A cholera epidemic in a rural area of northeast India

Sporadic cases of acute diarrhoea with high morbidity occur commonly in rural areas of northeast India, throughout the year. At times they take epidemic form and one such outbreak occurred with attack and case fatality rates of 11.6% and 0.8%, respectively, in October 2002, in a remote locality of Assam. Vibrio cholerae O1 El Tor Ogawa was isolated in 63% of hospitalized acute diarrhoea patients. Ineffective antibacterial treatment, poor hygiene practices and bad peridomestic sanitation were the factors associated with the persistence and spread of the pathogen, leading to the outbreak of cholera, resistant to commonly-used antimicrobials.