Document Detail


An urban, water-borne outbreak of diarrhoea and shigellosis in a district town in eastern India.
MedLine Citation:
PMID:  20334044     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: In September 2007, the Gayeshpur municipality reported a cluster of cases with diarrhoea. We aimed to identify the causative agent and the source of the disease. METHODS: We defined a case as the occurrence of diarrhoea (> 3 loose stools/day) with fever or bloody stools in a resident of Gayeshpur in September-October 2007. We asked healthcare facilities to report cases, collected stool specimens from patients, constructed an epidemic curve, drew a map and calculated the incidence by age and sex. We also conducted a matched case-control study (58 in each group), calculated matched odds ratio (MOR) and population attributable fraction (PAF), as well as assessed the environment. RESULTS: We identified 461 cases (attack rate: 46/1000 population) and isolated Shigella flexneri (serotype 2a and 3a) from 3 of 4 stool specimens. The attack rate was higher among females (52/1000) and those in the age group of 45-59 years (71/1000). The outbreak started on 22 September, peaked multiple times and subsided on 12 October 2007. Cases were clustered distal to a leaking pipeline that crossed an open drain to intermittently supply non-chlorinated water to taps. The 58 cases and 58 controls were matched for age and sex. Drinking tap water (MOR: 10; 95% CI: 3-32; PAF: 89%), washing utensils in tap water (MOR: 3.7; 95% CI: 1.2-11.3) and bathing in tap water (MOR: 3.5; 95% CI: 1.1-11) were associated with the illness. CONCLUSION: This outbreak of diarrhoea and Shigella flexneri dysentery was caused by contamination of tap water and subsided following repair of the pipeline. We recommended regular chlorination of the water and maintenance of pipelines.
Authors:
T Saha; M Murhekar; Y J Hutin; T Ramamurthy
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The National medical journal of India     Volume:  22     ISSN:  0970-258X     ISO Abbreviation:  Natl Med J India     Publication Date:    2009 Sep-Oct
Date Detail:
Created Date:  2010-03-25     Completed Date:  2010-04-15     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8809315     Medline TA:  Natl Med J India     Country:  India    
Other Details:
Languages:  eng     Pagination:  237-9     Citation Subset:  IM    
Affiliation:
National Institute of Epidemiology (NIE), Indian Council of Medical Research (ICMR) R 127, Third Avenue, Tamil Nadu Housing Board, Phase I and II Ayapakkam, Chennai 600077, Tamil Nadu, India.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Diarrhea / epidemiology*
Disease Outbreaks*
Dysentery, Bacillary / epidemiology*
Female
Humans
India / epidemiology
Male
Middle Aged
Water Microbiology*

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