/traa059.
In the Gangetic plains of India, including Delhi, cholera is endemic. On 10 May 2018, staff at the north Delhi district surveillance unit identified a laboratory-confirmed cholera outbreak when five people tested positive for Vibrio cholerae O1 Ogawa serotype in Bhadola. We investigated to identify risk factors and recommend prevention measures.
We defined a case as ≥3 loose stools within 24 h in a Bhadola resident during 1 April-29 May 2018. We searched for cases house-to-house. In a 1 : 1 unmatched case control study, a control was defined as an absence of loose stools in a Bhadola resident during 1 April-29 May 2018. We selected cases and controls randomly. We tested stool samples for Vibrio cholerae by culture. We tested drinking water for fecal contamination. Using multivariable logistic regression we calculated adjusted ORs (aORs) with 95% CIs.
We identified 129 cases; the median age was 14.5 y, 52% were females, 27% were hospitalized and there were no deaths. Symptoms were abdominal pain (54%), vomiting (44%) and fever (29%). Among 90 cases and controls, the odds of illness were higher for drinking untreated municipal water (aOR=2.3; 95% CI 1.0 to 6.2) and not knowing about diarrhea transmission (aOR=4.9; 95% CI 1.0 to 21.1). Of 12 stool samples, 6 (50%) tested positive for Vibrio cholerae O1 Ogawa serotype. Of 15 water samples, 8 (53%) showed growth of fecal coliforms.
This laboratory-confirmed cholera outbreak associated with drinking untreated municipal water and lack of knowledge of diarrhea transmission triggered public health action in Bhadola, Delhi.
在印度的恒河平原地区，包括德里，霍乱是地方病。2018 年 5 月 10 日，北德里区监测单位的工作人员在巴多拉发现了一起实验室确诊的霍乱暴发事件，当时有 5 人在巴多拉检测出霍乱弧菌 O1 群稻叶型阳性。我们进行了调查，以确定危险因素并提出预防措施。
我们将巴多拉居民在 2018 年 4 月 1 日至 5 月 29 日期间 24 小时内出现≥3 次稀便定义为病例。我们通过挨家挨户的方式搜索病例。在 1:1 配对病例对照研究中，将巴多拉居民在 2018 年 4 月 1 日至 5 月 29 日期间无稀便定义为对照。我们随机选择病例和对照。我们通过培养检测粪便样本中的霍乱弧菌。我们检测饮用水是否受到粪便污染。使用多变量逻辑回归，我们计算了调整后的比值比（aOR）及其 95%置信区间（CI）。
我们共发现了 129 例病例，中位年龄为 14.5 岁，52%为女性，27%住院，无死亡病例。症状包括腹痛（54%）、呕吐（44%）和发热（29%）。在 90 例病例和对照中，饮用未处理的市政水（aOR=2.3；95%CI 1.0 至 6.2）和不了解腹泻传播途径（aOR=4.9；95%CI 1.0 至 21.1）的患病风险更高。在 12 份粪便样本中，有 6 份（50%）检测出霍乱弧菌 O1 群稻叶型阳性。在 15 份水样中，有 8 份（53%）显示粪便大肠菌群生长。
此次实验室确诊的霍乱暴发与饮用未处理的市政水和缺乏腹泻传播知识有关，引发了德里巴多拉的公共卫生行动。
