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A NOTE on CHOLERA OUTBREAKS a Day Or Two to 50 Days, the Average Being 10.6 (1944-45) in the SINGUR HEALTH Days

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A NOTE on CHOLERA OUTBREAKS a Day Or Two to 50 Days, the Average Being 10.6 (1944-45) in the SINGUR HEALTH Days Aug., 1946] CHOLERA OUTBREAKS IN SINGUR HEALTH CENTRE : SEAL 321 Public Health Section The duration of these outbreaks varied from A NOTE ON CHOLERA OUTBREAKS a day or two to 50 days, the average being 10.6 (1944-45) IN THE SINGUR HEALTH days. The investigation accompanied by control CENTRE AREA, BENGAL, WITH measures was undertaken at varying intervals in SPECIAL REFERENCE TO different outbreaks, starting within a few hours CONTROL MEASURES * to as long as 35 days after the onset, the average interval being 7.5 days. Definite history of % S. c. SEAL, M.B., D.P.H.j F.A.P.H.A. importation was elicited in 13 outbreaks and in 4. (Assistant Professor of Epidemiology, All-India Institute probable importation another The other of Hygiene and Public Health, Calcutta) suspected sources or agencies were local mela 1 and contaminated milk while no definite The Health Centre of four 1, Singur consisting source could be elicited in 5 of them. Bora Melas, B?ards, viz, Singur, Balarambati, hats and industrial centres are a few of the nJ0rL in the district of ?p? Begumpur (see map) potent focal points from which cholera is with an area of 33 square miles fi '^en?a^ imported into the area. Water does and? 63,000 came under the generally population, present not seem to take noticeable in these m health in 1944. any part Sin organization January outbreaks except occasionally in spreading the a 11 the area has been utilized the c-f ^en by disease for a short while within a limited area ^ns^ute of and Public + Hygiene Health, the use of the infected dobas. Direct Caf a' ^?r ya"ous studies under rural through conHV contact and on the other seem to ?ns- ^is connection the author investi- flies, hand, 2a+ j more definite role in the local ^oca^ cholera outbreaks with a play spread. view +n^? some but efficient niptk j? ev?lving simpler within the means of the local Results of the application of certain control healthn co.n^r{?^ organization and the community, measures Wenty~four of the 27 outbreaks of cholera in thp The rate is 25 per cent for the between 19th and 30th gross fatality Anril^in April, 1944, series of outbreaks reported here. This will 1 year) were the vari (roughly studied, appear if the effect of the control measures ?US areas ?f outbreak been visited at high diff having is without the details. The most import- ?f the judged "thp6^6?^ s^a?es epidemic depending upon ant factor in the control of cholera is lnterval of time that between the single n elapsed notification. It will be noticed from table I case ac^ua^ anc* that in certain cases the information was received visifrre^Ce-This has a study 0? permitted comparative very late; for instance, in the case of Panchghora J-the effects of certain control measures on outbreak it was delayed for as many as 35 days at different ?.utbreaks their phases, with the result that the epidemic had spread frnSe which some of the method general principles widely and 30 cases with 8 deaths (26.6 per ?f cholera in the rural areas of Bengal ha Ve cent) had already occurred before any control C?n^ro*been These will be described t developed. measure was actually instituted. Even so, 14 A of the outbreaks has brief account more cases had occurred before the final curtain beesently. in to the Siyen table I arranged according could be drawn over this cje0ri of time epidemic, although hptCenc^ng order of interval elapsing only one of them died. Ween the onset and the first field visit. The average duration of the outbreaks was seen from table I that within the con 10^ days and the average interval between the year as as 17 (25 ?^.a many villages onset and notification was 7% days. In other perrsecent) in area were affected with cholera. the three-fourths of the cases had ijpu had three words, roughly Ratanpur and Pahlampur already occurred before the information was stagess and ha i + ea?h, Biramnagar Baruipara received. Thus of the 203 cases 157 or 77.3 per ? each and the rest had out- brp i_ single cent actually occurred before notification and cases was ? The total number of 2(Vi only> only 46 or 22.7 per cent after the party's visit. Wlth 51 case rate 25 deaths, the fatality being Also of the 51 deaths recorded as many as 45 cent- The distribution of cases in fi?1" frequency or 88.2 per cent occurred before the control hese outbreaks was as follows :? 