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EMPHNET 6th Regional Conference 2018: "Innovative approaches: Adapting to the current EMR context" (111)
Investigation of Cholera Outbreak at Rawalpindi, Pakistan - August 2017

Investigation of Cholera Outbreak at Rawalpindi, Pakistan - August 2017

Investigation of Cholera Outbreak at Rawalpindi, Pakistan - August 2017

Authors of this article:

Khurram Akram
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    Abstract

    Corresponding Author:

    Khurram Akram


    Background: Cholera is endemic in Pakistan with many outbreaks during the summer season. On July 29, 2017, two suspected cholera cases were reported from a tertiary care hospital in Rawalpindi. On the request of District Health Authorities, a team was constituted.

    Objective: To assess the magnitude of the outbreak, evaluate possible risk factors and recommend control measures.

    Methods: Investigation was carried out from Aug 01-15, 2017. Hospital records were reviewed, and active case-finding was conducted. A case was defined as sudden onset of loose watery stools (3 in past 24 hours) with any of the symptoms like vomiting, nausea, abdominal cramps or fever in a resident of Dhok-Paracha, Amarpura & Dhok-Chaudhriyan, Rawalpindi, from July 19-August 07, 2017. Age and sex-matched neighborhood controls were enrolled. Data was collected using a structured questionnaire. Four stool samples and three water samples were sent to National Institute of Health for microbiological analysis

    Results: A total of 30 cases with 02 deaths (CFR 2.2%) were identified out of which 28 cases were detected through active case-search. There was a male predominance (n=20, 66%) with mean age of 13.7 years (range: 02 months-55 years). Overall AR was 0.68% with 16-20 years being the most severely affected age group (AR 1.8%). Out of 30 cases, 14 were consuming well-water (OR 10.37, 95% CI 3.61-29.74) and 12 were consuming tap water (OR 3.94, 95% CI 1.54-10.08). Water samples showed presence of coliforms (240 CFU/100 ml). Vibrio Cholera Serotype Inaba isolated from stool samples. Heavy rainfall was recorded (455.5 ml) from June 26 to August 6, 2017.

    Conclusions: Consumption of contaminated water was the most probable cause of the outbreak. Contamination of water sources during recent flash floods was the source of contamination. Chlorination of water sources was conducted. Health awareness sessions on safe drinking water were conducted in the community.

    iproc 2018;4(1):e10579

    doi:10.2196/10579


    Edited by Y Khader; This is a non–peer-reviewed article. submitted 29.03.18; accepted 29.03.18; published 29.03.18

    Copyright

    ©Khurram Akram. Originally published in Iproceedings (http://www.iproc.org), 29.03.2018.

    This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in Iproceedings, is properly cited. The complete bibliographic information, a link to the original publication on http://www.iproc.org/, as well as this copyright and license information must be included.