ABSTRACT
To determine the modes of transmission of cholera in the regency of Pidie, Indonesia, and to consider strategies for its control, we set up a laboratory to identify Vibrio cholerae 01 from patients with severe diarrhea in all government clinics in the regency and questioned culture-positive cases and neighborhood controls about possible exposures to V. cholerae 01. Between 12 July and 15 August 1982, 63 of 138 suspected cholera cases were confirmed by the laboratory; 53 of these patients were seen and followed up. We were unable to identify a single, indisputable mode of transmission for cholera which was amenable to immediate control. Nonetheless, a number of factors, including exposure to water from the Tiro-Sigli River and consumption of ice, were associated with disease. Other findings bring into question the value of current practices of chlorinating dugwells and disinfecting homes with Lysol during a cholera outbreak. The case-control approach to investigating the mode of transmission of cholera has distinct limitations when applied in endemic setting where there may not be a single predominant vehicle of transmission, or where the vehicle such as river water is used by all and is only periodically contaminated.
Subject(s)
Cholera/transmission , Adolescent , Adult , Child , Child, Preschool , Cholera/epidemiology , Female , Food Microbiology , Humans , Indonesia , Infant , Male , Middle Aged , Vibrio cholerae/isolation & purification , Water MicrobiologyABSTRACT
The influx of refugees from Vietnam had created some consequences especially in transmission of certain communicable diseases. During several months of their first arrival, most of illness (90%) were caused by upper respiratory tract infections, skin diseases and diarrhoeal diseases. Several efforts and measures had been done by the Government of Indonesia in collaboration with several agencies i.e. P3V, PMI, UNHCR, W.VI, etc. As a result of the activities, a reduction of diarrhoeal diseases, has been observed. There was no cholera or typhoid cases detected through routine surveillance activities or by special survey. If we examine the morbidity and mortality pattern of refugees or we are comparing with Indonesian figures, it can be concluded that diarrhoeal diseases is not a significant health problem among refugees in Indonesia.
Subject(s)
Diarrhea/epidemiology , Refugees , Humans , Indonesia , Respiratory Tract Infections/epidemiology , Skin Diseases/epidemiology , Vietnam/ethnologyABSTRACT
As the seventh pandemic of cholera is caused by V. cholerae biotype El Tor, the former criteria for endemicity of cholera need to be reconsidered as regards their applicability in areas that are infected with cholera. As the mortality rate of cholera nowadays can be reduced to a very low level due to modern methods of treatment, it is suggested that the infection rates of cholera should be taken into consideration as criteria of cholera endemicity, i.e. 1. Five years persistence of cholera cases in a given area. 2. Five percent infection rate among family contacts of cholera cases. 3. Minimum infection rate of 1% in a vicinity where cholera cases occur. It was also found that in such an endemic area it is very difficult to eliminate V. cholerae infection from a locality, even when all family contacts are treated with the full dose of tetracycline.
