Publication:

Footprints to findings: insight into causality of an acute gastroenteritis outbreak in a closed community

cases of acute gastroenteritis (AGE) within an urban community located in western Maharashtra. This investigation sought to identify the origin and causal agents of the outbreak, as well as to establish and implement measures to control its spread.

Methods A matched case-control study was conducted by taking 30 cases and 78 controls from that semi-urban residential area.  Blood and stool culture samples of patients reporting to a primary health care facility were obtained using conventional culture techniques and polymerase chain reaction (PCR) kits. Epidemiological investigations comprised a review of surveillance data, filling of epidemiological case sheets, sanitary surveys, inspection of water supply and bacteriological surveillance of water and environmental engineering surveys.

Results The crude attack rate was reported to be 7%. Laboratory tests revealed multiple pathogens, including Pseudomonas, diarrheagenic E. coli, and Shigella. Environmental assessments highlighted issues such as rusted and leaky water pipes, sewage pipeline problems and insufficient chlorination of the water supply.

Conclusions A widespread outbreak of waterborne gastroenteritis occurred in this region due to contamination of drinking water. The contamination was caused by an improper connection between the sewage system and potable water pipelines. Recommended actions included repair of cross connections, improved treatment methods, adequate chlorination, regular inspections of the water supply and health education which significantly reduced the impact of outbreak.