Academic journal article Journal of Health Population and Nutrition

Is Vibrio Fluvialis Emerging as a Pathogen with Epidemic Potential in Coastal Region of Eastern India Following Cyclone Aila?

Academic journal article Journal of Health Population and Nutrition

Is Vibrio Fluvialis Emerging as a Pathogen with Epidemic Potential in Coastal Region of Eastern India Following Cyclone Aila?

Article excerpt

INTRODUCTION

On 25 May 2009, a major cyclone named Aila at a speed of 120-140 km per hour hit the coastal islands of the Sunderbans, the largest delta islands in the world, situated in the southern part of West Bengal, eastern India. The Sunderbans has been facing the brunt of 'global warming' recently because of which the islands have been reported to be under water during the high tides. During the cyclone, a high tidal wave of about eight metres in height resulted in the destruction of the river embankments for a distance of around 150 km. This brought about massive devastation of man and property in these areas.

Aila hit the islands of the Sundarbans leading to flood that caused an epidemic of watery diarrhoea all over these islands just a week after the calamity struck this area. This epidemic was preceded by a focal outbreak of watery diarrhoea (with or without presence of blood in stool) caused by Vibrio fluvialis in February 2009 in Pakhirala village of Gosaba block in the Sundarbans. A team from the National Institute of Cholera & Enteric Diseases, Kolkata, carried out the investigation and confirmed the aetiological agent at that time. The organism was detected from the piped water-supply system used for drinking purpose in the affected village and from stool samples of infected patients. Except the treatment of the affected cases, no specific intervention, particularly provision of environmental sanitation, was offered to the community. Fortunately, there was a natural decline of the outbreak within six weeks from its onset. This rose the question whether V. fluvialis could lead to an epidemic in coastal regions, particularly following natural disasters, such as flood which is common in these delta areas. An investigation was made to find out the outbreak-causing potentiality and epidemiology of V. fluvialis in the Sundarbans following Aila.

MATERIALS AND METHODS

Study area

Villages across the Gosaba block of the Sundarbans were affected during the post-Aila diarrhoea epidemic. Pakhirala village was one of the many affected villages (Fig. 1).

One of the major attractions of this village is that tourism in the Sundarbans is based on this village. Of the 44,657 inhabitants in 80 villages of Gosaba block of the Sundarbans, 71% were reported to be affected. All patients with features of moderate to severe watery diarrhoea were attended and/or admitted to the nearby health facilities that included primary or block health centres and private hospitals run by non-governmental organizations (NGOs). Admission registers of these health establishments were consulted to understand the epidemiology of the outbreak.

[FIGURE 1 OMITTED]

Study population and sample collection

For the purpose of this study, 'diarrhoea cases' were defined as those who passed three or more loose or liquid stools per day, or more frequently than is normal for the individual (1). Distinction among 'mild', 'moderate', and 'severe' diarrhoea was based on degree of dehydration. Patients with no signs or symptoms of dehydration were regarded as suffering from mild diarrhoea. Patients were considered to be suffering from 'moderate diarrhoea' if they showed the signs of sunken eyes, dry mouth, increased thirst, restlessness or irritable behaviour, and slow retraction of skin-pinch (1,2). Patients were regarded as suffering from severe diarrhoea if signs of severe dehydration were present, such as drowsiness or unconsciousness, inability to drink, weak and rapid radial pulse, low/undetectable blood pressure, cool, moist extremities, and lack of urine output (1,2).

A subset (n=100) of the affected people of Pakhirala village was interviewed using a pretested questionnaire and examined clinically to understand their morbidity profile. Following this, stool samples/rectal swabs were collected in Cary-Blair media from the affected people of this village and from other villages. …

Search by... Author
Show... All Results Primary Sources Peer-reviewed

Oops!

An unknown error has occurred. Please click the button below to reload the page. If the problem persists, please try again in a little while.