title: Multidrug-resistant Vibrio cholerae O1 in Belgaum, south India.
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. Vibrio cholerae 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 V. cholerae 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 de novo 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.
authors.affiliation: Regional Medical Research Centre, Indian Council of Medical Research (Department of Health Research), Belgaum, Karnataka 590010, India.
authors.forename: Subarna
authors.initials: S
authors.lastname: Roy
authors.affiliation: Belgaum Institute of Medical Sciences & District Civil Hospital, Belgaum, Karnataka, India.
authors.forename: M V
authors.initials: MV
authors.lastname: Parande
authors.affiliation: Belgaum Institute of Medical Sciences & District Civil Hospital, Belgaum, Karnataka, India.
authors.forename: B G
authors.initials: BG
authors.lastname: Mantur
authors.affiliation: Regional Medical Research Centre, Indian Council of Medical Research (Department of Health Research), Belgaum, Karnataka 590010, India.
authors.forename: S
authors.initials: S
authors.lastname: Bhat
authors.affiliation: Belgaum Institute of Medical Sciences & District Civil Hospital, Belgaum, Karnataka, India.
authors.forename: R
authors.initials: R
authors.lastname: Shinde
authors.affiliation: Belgaum Institute of Medical Sciences & District Civil Hospital, Belgaum, Karnataka, India.
authors.forename: A M
authors.initials: AM
authors.lastname: Parande
authors.affiliation: District Surveillance Unit, DHO, Belgaum, Karnataka, India.
authors.forename: Rajanish S
authors.initials: RS
authors.lastname: Meti
authors.affiliation: Belgaum Institute of Medical Sciences & District Civil Hospital, Belgaum, Karnataka, India.
authors.forename: M R
authors.initials: MR
authors.lastname: Chandrasekhar
authors.affiliation: Regional Medical Research Centre, Indian Council of Medical Research (Department of Health Research), Belgaum, Karnataka 590010, India.
authors.forename: S D
authors.initials: SD
authors.lastname: Kholkute
authors.affiliation: Regional Medical Research Centre, Indian Council of Medical Research (Department of Health Research), Belgaum, Karnataka 590010, India.
authors.forename: A
authors.initials: A
authors.lastname: Saini
authors.affiliation: Regional Medical Research Centre, Indian Council of Medical Research (Department of Health Research), Belgaum, Karnataka 590010, India.
authors.forename: M
authors.initials: M
authors.lastname: Joshi
authors.affiliation: Regional Medical Research Centre, Indian Council of Medical Research (Department of Health Research), Belgaum, Karnataka 590010, India.
authors.forename: A
authors.initials: A
authors.lastname: Gaonkar
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D002648:Child; D002675:Child, Preschool; D002771:Cholera / Q000453:epidemiology / Q000382:microbiology*; D003967:Diarrhea / Q000453:epidemiology / Q000382:microbiology; D004196:Disease Outbreaks; D024901:Drug Resistance, Multiple, Bacterial; D005243:Feces / Q000382:microbiology; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D007223:Infant; D008297:Male; D008875:Middle Aged; D019105:Random Amplified Polymorphic DNA Technique; D014734:Vibrio cholerae / Q000187:drug effects*; D014871:Water Microbiology; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents