India Epidemic Intelligence Service Officer, Epidemiology Division, National Centre for Disease Control, Delhi, India.
Deputy Director, Integrated Disease Surveillance Program, National Centre for Disease Control, Delhi, India.
Indian J Public Health. 2021 Jan;65(Supplement):S46-S50. doi: 10.4103/ijph.IJPH_1118_20.
Mandla District in Madhya Pradesh, India, reported a suspected cholera outbreak from Ghughri subdistrict on August 18, 2016.
We investigated to determine risk factors and recommend control and prevention measures.
We defined a case as >3 loose stools in 24 h in a Ghughri resident between July 20 and August 19, 2016. We identified cases by passive surveillance in health facilities and by a house-to-house survey in 28 highly affected villages. We conducted a 1:2 unmatched case-control study, collected stool samples for culture, and tested water sources for fecal contamination.
We identified 628 cases (61% female) from 96 villages; the median age was 27 years (range: 1 month-76 years). Illnesses began 7 days after rainfall with 259 (41%) hospitalizations and 14 (2%) deaths in people from remote villages who died before reaching a health facility; 12 (86%) worked in paddy fields. Illness was associated with drinking well water within paddy fields (odds ratio [OR] = 4.0, 95% confidence interval [CI] = 1.4-8.0) and not washing hands with soap after defecation (OR = 6.1, CI = 1.7-21). Of 34 stool cultures, 11 (34%) tested positive for Vibrio cholerae O1 Ogawa. We observed open defecation in affected villages around paddy fields. Of 16 tested water sources in paddy fields, eight (50%) were protected, but 100% had fecal contamination.
We recommended education regarding pit latrine sanitation and safe water, especially in paddy fields, provision of oral rehydration solution in remote villages, and chlorine tablets for point-of-use treatment of drinking water.
印度中央邦曼德拉区报告称，2016 年 8 月 18 日，古格里分区发生疑似霍乱疫情。
我们进行了调查，以确定危险因素，并提出控制和预防措施。
我们将 2016 年 7 月 20 日至 8 月 19 日期间古格里居民中出现>3 次稀便且 24 小时内就诊者定义为病例。我们通过医疗机构的被动监测和 28 个受影响严重的村庄的入户调查来识别病例。我们开展了 1:2 不匹配的病例对照研究，采集粪便标本进行培养，并检测水源是否受到粪便污染。
我们从 96 个村庄中发现了 628 例病例（61%为女性）；中位年龄为 27 岁（范围：1 个月-76 岁）。发病时间在降雨后 7 天内，来自偏远村庄的 259 例患者（41%）住院治疗，14 例（2%）死亡患者在到达医疗机构之前死亡；12 例（86%）在稻田工作。患病与在稻田中饮用井水（比值比[OR] = 4.0，95%置信区间[CI] = 1.4-8.0）和便后不用肥皂洗手（OR = 6.1，CI = 1.7-21）相关。34 份粪便培养物中，11 份（34%）检测出霍乱弧菌 O1 群稻叶型阳性。我们观察到受影响的稻田周围存在露天排便。在稻田中检测的 16 个水源中，8 个（50%）得到保护，但 100%受到粪便污染。
我们建议加强有关坑式厕所卫生和安全用水的教育，特别是在稻田中；向偏远村庄提供口服补液盐，并提供氯片剂用于现场处理饮用水。
