Cholera outbreak caused by drinking lakeshore water contaminated by feces washed down from a hill-side residential area: Kaiso Village, Uganda

Introduction: cholera is a bacterial diarrheal disease caused by Vibrio cholerae. On 15 October 2015, a cholera outbreak involving dozens of cases and 2 deaths was reported in Kaiso, a lakeshore fishing village. The district health department responded by setting up a treatment center and sensitizing the community. Despite initial response, the outbreak persisted, prompting a detailed epidemiological investigation to identify the source and mode of transmission and recommend evidence-based interventions to stop the epidemic.Methods: we defined a suspected case as onset of acute watery diarrhoea in a Kaiso Village resident from 1st October 2015 onward; a confirmed case was a suspected case with Vibrio cholerae isolated from stool. We performed descriptive epidemiology to generate a hypothesis, and conducted a case-control study to compare exposure histories of 61 cases and 126 controls randomly selected among village residents (age ≥ 4 years in both groups). We conducted environmental assessment and obtained meteorological data from a local weather station.Results: 123 suspected cases (2 deaths) were line-listed at the village's cholera clinic. The initial 2 deceased cases had onset on 2nd and 10th October. Heavy rainfall occurred during 7­11th October, setting in a point-source outbreak which started on 12th and peaked on 13th October. Three water collection points (WCP) A, B and C were associated with the outbreak. 9.8% (6/61) of case-persons and 31% (39/126) of control-persons usually collected water from WCP A. In comparison, 21% (13/61) of case-persons and 37% (46/126) of control-persons usually collected water from WCP B (OR = 1.8, 95%CI: 0.64-5.3) and 69% (42/61) of case-persons and 33% (41/126) of control-persons from WCP C (OR = 6.7; 95%CI = 2.5-17). 100% (61/61) of case-persons and 93% (117/126) of control-persons never treated/boiled drinking water (OR = ∞, 95%CIFisher = 1.0-∞). A gully channel from a hillside open defecation area washed down feces to the lakeshore at WCP C.Conclusion: this outbreak was caused by drinking lakeshore water contaminated by feces washed down a gully from the village. We recommended water boiling and treatment, fixing the broken piped-water system, and constructing latrines. The outbreak was stopped by implementing treatment and boiling of drinking water at household level

Vibrio cholerae a Madagascar : a propos d'une souche multiresistante

"Multiresistant Vibrio cholerae strain in Madagascar : report of the first case"": Madagascar was cholera free until March 1999. The first case was reported in Mahajanga; anorth west coast harbor. Ten months later and despite a massive use of tetracycline as proplylactic drug; cholera had reached every region of the island.All suspected cholera samples were analysed at the Pasteur Institute of Madagascar where susceptibility to tetracycline was systematically performed. On February 2000; a multidrug resistant strain of V. cholerae was isolated. We studied this strain by performing Minimal Inhibitory Concentration (MIC) and by plasmidic and conjugative assay.As the original strain; this multiresistant V. cholerae showed a resistance to cotrimoxazole; to streptomycin and chloramphenicol but; in addition to; appeared strongly resistant to ampicillin and tetracycline. This strain harboured a 26 kb self-transmissible plasmid. Conjugation tests showed the possibility of plasmidic segregates or acquisition of two different plasmids. The weak transfer rate could explain why we have isolated only one multiresistant strain. The emergence of a such multiresistant strain should encourage the medical authorities to reinforce the epidemic survey in every medical Malagasy district and to carry out new antimicrobial surveys to describe the mechanisms of the spread of these resistances."

Susceptibility of salmonella; shigella and vibrio cholerae 01 to antimicrobial agents at Muhimbili Medical Centre; Dar es Salaam during 1990-19 [sic]

Surveillance of susceptibility of salmonelle; shigella; and v.cholerae 01 to antimicrobial agents was conducted in the period January 1990 - June 1991 at Muhimibili Medical Centre Dar es Salaam. Of the 82 salmonella isolates studied 53(64.4 percent) were resistant to sulphonamide/trimethoprim; 50(61 percent) to ampicillin; 31(37.8 percent) to tetracycline and none was resistant to chlormaphenicol or ciprofloxacin. Of 73 shigella isolates 44(60.2 percent) were equally resistant to sulphonamide/trimethoprim and ampicillin; and 43(58.9 percent) to tetracycline. Eight (10.9 percent) of the shigella were resistant to chloramphenicol and 1(1.3 percent) was resistant to augmentin and none was resistant to ciprofloxacin. [abstract terminated]