1887

Abstract

An outbreak of acute diarrhoea occurred in the Belgundi area (population 3896) of Belgaum Taluka (population 815 581) in Karnataka, South India, in June 2010. An estimated 16.22 % of people were affected and 0.16 % deaths were reported. O1 El Tor was isolated from 18 of the 147 stool samples cultured. Seven out of eight drinking water samples collected from different sources were found to be grossly contaminated with faecal coliforms. All isolates were multidrug resistant, with some showing resistance to quinolones, gentamicin and cephalosporins in addition to co-trimoxazole and tetracycline, the drugs that were being used by the state health authorities for empirical treatment. Two serotypes and at least eight genotypes of were observed among the isolates. Cholera was confirmed as one, if not the only, cause of the outbreak, which, to our belief, is the first report of cholera from this region. It might have occurred due to a ‘flare up’ in the number of endemic strains triggered by shortage of portable water, onset of monsoon rains and breakdown of sanitation systems, rather than being a outbreak arising out of new exogenous infectious sources. A change in the empirical treatment, coupled with chlorination, improvement in sanitation measures and extensive Information Education Communication activities, resulted in decline of the outbreak and prevention of further deaths.

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2012-11-01
2019-10-14
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References

  1. Akond M. A., Alam S., Hasan S. M. R., Uddin S. N., Shirin M.. ( 2008;). Antibiotic resistance of Vibrio cholerae from poultry sources of Dhaka, Bangladesh. . Advan Biol Res 2:, 60–67.
    [Google Scholar]
  2. Ausubel F. M., Brent R., Kingston R. E.. & other authors ( 1999;). Short Protocols in Molecular Biology, , 4th edn.. New York:: John Wiley;.
    [Google Scholar]
  3. Bauer A. W., Kirby W. M., Sherris J. C., Turck M.. ( 1966;). Antibiotic susceptibility testing by a standardized single disk method. . Am J Clin Pathol 45:, 493–496.[PubMed]
    [Google Scholar]
  4. Belgaum City Corporation (2001).; http://www.belgaumcity.gov.in/ Updated July 31, 2011. Accessed on July 31, 2011.
  5. Bhaskaran K., Gorrill R. H.. ( 1957;). A study of antigenic variation in Vibrio cholerae. . J Gen Microbiol 16:, 721–729. [CrossRef][PubMed]
    [Google Scholar]
  6. Bhattacharya D., Bhattacharjee H., Ramanathan T., Sudharma S. D., Singhania M., Sugunan A. P., Roy S.. ( 2011;). Third-generation cephalosporin resistance in clinical isolate of Shigella sonnei in Andaman & Nicobar Islands, India. . J Infect Dev Ctries 5:, 674–676.[PubMed]
    [Google Scholar]
  7. Bhattacharya D., Sayi D. S., Thamizhmani R., Bhattacharjee H., Bharadwaj A. P., Roy A., Sugunan A. P.. ( 2012;). Emergence of multidrug-resistant Vibrio cholerae O1 Biotype El Tor in Port Blair, India. . Am J Trop Med Hyg 86:, 1015–1017. [CrossRef][PubMed]
    [Google Scholar]
  8. Government of India (2001).; http://www.censusindia.gov.in/PopulationFinder/District_Master.aspx?state_code=29 Accessed on July 31, 2011.
  9. CLSI ( 2007;). Performance Standards for Antimicrobial Disk Susceptibility Tests; Approved Standard M2-A10. Wayne, PA:: Clinical and Laboratory Standards Institute;.
    [Google Scholar]
  10. Colwell R. R., Huq A., Chowdhury M. A. R., Brayton P. R., Xu B.. ( 1995;). Serogroup conversion of Vibrio cholerae. . Can J Microbiol 41:, 946–950. [CrossRef][PubMed]
    [Google Scholar]
  11. Das S., Saha R., Kaur I. R.. ( 2008;). Trend of antibiotic resistance of Vibrio cholerae strains from East Delhi. . Indian J Med Res 127:, 478–482.[PubMed]
    [Google Scholar]
  12. Fields P. I., Popovic T., Wachsmuth K., Olsvik O.. ( 1992;). Use of polymerase chain reaction for detection of toxigenic Vibrio cholerae O1 strains from the Latin American cholera epidemic. . J Clin Microbiol 30:, 2118–2121.[PubMed]
