Descriptive Epidemiology of a Gastroenteritis Out Break in Sunsari District, Nepal

Abstract

Gastroenteritis (GE) outbreak and cholera epidemics continue to be the major public
health problems in Nepal. Every year during and immediately after the rainy season,
outbreak of GE occurs. In the post monsoon period of 1998 also, outbreak of GE
occurred in a wide area covering several districts in terai region. In this paper, several
epidemiological aspects of the current outbreak are being reported. This study was
carried out in sunsari district. The cases of GE brought to district hospital were
interviewed by a trained health worker to collect information about the episode and
possible source of infection. Stool samples were collected from the patients and tested
for organisms. On the spot visits were made to collect more information. Water samples
were also collected and tested in Microbiology laboratory, B. P. Koirala Institute of
Health Sciences (BPKIHS). There were 947 cases of GE. Among them 55.2% were
females and 44.8% males patients. The age ranged from 7 months to 86 years with
mean age of 22.8 years. There were 8 deaths. Maximum number of cases occurred in
the first fornight of October 1998. Due to prior administration of antibiotics, no growth
was seen in 27 samples. However, 4 samples showed growth of Shigella. Vibrio cholera
was isolated from 2 cases. Eight out of thirteen water samples were found to be
unsatisfactory for drinking. The contamination of drinking water source and
unhygienic habits were the main causes for such outbreaks. Therefore, it is pertinent
that GE outbreaks may be prevented by simply promoting sanitation and hygienic
practices related to handling of drinking water and defecation.