title: Two sequential outbreaks in two villages illustrate the various modes of transmission of cholera.
abstract: We investigated two sequential outbreaks of severe diarrhoea in two neighbouring villages of Orissa, in 2005. We conducted descriptive and matched case-control studies. The attack rates were 5.6% (n=62) and 5.2% (n=51), respectively, in the first and second villages. One death was reported in the second village (case fatality 2%). We identified that consumption of milk products prepared in the household of the index case [matched odds ratio (mOR) 5.7, 95% confidence interval (CI) 1.7-30] in the first village, and drinking well water in the second village were associated with the illness (mOR 4.7, 95% CI 1.6-19). We isolated Vibrio cholerae El Tor O1 Ogawa from stool samples from both the villages. Mishandling of milk products led to a cholera outbreak in the first village, which led to sewerage contamination of a well and another outbreak in the second village. Environmental contamination should be expected and prevented during cholera outbreaks.
authors.affiliation: National Institute of Epidemiology (ICMR), Chennai, India. dramitav@gmail.com
authors.forename: A
authors.initials: A
authors.lastname: DAS
authors.forename: P
authors.initials: P
authors.lastname: Manickam
authors.forename: Y
authors.initials: Y
authors.lastname: Hutin
authors.forename: B
authors.initials: B
authors.lastname: Pattanaik
authors.forename: B B
authors.initials: BB
authors.lastname: Pal
authors.forename: G P
authors.initials: GP
authors.lastname: Chhotray
authors.forename: S K
authors.initials: SK
authors.lastname: Kar
authors.forename: M D
authors.initials: MD
authors.lastname: Gupte
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000818:Animals; D016022:Case-Control Studies; D002417:Cattle; D002648:Child; D002675:Child, Preschool; D002771:Cholera / Q000453:epidemiology* / Q000382:microbiology / Q000635:transmission*; D004196:Disease Outbreaks; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D007223:Infant; D008297:Male; D008875:Middle Aged; D008892:Milk / Q000382:microbiology; D013997:Time Factors; D014734:Vibrio cholerae / Q000145:classification; D014871:Water Microbiology; D055815:Young Adult