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Cholera Outbreak Continues in India as Monsoon Season Begins

AUG 02, 2016 | BRIAN P. DUNLEAVY
An ongoing outbreak of cholera in Rayagada, India has reportedly claimed the lives of 5 people in the region some 950 miles southeast of New Delhi.
 
According to the Times of India, in an article published on July 26, more than 30 people in several villages in the tribal-controlled area have been undergoing treatment for the water-borne infection, which causes severe diarrhea. The region has been plagued by issues of violence and poverty, and other infectious diseases—including dengue fever—have created public health challenges there in recent months.
 
The Times of India reports that the nation’s health minister, Atanu Sabyasachi Nayak, has come under fire in the Asian nation for leaving Rayagada without actually visiting an affected village. A local leader of the BJP political party, Siba Shankar Ulaka, told the paper that “to take stock of the cholera situation he should have visited to the villages and not remained confined to the district headquarters to discuss the situation with the officials.” The paper was not able to reach the health minister for comment.
 
Unfortunately, the outbreak in India has been overshadowed somewhat by ongoing crises associated with Zika virus in South America and yellow fever outbreaks in Africa and elsewhere. However, the situation in Rayagada highlights the dangers of contaminated water and the risk for cholera in impoverished regions. According to the World Health Organization, there are nearly 200,000 cases of the infection reported each year; although the majority (more than 50% occur in Africa), some 30% are identified in Asian nations like India.
 
William P Robins, PhD, a professor in the Department of Microbiology and Immunobiology at Harvard University School of Medicine, told Contagion that “many parts of India and Bangladesh are susceptible to cholera almost every year, especially areas that are coastal or estuarine with high rainfall,” and the disease is actually underreported, particularly during rainy season. Unfortunately, developing countries such as these face challenges in the battle against these types of diseases, he adds, because antibiotics are ineffective at preventing onset or progression of the disease “once symptoms have appeared,” and problems associated with water supply and infrastructure require the investment of significant time and resources to resolve.
 
“Keeping infected apart from the household or other people during treatment and containing infected fecal waste does help prevent the spread of cholera in the community,” said Dr. Robins, who has published several articles on cholera. “Vaccination remains one of the best options for protecting communities in areas were cholera is a recurring problem. Vaccines do not offer [full] protection, but if a significant portion of the community has some immunity against disease, it becomes much more difficult for the disease to spread. If medical care is adequately provided to the community [in Rayagada] and this response is not overwhelmed by the number of patients, this outbreak should be contained with minimal casualties. Unfortunately, the emergence of the monsoon season and heavy rain/flooding certainly does not help with keeping waste separated from clean drinking water.”
 
Brian P. Dunleavy is a medical writer and editor based in New York. His work has appeared in numerous healthcare-related publications. He is the former editor of Infectious Disease Special Edition.
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