Cholera Outbreak in South India in Association with Religious Gathering

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Cholera outbreaks have been frequently reported from various parts of developing world mainly owing to poor sanitation of potable water. Most of its outbreak has been reported during monsoon (1). However, the outbreaks are not restricted to this period. Cholera outbreaks have also been reported in refugee camp, prison, funeral feast, etc., (2). Cholera is caused by two serogroups of Vibrio cholerae O1 and O139. Among them O1 has two biotypes Classical and El Tor. Classical biotype was completely replaced by El Tor Vibrio cholerae over the past few decades and almost all of the cholera outbreaks recently reported were belongs to El Tor biotype (3, 4, 5). A similar outbreak emerged in the Theni district of Tamil Nadu state during middle of the May month of, year 2010 in association with the religious gathering of “Veerapondi” festival. The festival has been celebrated during May month of every year by gathering of around 2 lakhs spiritual devotees from south India. Stool samples were collected from the patients suffering with acute watery diarrhea and were inoculated in alkaline peptone water (APW) and incubated at 37°C for 4-8 hours to selectively enrich the growth of Vibrio cholerae. Then the darting type of motility were examined in the stool samples by Hanging drop method. Then the samples were inoculated on Nutrient Agar, Macconkey Agar and Thiosulphate Citrate Bile salt Sucrose (TCBS) agar (Himedia, Mumbai) and incubated for overnight at 37°C. Isolates were further tested for Oxidase positive reaction, sucrose fermentation on TCBS and agglutination with O1 group specific antiserum, Ogawa/Inaba type specific antiserum (King Institute of Preventive Medicine, Chennai) (6). Then the isolates were evaluated for antibiotic sus... ... middle of paper ... ...ankhiwale NS, Powar RM. Re-emergence of El Tor vibrio in outbreak of cholera in and around Nagpur. Indian J Med Res 2004;120:478 – 80. 5. Kanungo S, Sah BK, Lopez AL, Sung JS, Paisley AM, Sur D, Clemens JD, Balakrish Nair G. Cholera in India: an analysis of reports, 1997 -2006. Bull World Health Organ 2010;88:185–91. 6. Centers for Disease Control and Prevention. Laboratory Methods for the Diagnosis of Epidemic Dysentery and Cholera. Atlanta, Georgia: CDC, 1999. 7. Clinical and Laboratory Standards Institute: Performance Standards for Antimicrobial Susceptibility Testing: Sixteenth Informational Supplement M100-S16. CLSI, Wayne, PA, USA, 2006. 8. Chandar J, Kaistha N, Gupta V, Mehta M, Singla N, Deep A, Sarkar BL. Epidemiology and antibiograms of Vibrio cholerae isolates from a tertiary care hospital in Chandigarh, north India. Indian J Med Res 2009;129:613 – 7.

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