    [Google Scholar]
  13. Garg P., Nandy R. K., Chaudhury P., Chowdhury N. R., De K., Ramamurthy T., Yamasaki S., Bhattacharya S. K., Takeda Y., Nair G. B.. ( 2000;). Emergence of Vibrio cholerae O1 biotype El Tor serotype Inaba from the prevailing O1 Ogawa serotype strains in India. . J Clin Microbiol 38:, 4249–4253.[PubMed]
    [Google Scholar]
  14. Ghosh A., Ramamurthy T.. ( 2011;). Antimicrobials & cholera: are we stranded?. Indian J Med Res 133:, 225–231.[PubMed]
    [Google Scholar]
  15. Goel A. K., Jain M., Kumar P., Sarguna P., Bai M., Ghosh N., Gopalan N.. ( 2011;). Molecular characterization reveals involvement of altered El Tor biotype Vibrio cholerae O1 strains in cholera outbreak at Hyderabad, India. . J Microbiol 49:, 280–284. [CrossRef][PubMed]
    [Google Scholar]
  16. Hoshino K., Yamasaki S., Mukhopadhyay A. K., Chakraborty S., Basu A., Bhattacharya S. K., Nair G. B., Shimada T., Takeda Y.. ( 1998;). Development and evaluation of a multiplex PCR assay for rapid detection of toxigenic Vibrio cholerae O1 and O139. . FEMS Immunol Med Microbiol 20:, 201–207. [CrossRef][PubMed]
    [Google Scholar]
  17. Jain M., Goel A. K., Bhattacharya P., Ghatole M., Kamboj D. V.. ( 2011;). Multidrug resistant Vibrio cholerae O1 El Tor carrying classical ctxB allele involved in a cholera outbreak in South Western India. . Acta Trop 117:, 152–156. [CrossRef][PubMed]
    [Google Scholar]
  18. Kanungo S., Sah B. K., Lopez A. L., Sung J. S., Paisley A. M., Sur D., Clemens J. D., Nair G. B.. ( 2010;). Cholera in India: an analysis of reports, 1997-2006. . Bull World Health Organ 88:, 185–191. [CrossRef][PubMed]
    [Google Scholar]
  19. Keasler S. P., Hall R. H.. ( 1993;). Detecting and biotyping Vibrio cholerae O1 with multiplex polymerase chain reaction. . Lancet 341:, 1661. [CrossRef][PubMed]
    [Google Scholar]
  20. Manning P. A., Stroeher U. H., Morona R.. ( 1994;). Molecular basis for O-antigen biosynthesis in Vibrio cholerae O1: Ogawa-Inaba switching. . In Vibrio cholerae and Cholera: Molecular to Global Perspectives, pp. 77–94. Edited by Wachsmuth K., Blake P. A., Olsvik O... Washington, DC:: American Society for Microbiology;.
    [Google Scholar]
  21. Mishra M., Mohammed F., Akulwar S. L., Katkar V. J., Tankhiwale N. S., Powar R. M.. ( 2004;). Re-emergence of El Tor vibrio in outbreak of cholera in & around Nagpur. . Indian J Med Res 120:, 478–480.[PubMed]
    [Google Scholar]
  22. Orlandi P. P., Magalhães G. F., Matos N. B., Silva T., Penatti M., Nogueira P. A., Silva L. H.. ( 2006;). Etiology of diarrheal infections in children of Porto Velho (Rondonia, Western Amazon region, Brazil). . Braz J Med Biol Res 39:, 507–517. [CrossRef][PubMed]
    [Google Scholar]
  23. Roy S., Dutta B., Ghosh A. R., Sugunan A. P., Nandy R. K., Bhattacharya S. K., Sehgal S. C.. ( 2005;). Molecular tracking of the lineage of strains of Vibrio cholerae O1 biotype El Tor associated with a cholera outbreak in Andaman and Nicobar Islands, India. . Trop Med Int Health 10:, 604–611. [CrossRef][PubMed]
    [Google Scholar]
  24. Seal S. C.. ( 1960;). The problem of cholera in India. . Indian J Public Health 4:, 1–27.
    [Google Scholar]
  25. Sugunan A. P., Roy S., Murhekar M. V., Naik T. N., Sehgal S. C.. ( 2007;). Outbreak of rotaviral diarrhoea in a relief camp for tsunami victims at Car Nicobar Island, India. . J Public Health (Oxf) 29:, 449–450. [CrossRef][PubMed]
    [Google Scholar]
  26. Sun L., Klein E. Y., Laxminarayan R.. ( 2012;). Seasonality and temporal correlation between community antibiotic use and resistance in the United States. . Clin Infect Dis 55:, 687–694. [CrossRef][PubMed]
    [Google Scholar]
  27. WHO ( 1987;). Manual for Laboratory Investigations of Acute Enteric Infections. CDD/83.3. Geneva, Switzerland:: World Health Organization;.
    [Google Scholar]
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