5 Single 10 and 20 5 and 10 1 and cases ^ 30 and 40 20 and 30 lIrnber of cases between 40 and 50 ^ lIrnber of 1 nil outbreaks .. were and or Sec- measures adopted, only 6 11 8 per and Veterinary * cent afterwards. Translated into Pr^resented before the Medical Congress, fatality'rates Indian Science were 28.7 and 13.0 cent 011 of the these per ?f the 33rd session 1946. respectively'; 10 2nd January, (1 at Bangalore on the Table I 322 A brief account of the cholera outbreaks in the Singur Health Centre Area (1944-45) arranged in descending order of interval between the onset and the first field visit After first field Outbreaks Total Before notification Interval visit between Affected of first case Types Probable source or mode of vibrio isolated and first villages Serial Date of Duration, transmission Cases Deaths Cases Deaths Cases Deaths (%) field visit number onset days (%) (%) 35 days Panchghora 21-7-44 50 44 9 (20.4) 30 8 (26.6) 14 1 (7.0) Ogawa Imported from Belur (an industrial centre). 1 22 ,, Ratanpur 28-3-44 22 9 4 (44.4) 9 4 (44.4) 0 0 NAG No definite source elicited. 10 6-11-44 22 18 ? Kamlapur 12 4 (33.3) 9 3 (33.3) 3 1 (33.3) Ogawa from Rash mela. Imported THE 9 6-11-44 .15 ? Begumpur 19 21 7 (33.3) 18 6 (33.3) 3 1 (33.3) Do. Do. do. 5 20 13 ? Adan 17-8-44 14 2 (14.2) 10 1 (10.0) 4 1 (25.0) Do. Imported from Panchghora outbreak. 11 Serampore 13 28-11-44 13 15 4 (26.6) 13 4 (30.7) 2 0 Do. No definite source elicited. 10 .. Baruipara 3 12-8-44 13 7 1 (14.2) 5 1 (20.0) 2 0 Inaba Imported from Jhulanjatra mela. INDIAN 22 14-4-45 10 ? Basubati West 13 8 2 (25.0) 7 2 (28.0) 1 0 Ogawa Imported from Shiakhala hat. 11-3-45 8 ? Beraberi 15 10 6 1 (16.6) 5 1 (20.0) 1 0 Do. Imported by pilgrims arriving from Brindaban. 7 ? Pahlampur 14 28-12-44 6 2 (33.3) 6 2 (33.3) 0 0 Do. ? Imported from Sheorafuli hat. 6 Do. ]8 29-3-45 5 6 1 (16.6) 6 1 (16.6) 0 0 Do. ? Do. do. 6 Basubati North 24 30-4-45 7 S 4 (50.0) 4 (50.0) 0 0 Do. Imported from Basubati West outbreak. MEDICAL 4 29-9-44 ? Mahamadpur 7 3 0 0 1 0 Sample spoiled No definite source elicited. South. 28-10-44 4 ? Jagatnagar 11 q 1 (11.1) 3 1 (33.3) Ogawa Imported by a child coming from another village. 12 27-11-44 3 ? Pahlampur 4 2 1 (50.0) 1 (50.0) 0 0 No sample ? Imported from Sheorafuli hat. 3 23-4-45 ? Baruipara 23* 11 19 6 (31.5) 5 (55.5) 10 1 (10.0) Ogawa Imported from Bora and spread through a feast. GAZETTE 2 2 20-4-44 ? Biramnagar 10 5 0 0 2 0 Do. Local Charak mela. 2 .. 3-4-45 ? Ratanpur 19 1 1 0 0 0 0 Do. No definite source elicited. 1 day Bankipur 21 18-4-45 1 1 0 0 0 0 Do. Imported from Calcutta. 1 ? Bora 11 23-11-44 Bazar 2 3 2 (66.6) 2 (66.5) 0 0 No sample Imported from Konnagar (an industrial centre). 12 hours Ratanpur 16 19-3-45 0 0 Ogawa Milk obtained from a cholera infected house. Ber .. 20 5-4-45 8 ? 0 0 Do. ? Imported from Sheorafuli hat. 6 ? Paltagar 17 26-3-45 0 0 Negative No definite source elicited. 4 ? Bankagacha G 29-8-44 0 0 Ogawa Imported from Panchghora outbreak. [Aug., 203 51 (25.1) 157 45 (28.7) 46 6 (13.0) * See special remarks in the text. 1946 CENTRE : SEAL 323 Aug., 1946] CHOLERA OUTBREAKS IN SINGUR HEALTH Map The X2 value being 5.2 the differ- Map ence between the two rates is S1gnificant even for 2 per cent level and this has been achieved in spite the delay in reporting and adoption of simple measures. Of Jhe six deaths that occurred after the field party's visit only one case at in Begumpur, a male child whom cholera was superimposed on chronic dysentery, died when the of case was in hand; the rest the cases, one each at Panchghora, ^dan, Jagatnagar, Kamalapur and ?aruipara, died within a few hours attack before any relief could be given. It may be mentioned here that, or though very few, some patients _ families were at the beginning the reluctant both in accepting SktUk Msp of the 3 ret operation 5c.hrme. Judical relief and in instituting of the Sinjtr fearfjmietion the suggested control measures out ?t suspicion, ignorance or mis- representation by some interested Parties.
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