title: Is Vibrio fluvialis emerging as a pathogen with epidemic potential in coastal region of eastern India following cyclone Aila?
abstract: An isolated area with diarrhoea epidemic was explored at Pakhirala village of the Sundarbans, a coastal region of South 24 Parganas district of West Bengal, eastern India. The Pakhirala village was surrounded by other villages affected by a similar epidemic. The affected villages experienced this epidemic following the cyclone Aila, which had hit the coastal region of the Sundarbans in eastern India. In Pakhirala, the situation was the worst. Within a span of six weeks (5 June-20 July 2009), 3,529 (91.2%) of 3,871 residents were affected by watery diarrhoea. Of all the cases (n = 3,529), 918 (26%) were affected by moderate to severe diarrhoea. In other villages, 28,550 (70%) of the 40,786 people were affected; of them, 3,997 (14%) had moderate to severe watery diarrhoea. The attack rate and the severity of the cases were significantly higher in Pakhirala village compared to other affected villages. The laboratory results revealed that Vibrio fluvialis was the predominant pathogen in Pakhirala village (5 of 6 laboratory-confirmed organisms) whereas Vibrio cholerae O1 Ogawa was the predominant pathogen in other villages of Gosaba block (7 of 9 bacteriologically-confirmed organisms). This result indicates that V fluvialis behaves more aggressively than V cholerae O1 in an epidemic situation with a higher attack rate and a different clinical picture. An in-depth study is required to explore its pathogenicity in detail, geographical distribution, and possible control measures, including development of specific vaccine preparation and determination of its efficacy.
authors.affiliation: Tagore Society for Rural Development, Rangabelia, South 24 Parganas, India.
authors.forename: Subhajit
authors.initials: S
authors.lastname: Bhattacharjee
authors.forename: Sayantani
authors.initials: S
authors.lastname: Bhattacharjee
authors.forename: Baishali
authors.initials: B
authors.lastname: Bal
authors.forename: Reshmi
authors.initials: R
authors.lastname: Pal
authors.forename: Swapan Kumar
authors.initials: SK
authors.lastname: Niyogi
authors.forename: Kamalesh
authors.initials: K
authors.lastname: Sarkar
mesh_terms: D000367:Age Factors; D021821:Communicable Diseases, Emerging / Q000453:epidemiology* / Q000382:microbiology; D003430:Cross-Sectional Studies; D055867:Cyclonic Storms; D003967:Diarrhea / Q000453:epidemiology; D004196:Disease Outbreaks; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D012007:Rectum / Q000382:microbiology; D014733:Vibrio / Q000302:isolation & purification / Q000472:pathogenicity*; D014735:Vibrio Infections / Q000453:epidemiology* / Q000382:microbiology
references.citation: J Diarrhoeal Dis Res. 1990 Mar-Jun;8(1-2):24-6
references.pmid: 2229987
references.citation: Res Microbiol. 2008 Sep-Oct;159(7-8):495-506
references.pmid: 18692131
references.citation: J Appl Bacteriol. 1981 Feb;50(1):73-94
references.pmid: 6971864
references.citation: Indian J Med Res. 2009 May;129(5):613-7
references.pmid: 19675394
references.citation: Clin Infect Dis. 1995 Jul;21(1):237-8
references.pmid: 7578751
references.citation: Lancet. 1993 Aug 14;342(8868):387-90
references.pmid: 8101899
references.citation: J Clin Microbiol. 1984 Jul;20(1):125-7
references.pmid: 6746884
references.citation: Appl Environ Microbiol. 1980 Oct;40(4):715-20
references.pmid: 7425623
references.citation: Science. 2009 Aug 7;325(5941):674
references.pmid: 19661401
references.citation: Infect Immun. 1982 Feb;35(2):702-8
references.pmid: 7035373
references.citation: Ann Intern Med. 1986 Aug;105(2):294-5
references.pmid: 3729210
references.citation: Diagn Microbiol Infect Dis. 2002 Jun;43(2):91-7
references.pmid: 12088614
references.citation: PLoS One. 2008 Jun 04;3(6):e2323
references.pmid: 18523643
references.citation: J Diarrhoeal Dis Res. 1990 Dec;8(4):163-5
references.pmid: 2081883
references.citation: J Med Microbiol. 2005 Aug;54(Pt 8):707-716
references.pmid: 16014422
references.citation: Lancet. 1977 Sep 10;2(8037):565-6
references.pmid: 95779
references.citation: J Clin Microbiol. 1982 Nov;16(5):991-2
references.pmid: 7153353
references.citation: Clin Infect Dis. 1994 Sep;19(3):541-2
references.pmid: 7811875
references.citation: J Clin Microbiol. 1980 Jun;11(6):621-4
references.pmid: 7430332
references.citation: Indian J Gastroenterol. 2009 Mar-Apr;28(2):62-4
references.pmid: 19696991
references.citation: South Med J. 1997 May;90(5):544-5
references.pmid: 9160077
references.citation: Lancet. 1993 Mar 13;341(8846):703-4
references.pmid: 8095620
references.citation: J Infect. 2006 Mar;52(3):e95-8
references.pmid: 15996742
references.citation: Jpn J Infect Dis. 2006 Aug;59(4):266-9
references.pmid: 16936349