Prevalence of iodine deficiency disorders among school student of Purba Medinipur, 2018: a cross sectional study

Background: Iodine deficiency disorder is one of the preventable public health diseases in India. Prevalence of goiter is also still prevalence at sub-Himalayan region of West Bengal. Study was conducted to assess prevalence of goiter among school students between 6 and 12 years age, to find out urinary excretion of iodine and iodine content in salt sample and to recommend for consuming iodized salt.Methods: We conducted the study among the school students aged 6 to 12 years during the month of June 2018 in Purba Medinipur district, West Bengal, India. Multistage cluster sampling method was conducted for selecting the study population. Clinical examination was done by medical officer to detect goiters. Salt and urine samples were taken from the selected students and were sent to State Iodine Monitoring Laboratory, Kolkata for examination of iodine content in household salt samples and urine samples.Results: Total 2821 students were examined for survey. Over all prevalence of goiter was 3.75% (109/2821). Girls had more prevalence 4.63% than boys 3.18%. Average urinary iodine excretion (UIE) level is 184.74% in 30 clusters of 339 urine samples. Only 5.60% showed UIE level ≤100 microgram/liter. Total 541 household salt samples were tested for iodine and average iodine content was 22.85%. Among them 91.5% (495) had iodine ≥15 ppm indicating adequate iodine contents in salt samples.Conclusions:Purba Medinipur may be considered a non-endemic district. We recommended continuing use of iodized salt.

Dengue fever in a rural area of West Bengal, India, 2012: an outbreak investigation.

Background: During September 2012, an increased number of fever cases was reported from Ramnagar-II block, Purba Medinipur district. This study investigated the outbreak, with the following objectives: to describe the distribution of fever cases, to determine the risk factors and to recommend preventive measures. Materials and Methods: The clinical features, date of onset and outcome of all cases of fever were listed. Blood specimens were collected from affected patients and sent for serological examination. An epidemic curve was plotted and environmental and entomological surveys were carried out. Results: There was a total of 100 cases, of which 56% (56/100) were men. Among the four villages studied, the highest number of cases was from Gopalpur 37% (37/100), followed by Badalpur 26% (26/100); 19% (19/100) of cases had a history of migration from dengue-endemic areas. The majority of cases were in age group 15–45 years – 52% (52/100), followed by the age group >45 years – 28% (28/100). All the cases had history of fever (100%), followed by myalgia – 82%, headache – 78%, and retro-orbital pain – 73%. The outbreak started on 7 September 2012, peaked on 18 September, then gradually declined and no further cases were noted after 28 September 2012. Seventy-nine per cent (79/100) of cases were NS1 test positive (non-structural antigen-1) and 72% (13/18) cases were positive on a dengue monoclonal antibody (IgM) capture enzyme-linked immunosorbent assay (MAC-ELISA) test. All recovered except one (case-fatality ratio: 1%). The values for Household Index, Container Index and Breteau Index of the four villages were: Badalpur, 3%, 10% and 5%; Gopalpur, 13%, 23% and 18%; Ramchandrapur, 9%, 11%, and 13%; and Tajpur, 2%, 2% and 2%. Conclusion: The outbreak was probably due to dengue fever. The study led to a recommendation to destroy water containers and use mosquito nets. The outbreak was controlled.

An outbreak of pandemic influenza A (H1N1) in Kolkata, West Bengal, India, 2010.

Background & objectives: An increased number of cases with influenza like illness (ILI) were reported in Greater Kolkata Metropolitan Area (GKMA) during July and August 2010. We investigated these cases to confirm the outbreak, describe the distribution of patients and propose control measures. Methods: A suspected case of influenza like illness (ILI) was defined as acute onset of fever (>38°C) with cough or sore throat and a confirmed case as ILI case with throat swab positive for influenza A (H1N1) on RT-PCR. The demographic and clinical details were collected from patients attending the swine flu OPD of Infectious Disease Hospital, Kolkata, during July 5 to August 16, 2010. Results: Overall 440 patients with ILI attended the swine flu OPD of Infectious Disease and Bengal General hospital during the study period, of which 129 were positive for influenza A (H1N1). Four patients died (case fatality ratio: 0.90%). Besides fever, common symptoms included cough (73%), running nose (54%), sore throat (43%), respiratory distress (25%) and diarrhoea (4%). Forty seven (11%) patients (including the four who died) had co-morbidities. The outbreak started on July 10, peaked on July 24 and subsided by August 14, 2010. A total of 372 (85%) patients were from GKMA. Majority (n=168, 45%) of the cases from GKMA were from 6 boroughs of Kolkata Municipal Areas. Interpretation & conclusions: An outbreak of influenza A (H1N1) occurred in Kolkata predominantly affecting young and middle aged population. State health authorities implemented several interventions to limit the outbreak including training of health care providers in case management and infection control, vaccination of health care workers, creation of isolation wards and administration of oseltamivir to ILI patients, and community health education about social distance and personal hygiene measures.

Cholera outbreak secondary to contaminated pipe water in an urban area, West Bengal, India, 2006.

Outbreaks of cholera are common in West Bengal. In April 2006, Garulia municipality reported a cluster of diarrhea cases. We investigated this cluster to identify the etiological agent, source of transmission and propose control measures. We defined a case of diarrhea as occurrence of >3 loose/watery stools a day among the residents of Garulia since April 2006. We searched for cases of diarrhea in health care facilities and health camp. We conducted a gender- and age-matched case–control study to identify risk factors. We inspected the sanitation and water supply system. We collected rectal swabs from diarrhea patients and water specimens from the affected areas for laboratory investigation. Two hundred and ninetyeight cases of diarrhea were reported to various health care facilities (attack rate: 3.5/1000, no deaths). The attack rate was highest among children (6.4/1000). Vibrio cholerae El Tor O1 Inaba was isolated from two of 7 rectal swabs. The outbreak started on 10 April 2006, peaked on 26 April and lasted till 6 May. Cases clustered in an area distal to leaking water pipelines. Drinking municipal water exclusively was significantly associated with the illness (OR 13, 95% CI=6.5–27). Eight of the 12 water specimens from the affected area had fecal contamination and poor chlorine content. This outbreak was due to a contaminated municipal piped water supply and V. cholera 01 Inaba was possibly the causative organism.