Assessment of Epidemiological Factors in a Cholera Outbreak in an Urban Area of Western India

Background: Cholera is a preventable disease, still it remains a major public health problem among developing countries like India. Access to safe water and a sanitary environment can easily control many gastrointestinal infections including Cholera. In the last week of June 2021 large number of acute diarrhoeal cases were reported which was higher than expected subsequently confirmed as an outbreak of Cholera. Objective: To verify the diagnosis, identify risk factors and institute appropriate control measures to control the outbreak. Materials and Methods: A cross-sectional study was undertaken to identify the time, place and personal distribution of the disease. Based on the findings of the descriptive study, sanitary survey and environmental examination a hypothesis was formulated. A case-control study was carried out to test a hypothesis Results: A total of 158 cholera cases were reported with one death. Male and females were affected equally. All age groups affected, 18.35% of the cases were reported among children aged 0-5 years old. It was a common source epidemic and water was source of infection. The water sample reported faecal contamination. Those households not using water purification methods were 1.454 times more affected (OR=1.454) than those using water purification methods. Conclusion: The Vibrio Cholerae bacterium caused the cholera outbreak in Nadiad. Infection was caused by contaminated drinking water.

Microbial Quality of Water in Rural Households of Ethiopia: Implications for Milk Safety and Public Health.

Waterborne pathogenic agents affect the health of people either by direct consumption of contaminated water or by its indirect use in food production and/or processing. Studies on the microbiological quality of water in rural areas of Ethiopia are still limited, especially at the household level. The aim of the present study was to assess the microbial quality of water from different sources in rural households in two districts of the Ethiopian Rift Valley area. The correlation between E. coli counts in water and milk was also investigated. In total, 233 water samples (126 collected in dry and 107 in wet season) and 53 milk samples (19 from raw milk and 36 from processed milk products) were analyzed for E. coli contamination. The overall prevalence of E. coli in water samples was 54.9% (n=233). In most of the analyzed samples, a higher prevalence of E. coli was recorded during the wet compared to the dry season. The highest load of E. coli was detected in water samples from dugouts. The quality of raw milk and traditionally-processed milk products showed variations between districts, and the traditionally-processed milk products were found to contain higher E. coli loads than raw milk. The correlation between the E. coli counts in water and milk only showed a weak but positive relationship (r=0.1). Taking E. coli as a proxy for water quality, the microbiological quality of water consumed in the study area was found to be very poor, posing a potential food safety and health risk to the rural communities.

Microrganismos em percolado após aplicações dejetos líquidos de suínos / Microorganisms in leachate after pig slurry applications

Os dejetos líquidos de suínos (DLS) são utilizados como fertilizante em solos agrícolas. A intensificação de criações com alta concentração de animais em pequenas propriedades tem gerado grande volume de dejetos. Os DLS podem conter microrganismos patogênicos, podendo contaminar águas superficiais e subsuperficiais. O estudo foi realizado para avaliar a presença de microrganismos patogênicos após a aplicação de DLS em amostras de um Argissolo Vermelho Distrófico e de um Nitossolo Vermelho Distrófico. Para tal, aplicou-se doses equivalentes a 0 (Testemunha), 25 (T2), 50 (T3) e 100 (T4) m3 ha-1 de dejetos líquidos de suínos provenientes de dois sistemas de criação denominados de "creche" e "terminação". Os dejetos originários do sistema de criação "creche" apresentaram maiores riscos de contaminação de águas superficiais e subsuperficiais por coliformes totais e Escherichia coli. O valor do pH possivelmente esteve relacionado à ausência de coliformes totais e Escherichia coli no percolado do Argissolo.

Wastes from swine production (WSP) are used as fertilizer in agricultural soils. The intensification of farms with high concentration of animals in small proprerties has generated a great amount of wastes. The WSP may contain pathogenic microorganisms and can contaminate surface and subsurface water. The study was conducted to evaluate the environmental and health impact of the application of WSP in samples of an Alfisol and an Ultisol. To do this they were applied doses equivalent to 0 (control), 25 (T2), 50 (T3) and 100 (T4) m3 ha-1 of pig slurry from two farming systems called "nursery" and "termination". The waste originated from the "nursery" had higher risks of contamination of surface and subsurface soils for total coliform and Escherichia coli. The pH was possibly related to the absence of total coliform and Escherichia coli in leachate from the Ultisol.

Detection of somatic coliphages as indicators of faecal contamination in estuarine waters / Detección de colifagos somáticos como indicadores de contaminación fecal en aguas estuarinas

The appearance of enteric disease outbreaks associated with the use of waters considered bacteriologically suitable, calls for the search of new and more precise indicators. Samples of estuarine water were collected in order to quantify E. coli and E. coli ATCC 13706 somatic coliphages and to compare the usefulness of the latter to detect faecal contamination when the concentration of traditional indicators is not quantifiable. Statistical analyses suggested the division of sampling sites into two groups: group I and group II, according to the minor or major level of faecal pollution respectively registered. In group II a high correlation between the coliphages and E. coli (r: 0.73 p<0.01) was detected. E. coli always exceeded coliphage abundance. In group I, this relationship was statistically significant (r: 0.55 p< 0.05), coliphage counts were higher than those of E. coli and were detected in the absence of the latter. In summary, the use of E. coli ATCC 13706 somatic coliphages is proposed as a complementary tool for the diagnosis of the level of faecal contamination of estuarine waters, especially in areas of low pollution.

La aparición de brotes de enfermedades víricas entéricas asociadas al uso de aguas bacteriológicamente aptas impone la búsqueda de nuevos y más precisos indicadores de contaminación. Se recolectaron muestras de agua estuarina, donde se cuantificaron simultáneamente la bacteria E. coli y los colifagos somáticos de E. coli ATCC 13706, a fin de evaluar la utilidad de estos últimos para detectar contaminación fecal cuando la concentración de los indicadores tradicionales no es cuantificable. Los resultados estadísticos sugirieron la división de las estaciones de muestreo en dos grupos, I y II, de acuerdo con el menor o mayor nivel de contaminación fecal registrado, respectivamente. En el grupo II se detectó una alta correlación entre los recuentos de colifagos y de E. coli (r: 0,73 p<0,01). Asimismo, en este grupo la abundancia de E. coli siempre superó a la de colifagos. En el grupo I la correlación fue estadísticamente significativa (r: 0,55 p < 0,05), pero de mediana magnitud, los recuentos de colifagos superaron a los de E. coli, y éstos fueron detectados aun en ausencia de la bacteria. En conclusión, los colifagos somáticos de E. coli ATCC 13706 serían una herramienta accesoria en el diagnóstico del nivel de contaminación fecal de aguas estuarinas, sobre todo en áreas donde ésta es baja.