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Research Article

Cholera Outbreaks in Urban Bangladesh In 2011

Farhana Haque1,2*, M. Jahangir Hossain1, Subodh Kumar Kundu2, Abu Mohd. Naser1, Mahmudur Rahman2 and Stephen P. Luby1,3

1Centre for Communicable Diseases (CCD), International Centre for Diarrheal Disease Research, Bangladesh (icddr,b)

2Institute of Epidemiology, Disease Control and Research (IEDCR), Dhaka, Bangladesh

3Global Disease Detection and Emergency Response, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA

*Corresponding Author:
Farhana Haque
icddr, b, 68, Shaheed Tajuddin Ahmed Sarani
Mohakhali, Dhaka-1212, Bangladesh
Tel: + 88 01 717 644 557, 88 029 898 796
Fax: + 88 028821237
E-mail: [email protected], [email protected]

Received date: June 12, 2013; Accepted date: June 28, 2013; Published date: July 02, 2013

Citation: Haque F, Hossain MJ, Kundu SK, Naser AM, Rahman M, et al. (2013) Cholera Outbreaks in Urban Bangladesh In 2011. Epidemiol 3:126. doi: 10.4172/2161-1165.1000126

Copyright: © 2013 Haque F, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


In 2011, a multidisciplinary team investigated two diarrhoea outbreaks affecting urban Bangladeshi communities from the districts of Bogra and Kishorganj to identify etiology, pathways of transmission, and factors contributing to these outbreaks.
We defined case-patients with severe diarrhoea as residents from affected communities admitted with ≥3 loose stools per day. We listed case-patients, interviewed and examined them, and collected rectal swabs. We visited the affected communities to explore the water and sanitation infrastructure. We tested the microbial load of water samples from selected case household taps, tube wells, and pump stations. We conducted anthropological investigations to understand community perceptions regarding the outbreaks.
We identified 21 case-patients from Bogra and 84 from Kishorganj. The median age in Bogra was 23 years, and 21 years in Kishorganj. There were no reported deaths. We isolated Vibrio in 29% (5/17) of rectal swabs from Bogra and in 40% (8/20) from Kishorganj. We found Vibrio in 1/8 tap water samples from Bogra and in both of the samples from Kishorganj. We did not find Vibrio in water samples from pumps or tube wells in either outbreak. Ground water extracted through deep tube wells was supplied intermittently through interconnected pipes without treatment in both areas. We found leakages in the water pipes in Bogra, and in Kishorganj water pipes passed through open sewers.
The rapid onset of severe diarrhoea predominantly affecting adults and the isolation of cholera in rectal swabs confirmed that these outbreaks were caused by Vibrio cholerae. The detection of Vibrio in water samples organisms from taps but not from pumps or tube wells, suggested contamination within the pipes. Safe water provision is difficult in municipalities where supply is intermittent, and where pipes commonly leak. Research to develop and evaluate water purification strategies could identify appropriate approaches for ensuring safe drinking water in resourcepoor cities.


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