title: Twin outbreak of cholera in rural North Karnataka, India.
abstract: OBJECTIVE
  Successive outbreaks of acute watery diarrhoea occurred in Talikoti and Harnal, located in Bijapur District of the southern Indian s0 tate of Karnataka, in July and August 2012, respectively. These outbreaks were investigated to identify the aetiology and epidemiology.
  
  
  METHODS
  Information was collected from the local population and health centres. Stool and water samples were collected from the admitted patients and their drinking water sources. Standard microbiological and PCR techniques were employed for isolation and characterization of the pathogen.
  
  
  RESULTS
  While 101 people (0.38%) were affected in Talikoti, 200 (20.94%) were affected in Harnal which is a small remote village. All age groups were affected but no death occurred. While the outbreak was smaller, longer and apparently spread by person to person contact in Talikoti, it occurred as a single source flash outbreak at Harnal. A single clone of toxigenic Vibrio cholerae O1 Ogawa biotype El Tor was isolated from the two stool samples obtained from Talikoti and subsequently from three of five stool samples obtained from Harnal indicating village to village spread of the aetiological agent. Striking similarity in antibiotic resistance profiles of these isolates with a particular strain isolated from the city of Belgaum, 250 km away, in 2010, prompted tracking the lineage of the V. cholerae isolates by DNA fingerprinting. Random amplified polymorphic DNA (RAPD) fingerprinting assay helped confirm the origin of the incriminating strain to Belgaum.
  
  
  CONCLUSIONS
  Our study reported the first twin outbreak of cholera in two remote areas of Bijapur district, Karnataka, south India. It also indicated the need for immediate preparedness to deal with such emergencies.
authors.forename: Shuchismita
authors.initials: S
authors.lastname: Dey
authors.forename: Mahantesh V
authors.initials: MV
authors.lastname: Parande
authors.forename: Aisha M
authors.initials: AM
authors.lastname: Parande
authors.forename: S L
authors.initials: SL
authors.lastname: Lakkannavar
authors.forename: Poonam K
authors.initials: PK
authors.lastname: Rathore
authors.forename: B G
authors.initials: BG
authors.lastname: Mantur
authors.forename: Sanjiva D
authors.initials: SD
authors.lastname: Kholkute
authors.affiliation: Regional Medical Research Centre (ICMR), Department of Health Research, Belgaum, India.
authors.forename: Subarna
authors.initials: S
authors.lastname: Roy
mesh_terms: D002771:Cholera / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology / Q000473:pathology; D002772:Cholera Toxin / Q000302:isolation & purification; D016172:DNA Fingerprinting; D003967:Diarrhea / Q000453:epidemiology / Q000382:microbiology / Q000473:pathology; D004196:Disease Outbreaks; D005243:Feces / Q000382:microbiology; D006801:Humans; D007194:India; D041241:Vibrio cholerae O1 / Q000145:classification / Q000302:isolation & purification* / Q000472:pathogenicity; D014871:Water Microbiology
chemical_list: D002772:Cholera Toxin