EPIDEMIOLOGY OF ELTOR CHOLERA IN RURAL BANGLADESH - IMPORTANCE OF SURFACE-WATER IN TRANSMISSION

  • 1 January 1982
    • journal article
    • research article
    • Vol. 60  (3) , 395-404
Abstract
In order to define the role of H2O used for drinking, cooking, bathing and washing in the transmission of Vibrio cholerae biotype eltor infections in an area with endemic cholera, surveillance was initiated in neighborhoods with a culture-confirmed cholera index case and others with index cases with non-cholera diarrhea as controls. In neighborhoods with cholera infection, 44% of surface H2O sources were positive for V. cholerae; only 2% of surface sources were positive in control neighborhoods. Canals, rivers and tanks were most frequently positive. There was an increased risk of infection for families using H2O from culture-positive sources for drinking, cooking, bathing or washing and for those using H2O sources used by index families for drinking, cooking or bathing. Analysis of the results for individuals showed that in this case there was an increased risk of infection associated with using H2O from culture-positive sources for cooking, bathing or washing, but not with using H2O from culture-positive sources for drinking. Individuals who used the same H2O source as an index family for bathing were more likely to be infected than those using different sources. For families drinking from a culture-negative source, there was an association between infection and bathing in a positive source. For families using a different bathing source from the index family there was an association between infection and drinking from the same source as the index family, and for families using a different drinking source from the index family there was an association between infection and bathing in the same source as the index family. Evidently, the use of surface H2O is important in the transmission of V. cholerae and that, in addition to providing safe drinking H2O, education regarding the risk of transmission of infection by H2O from potentially contaminated sources used for other purposes, especially bathing, may also be necessary to control transmission in areas where eltor cholera is endemic.