An acute diarrheal disease outbreak in urban setting of Odisha, India.

Background: Diarrhea, exacerbated by poor hygiene and contaminated water, causes significant child mortality globally. Vibrio cholerae O1 is a primary pathogen, with outbreaks linked to specific biotypes and regions like India. This study documents an acute diarrheal disease outbreak in Rourkela (urban setting), Odisha.

Methods: A matched case-control study was carried out followed by preliminary investigations. Additionally, laboratory investigations were carried out to confirm the cholera outbreak.

Results: The current outbreak reported 1812 Acute Diarrheal Disease (ADD) cases, with a daily incidence rate of 32.7 per one lakh population as of 20th December 2023. Hospitalizations peaked at 58.7%, and six deaths occurred, yielding a case fatality rate of 3.3 per 1000 cases. Sudden rise in cases of ADD was seen in five of the healthcare facilities situated in the urban Rourkela. The mean diarrheal frequency per day among cases was 6.24 ± 2.61 with watery discharge, abdominal pain, and vomiting being reported commonly. And a significant association of cases was found with type of toilet used. Among all the cases; 20.59% were identified as Vibrio cholerae 01 and 2.94% as Shigella flexneri upon culture serotyping.

Conclusions: The emergence of multi-drug resistant strains has a significant impact on outbreak control. Holistic approaches are imperative in combating cholera transmission and minimizing its public health impact in India.