title: A rapidly-progressing outbreak of cholera in a shelter-home for mentally-retarded females, amta-II block, Howrah, West Bengal, India.
abstract: On 13 May 2010, a cluster of diarrhoeal disease cases was reported among the inmates of a shelter-home for mentally-retarded females in Parbaksi village of Howrah district in West Bengal, India. The outbreak was investigated to identify the aetiological agent and source of infection and to propose recommendations. A suspected case of cholera was defined as an acute onset of >3 loose watery stools in a female resident of the shelter-home since 1 May 2010. The demographic and clinical details were collected from the suspected case-patients, and the outbreak was described by time, place, and person. A retrospective cohort study was conducted to identify the risk factors associated with the illness. Of the 101 inmates, 91 (90%) developed diarrhoea, and three patients died (case fatality-3%). Four of the five stool specimens were positive for Vibrio cholerae O1 Ogawa. Drinking of water from the pond-connected tubewell (adjusted odds ratio=25.7, 95% confidence interval 2.7-236.4) was associated with the illness. Relocation of the pond-connected tubewell away from the groundwater tubewell, colour-coding of the tubewells meant for drinking purposes, and regular disinfection of the tubewells were recommended.
authors.affiliation: Field Epidemiology Training Programme, National Institute of Epidemiology (Indian Council of Medical Research), Chennai, India.
authors.forename: Subhransu Sekhar
authors.initials: SS
authors.lastname: Datta
authors.forename: R
authors.initials: R
authors.lastname: Ramakrishnan
authors.forename: Manoj V
authors.initials: MV
authors.lastname: Murhekar
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D002648:Child; D002675:Child, Preschool; D002771:Cholera / Q000453:epidemiology* / Q000209:etiology / Q000401:mortality; D003967:Diarrhea / Q000453:epidemiology* / Q000209:etiology / Q000382:microbiology*; D004196:Disease Outbreaks; D005260:Female; D016352:Group Homes; D006801:Humans; D007194:India / Q000453:epidemiology; D007223:Infant; D007231:Infant, Newborn; D008607:Intellectual Disability; D008875:Middle Aged; D015999:Multivariate Analysis; D012307:Risk Factors; D014734:Vibrio cholerae / Q000302:isolation & purification; D014871:Water Microbiology; D014881:Water Supply; D055815:Young Adult