India Epidemic Intelligence Services (EIS) Officer, Delhi, India.
Joint Director, Division of Epidemiology, National Centre for Disease Control, Delhi, India.
Indian J Public Health. 2021 Jan;65(Supplement):S14-S17. doi: 10.4103/ijph.IJPH_962_20.
Acute diarrheal disease (ADD) accounts for 12 million cases and 1216 deaths annually in India. On July 13, 2016, an ADD outbreak was reported from Sawargaon village from Nagpur district, Maharashtra.
The outbreak was investigated to describe the epidemiology and suggest control and preventive measures.
A case was defined as a person experiencing at least one loose stool in Sawargaon village between July 9, 2016, and July 31, 2016. We searched for cases by enhanced passive surveillance. We collected stool samples for bacterial culture and tested water from multiple water sources for fecal coliforms. We also reviewed sanitary practices and rainfall data.
A total of 889 cases were identified, with 51% female, 280 hospitalizations (31%), and two deaths. The median age was 27 years (range 6 months to 90 years). Cases started on July 9, a week after heavy rains. District authorities started chlorination of water sources on July 13 and cases declined soon after. Two of nine stool samples tested positive for Vibrio cholera O1 serogroup. Of the 18 water samples collected, 16 (88%) samples from multiple sources, including wells, hand pumps, and taps, were positive for fecal coliforms. Of 1,885 households in the village, 450 (24%) households had no toilets and open defecation was commonly observed in the nearby river bed.
This ADD outbreak was likely associated with drinking contaminated groundwater, which probably occurred after heavy rainfall in an area of open defecation. We recommended providing chlorinated drinking water, promoting safe sanitation practices, including building more public and private toilets, and enhancing diagnostic laboratory capacity.
印度每年有 1200 万例急性腹泻病（ADD）病例，导致 1216 人死亡。2016 年 7 月 13 日，马哈拉施特拉邦那格浦尔区的萨瓦冈村报告了一起 ADD 暴发事件。
对此次暴发进行调查，以描述其流行病学特征，并提出控制和预防措施。
将 2016 年 7 月 9 日至 7 月 31 日期间在萨瓦冈村至少有一次稀便的人定义为病例。我们通过加强被动监测寻找病例。我们采集粪便样本进行细菌培养，并检测多个水源的粪便大肠菌群。我们还审查了卫生习惯和降雨量数据。
共发现 889 例病例，其中 51%为女性，280 例住院（31%），2 例死亡。中位年龄为 27 岁（范围为 6 个月至 90 岁）。病例于 7 月 9 日开始出现，即在大雨过后的一周。区当局于 7 月 13 日开始对水源进行氯化消毒，此后病例迅速减少。9 份粪便样本中有 2 份检测出霍乱弧菌 O1 血清群阳性。采集的 18 份水样中，包括水井、手动泵和水龙头在内的多个水源的 16 份（88%）水样粪便大肠菌群检测呈阳性。在该村的 1885 户家庭中，450 户（24%）家庭没有厕所，附近的河床经常有露天排便现象。
此次 ADD 暴发可能与饮用受污染的地下水有关，这可能是在该地区露天排便后发生的强降雨所致。我们建议提供氯化饮用水，推广安全的卫生习惯，包括建造更多公共和私人厕所，并增强诊断实验室能力。
