title: An outbreak of cholera in Medipally village, Andhra Pradesh, India, 2013.
abstract: BACKGROUND
  Cholera continues to remain endemic in over 50 countries and has caused large epidemics with around 3-5 million cases occurring every year in Asia alone. In India, cholera is endemic in many states. However, etiological information and age-specific incidence related to cholera outbreaks is limited. In November 2013, district authorities reported a cluster of diarrheal disease among residents of Medipally to the state surveillance unit. We investigated this cluster to confirm its etiology, describe its magnitude, identify potential risk factors, and make recommendations for control.
  
  
  RESULTS
  A house-to-house active search was conducted to identify cases of acute diarrhea and collect information on drinking water source. Drinking water samples were collected from common water sources and sampled households to test for bacteriological quality. Ten stool samples were collected for culture. A matched case-control study was conducted to identify the risk factors. A total of 138 case-patients of diarrhea (Attack rate: 11.5/100;
  
  
  METHODS
  15 1,200) and 1 death (Case Fatality Ratio: 0.72/100) were identified. Five of the 10 stool samples were culture positive for V. cholerae, serogroup O1 El Tor. Drinking water from the overhead tank [Adjusted OR (AOR): 31.94, 95% CI: 7.3-139.5] was associated with risk of developing illness.
  
  
  CONCLUSIONS
  This outbreak affected nearly 11% of the village population and was due to contamination of the main drinking water source. Outbreaks such as this can be prevented by constructing the drain away from the water pipelines and by monitoring regular chlorination of drinking water source and inspection of pipelines for damage.
authors.affiliation: SHARE India, Hyderabad, Andhra Pradesh, India.
authors.forename: Chengappa K
authors.initials: CK
authors.lastname: Uthappa
authors.affiliation: SHARE India, Hyderabad, Andhra Pradesh, India.
authors.forename: Ramesh R
authors.initials: RR
authors.lastname: Allam
authors.affiliation: SHARE India, Hyderabad, Andhra Pradesh, India.
authors.forename: Chava
authors.initials: C
authors.lastname: Nalini
authors.affiliation: Directorate of Health, Ministry of Health and Family Welfare, Hyderabad, Andhra Pradesh, India.
authors.forename: Deepak
authors.initials: D
authors.lastname: Gunti
authors.affiliation: Directorate of Health, Ministry of Health and Family Welfare, Hyderabad, Andhra Pradesh, India.
authors.forename: Prasada R
authors.initials: PR
authors.lastname: Udaragudi
authors.affiliation: Directorate of Health, Ministry of Health and Family Welfare, Hyderabad, Andhra Pradesh, India.
authors.forename: Geetha P
authors.initials: GP
authors.lastname: Tadi
authors.affiliation: National Institute of Epidemiology, R-127, Tamil Nadu Housing Board, Ayapakkam, Chennai, Tamil Nadu, 600 077, India. mmurhekar@gmail.com.
authors.forename: Manoj V
authors.initials: MV
authors.lastname: Murhekar
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D002771:Cholera / Q000453:epidemiology* / Q000382:microbiology; D004196:Disease Outbreaks; D060766:Drinking Water / Q000382:microbiology*; D019353:Endemic Diseases; D005191:Family Characteristics; D005243:Feces / Q000382:microbiology; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D018881:Suburban Health; D041241:Vibrio cholerae O1 / Q000302:isolation & purification*; D014881:Water Supply; D055815:Young Adult
chemical_list: D060766:Drinking Water
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