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Cholera has not been reported from the Andaman and Nicobar Islands in India. In October 2002, an outbreak of diarrhea occurred among the Nicobarese tribe of the Nancowry group of islands. The outbreak affected 16 of the 45 inhabited villages of three islands with an attack rate of 12.8% and a case fatality ratio of 1.3%. Vibrio cholerae O1 El Tor was isolated from 18 of the 67 patients tested. A study conducted in one of the villages indicated that the outbreak was started there by a person who traveled to a nearby village where an outbreak was occurring. No specific water source could be identified as the source of infection because persons consuming water from all wells were affected. Water samples from 55 sources were tested and 38 of them were contaminated with Escherichia coli. The possible sources of V. cholerae are effluents from ships or poachers from neighboring countries where cholera is endemic.
Received February 19, 2004. Accepted for publication May 29, 2004.
Acknowledgments: We gratefully acknowledge the help and cooperation of the Nicobarese tribal chiefs of the various villages of Nancowry, Dr. Sher Singh (Chief Medical Officer, Community Health Centre, Kamorta), Justin Pereira (Assistant Commissioner, Nancowry), and the paramedical staff of the CHC of Kamorta and sub-centres at Tapong and Derring villages. We are also grateful to the Director and scientists of National Institute of Cholera and Enteric Diseases in Kolkata for their help in laboratory confirmation of diagnosis, and Professor K. Ramachandran (Consultant to the Field Epidemiology Training Programme of the National Institute of Epidemiology [NIE]) and Dr. P. Manickam (Research Officer at the NIE) for useful suggestions in the preparation of this manuscript. The American Committee on Clinical Tropical Medicine and Travelers’ Health (ACCTMTH) assisted with publication expenses.
Authors’ addresses: Attayoor P. Sugunan, Asit R. Ghosh, and Subarna Roy, Regional Medical Research Centre (Indian Council of Medical Research), Post Bag No. 13, Port Blair 744 101, Andaman and Nicobar Islands, India, Telephone: 91-3192-251158, Fax: 91-3192-251163, E-mails: pblsugunan{at}sancharnet.in and pblicmr{at}sancharnet.in. Mohan D. Gupte, National Institute of Epidemiology (Indian Council of Medical Research), Mayor V. Ramanathan Road, Chetput, Chennai, India, Telephone: 91-44-2836-1980, E-mail: nieicmr{at}vsnl.com. Subhash C. Sehgal, Regional Medical Research Centre (Indian Council of Medical Research), Post Bag No. 13, Port Blair 744 101, Andaman and Nicobar Islands, India, Telephone: 91-3192-251043, Fax: 91-3192-251163, E-mail: pblicmr{at}sancharnet.in.
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