Journal of Public Health Advance Access originally published online on June 1, 2007
Journal of Public Health 2007 29(3):308-309; doi:10.1093/pubmed/fdm032
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Emergence of Vibrio cholerae O1 Inaba in Andaman & Nicobar Islands, India
A. P. Sugunan
Subarna Roy
Regional Medical Research Centre (Indian Council of Medical Research),
Post Bag No. 13, Port Blair 744101, Andaman & Nicobar Islands, India
M. Shahina
W. A. Shah
A. P. Bharadwaj
S. S. Singh
Directorate of Health Services, G.B. Pant Hospital, Port Blair 744101,
Andaman & Nicobar Islands, India
K. Thanasekaran
M. Sathya Prakash
P. Vijayachari
Regional Medical Research Centre (Indian Council of Medical Research),
Post Bag No. 13, Port Blair 744101, Andaman & Nicobar Islands, India
E-mail: pblicmr{at}sancharnet.in
The seventh pandemic of cholera, which originated in a nearby Indonesian island, took over 40 years to reach Andaman & Nicobar Islands,1,2 where the first outbreak was reported in 2002 in Nancowry group of islands.3 Besides this, there have been a few imported cases of cholera in the islands (unpublished data). In all these instances, the causative organism was V. cholerae O1 Ogawa El Tor biotype.
In September–October 2006, 10 suspected cases of cholera were admitted to G.B. Pant Hospital, Port Blair, the only referral hospital in the archipelago. Most of the cases were from a semi-urban area called Brookshabad. Stool samples/rectal swabs were obtained from all of them and were processed for isolation of bacterial enteric pathogens. Six samples yielded cultures of V. cholerae serotype O1 Inaba biotype El Tor. All isolates were positive for ctxA, tcpA and O1 rfb genes in PCR.
Water samples were collected from a stream, the main drinking water source of Brookshabad, above a check dam from where water is pumped to a storage tank and distributed after passing through sand filters and also from several tanks and tested for contamination with coliforms using a rapid kit. All the samples except one were found to be contaminated with coliforms. Regular chlorination of all the water sources was carried out for a month with the help of the volunteers of a non-governmental organization that works in the area.
No more cases occurred after 2nd October and no deaths were reported. Further investigations showed that the first case, a 13-year-old boy from Brookshabad, who was in the hospital suffering from some other ailment, probably contracted the disease from another person, a municipal sewage worker. However, the source of infection for the sewage worker could not be traced. This index case apparently triggered a small outbreak in Brookshabad on his return. However, prompt public health intervention with the active participation of the community prevented a widespread outbreak. This is the first recorded occurrence of cholera due to V. cholerae Inaba in Andaman & Nicobar Islands. Cholera in India during the past decade had been mainly due to V. cholerae O1 Ogawa. However, after a gap of more than a decade, in recent years we have seen the re-emergence of the Inaba serotype that is postulated to have evolved from the circulating Ogawa serotype.4 During 2004 and 2005, cholera was recorded in 15 states of India, with seven outbreaks with a newly emerged V. cholerae O1 Inaba serotype as the main etiological agent.5,6 The present outbreak of diarrhoea in the remote Andaman Islands due to V. cholerae O1 Inaba has revealed the capability of Inaba serotype to spread rapidly among populations. Molecular epidemiological studies on the evolution of this pathogen and its spread is required.
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None.
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The study was supported by the internal funds of the Indian Council of Medical Research.
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- Sugunan AP, Ghosh AR, Roy S, et al. A cholera epidemic among the Nicobarese tibe of Nancowry, Andaman, and Nicobar, India. Am J Trop Med Hyg (2004) 71:822–7.
[Abstract/Free Full Text] - Shah WA, Shahina M, Ali N. First report of Vibrio cholerae infection from Andaman and Nicobar, India. J Commun Dis (2002) 34:270–5.[Medline]
- Roy S, Dutta B, Ghosh AR, et al. Molecular tracking of the lineage of strains of Vibrio cholerae O1 biotype El Tor associated with a cholera outbreak in Andaman and Nicobar Islands, India. Trop Med Int Health (2005) 10:604–11.[CrossRef][Web of Science][Medline]
- Garg P, Nandy RK, Chaudhury P, et al. Emergence of Vibrio cholerae O1 biotype El Tor serotype Inaba from the prevailing O1 Ogawa serotype strains in India. J Clin Microbiol (2000) 38:4249–53.
[Abstract/Free Full Text] - Dutta B, Ghosh R, Sharma NC, et al. Spread of cholera with newer clones of Vibrio cholerae O1 El Tor, serotype Inaba, in India. J Clin Microbiol (2006) 44:3391–3.
[Abstract/Free Full Text] - Pal BB, Khuntia HK, Samal SK, et al. Emergence of Vibrio cholerae O1 biotype El Tor serotype Inaba causing outbreaks of cholera in Orissa, India. Jpn J Infect Dis (2006) 59:266–9.[Medline]
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