title: Investigation of an Outbreak of Acute Gastroenteritis in Kollam, Kerala, India.
abstract: An outbreak investigation was initiated following a report of unusual occurrence of acute gastroenteritis in Ashramam area, Kollam district, Kerala, India. House to house survey was conducted to identify cases. Person, place, and time analysis was done. Hypothesis was generated based on findings from cross sectional study, anecdotal evidences, laboratory investigation, and environmental observations. Univariate analysis was done generating odds ratios and confidence intervals to identify factors associated with the disease. A total of 57 cases were reported. Attack rate was highest among children younger than 14 years (22%). Among them, 91.2% (52/57) of the cases and 45.8% (169/369) of the people who had not developed the disease were dependent on pipe water (OR 12.31; 95% CI 4.81-31.52) for drinking purpose. The time frame of the disease occurrence, environmental observations, anecdotal evidences, and the results of analytical study indicated the possibility of the acute gastroenteritis outbreak as a result of pipeline contamination. The study warrants establishment of a good water quality surveillance system.
authors.affiliation: Centre for Public Health Protection, Kollam, Kerala, India rakeshrenjini@gmail.com.
authors.forename: P S
authors.initials: PS
authors.lastname: Rakesh
authors.affiliation: Travancore Medical College, Kollam, Kerala, India.
authors.forename: Vishnu
authors.initials: V
authors.lastname: Narayanan
authors.affiliation: Travancore Medical College, Kollam, Kerala, India.
authors.forename: Swapna S
authors.initials: SS
authors.lastname: Pillai
authors.affiliation: Travancore Medical College, Kollam, Kerala, India.
authors.forename: Rahul
authors.initials: R
authors.lastname: Retheesh
authors.affiliation: Integrated Disease Surveillance Project, Kollam, Kerala, India.
authors.forename: Soumya
authors.initials: S
authors.lastname: Dev
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D002648:Child; D002675:Child, Preschool; D004196:Disease Outbreaks; D060766:Drinking Water; D004781:Environmental Exposure; D004784:Environmental Monitoring; D005191:Family Characteristics; D005260:Female; D005759:Gastroenteritis / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D007194:India / Q000453:epidemiology; D007223:Infant; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D060753:Water Quality; D014881:Water Supply; D055815:Young Adult
chemical_list: D060766:Drinking Water
keywords: acute gastroenteritis; outbreak investigation; pipeline contamination; water contamination; water quality