• 1

    Levine MM, Eduardo G, 1993. Cholera. Guerrant RL, Walker DH, Weller PF, eds. Tropical Infectious Diseases, Principles, Pathogens and Practice. Volume 1. First edition. London: Churchill Livingstone, 326–335.

  • 2

    Kaper JB, Morris G Jr, Levine MM, 1995. Cholera. Clin Microbiol Rev 8 :48–86.

  • 3

    Ramamurthy T, Grag S, Sharma R, Bhattacharya SK, Balakrish Nair G, Shimada T, Takeda T, Uesaka Y, Horigome K, Takeda Y, 1993. Emergence of novel strain of Vibrio cholerae with epidemic potential in southern and eastern India. Lancet 341 :703–704.

    • Search Google Scholar
    • Export Citation
  • 4

    Levine MM, 1991. South America: the return of cholera. Lancet 338 :45–46.

  • 5

    Koo D, Traverso H, Libel M, Drasbek C, Tauxe R, Brandling-Bennet D, 1996. Epidemic cholera in Latin America, 1991–1993: implications of case definitions used for public health surveillance. Bull Pan Am Health Organ 30 :134–143.

    • Search Google Scholar
    • Export Citation
  • 6

    Goma Epidemiology group, 1995. Public health impact of Rwandan refugee crisis: what happened in Goma, Zaire in July 1994? Lancet 345 :339–344.

    • Search Google Scholar
    • Export Citation
  • 7

    Siddique AK, Salam A, Islam MS, Akram K, Majumdar RN, Zaman K, Franczak N, 1995. Why treatment centres failed to prevent cholera deaths among Rwandan refugees in Goma, Zire. Lancet 345 :359–361.

    • Search Google Scholar
    • Export Citation
  • 8

    Ghosh AR, Sehgal SC, 1998. Haemolysin production in environmental isolates of V. parahaemolyticus from Andamans. Indian J Med Res 107 :151.

    • Search Google Scholar
    • Export Citation
  • 9

    Ghosh AR, Sehgal SC, 1998. Shigella infections among children in Andaman, an archipelago of tropical islands in Bay of Bengal. Epidemiol Infect 121 :43–48.

    • Search Google Scholar
    • Export Citation
  • 10

    Bart KJ, Huq Z, Khan M, Moosley WH, 1970. Seroepidemiologic studies during a simultaneous epidemic of infection with El Tor Ogawa and classical Inaba Vibrio cholerae.J Infect Dis 121 (Suppl):S17–S24.

    • Search Google Scholar
    • Export Citation
  • 11

    Glass RI, Baker S, Huq MI, Stoll BJ, Khan MU, Merson MH, Lee JV, Black RE, 1982. Endemic cholera in rural Bangladesh, 1966–1980. Am J Epidemiol 116 :959–970.

    • Search Google Scholar
    • Export Citation
  • 12

    Chevalier M, Vandekerkove M, 1980. Experimental study on the survival of Vibrio cholerae (El Tor biotype) in sea-water. Bull Soc Pathol Exot Filial 73 :364–372.

    • Search Google Scholar
    • Export Citation
  • 13

    World Health Organization, 1995. Cholera in 1994. Part I. Wkly Epidemiol Rec 70 :201–208.

  • 14

    Taxue RV, Holmberg SD, Dodin A, Wells JV, Blake PA, 1988. Epidemic cholera in Mali: high mortality and multiple routes of transmission in a famine area. Epidemiol Infect 100 :279–289.

    • Search Google Scholar
    • Export Citation
  • 15

    Faruque AS, Eusof A, Rahman AS, Zaman K, 1984. Study of makeshift hospital during cholera outbreak. Bangladesh Med Res Counc Bull 10 :45–52.

    • Search Google Scholar
    • Export Citation
  • 16

    Bag PK, Maiti S, Sharma C, Ghosh A, Basu A, Mitra R, Bhattacharya SK, Nakamura S, Yamasaki S, Balakrish Nair G, 1998. Rapid spread of the new clone of Vibrio cholerae O1 El Tor in cholera endemic areas in India. Epidemiol Infect 121 :245–251.

    • Search Google Scholar
    • Export Citation
  • 17

    McKarthy SA, Khambaty FM, 1985. International dissemination of Vibrio cholerae by cargo ship ballast and other nonpotable waters. Appl Environ Microbiol 121 :791–796.

    • Search Google Scholar
    • Export Citation
  • 18

    DePola A, Capers GM, Motes ML, Olsvik O, Fields PI, Wells J, Wachsmuth IK, Cebula TA, Koch WH, Khambaty MH, Pyne WL, Wentz BA, 1992. Isolation of Latin American epidemic strain of Vibrio cholerae O1 from US Gulf Coast (letter). Lancet 339 :624.

    • Search Google Scholar
    • Export Citation
  • 19

    Shandra WS, Hafkin B, Martin DL, Taylor JP, Maserang DL, Wells JG, Kelly M, Ghandi K, Kaper JB, Lee V, Blake PA, 1982. Persistence of cholera in the United States. Am J Trop Med Hyg 32 :812–817.

    • Search Google Scholar
    • Export Citation
  • 20

    Felsenfeld O, 1965. Notes on food, beverages and fomites contaminated with Vibrio cholerae.Bull World Health Organ 33 :725–734.

  • 21

    Madico G, Checkley W, Gilman RH, Bravo N, Cabrera L, Calderon M, Ceballos A, 1996. Active surveillance for Vibrio cholera O1 and vibriophages in sewage water as a potential tool to predict cholera outbreaks. J Clin Microbiol 34 :2968–2972.

    • Search Google Scholar
    • Export Citation
 
 
 

 

 
 
 

 

 

 

 

 

 

A CHOLERA EPIDEMIC AMONG THE NICOBARESE TRIBE OF NANCOWRY, ANDAMAN, AND NICOBAR, INDIA

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  • 1 Regional Medical Research Centre (Indian Council of Medical Research), Port Blair, Andaman and Nicobar Islands, India; National Institute of Epidemiology (Indian Council of Medical Research), Chetput, Chennai, India

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.

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