OBJECTIVES A total of 229 confirmed cholera cases were reported in Alborz Province during an outbreak that lasted from June 2011 to August 2011. This study aimed to identify potential sources of transmission in order to determine suitable interventions in similar outbreaks. In other words, the lessons learned from this retrospective study can be utilized to manage future similar outbreaks.
METHODS
An age-matched and sex-matched case-control study was conducted during the outbreak. For each case, two control subjects were selected from the neighborhood. A case of cholera was defined as a bacteriologically confirmed case with signs and symptoms of cholera. This study was conducted from June 14, 2011 through August 23, 2011. The data were analyzed by calculating odds ratios (ORs) using the logistic regression method.
RESULTS
In this outbreak, 229 confirmed cholera cases were diagnosed. The following risk factors were found to be associated with cholera: consumption of unrefrigerated leftover food (OR, 3.05; 95% confidence interval [CI], 1.72 to 5.41), consumption of vegetables and fruits in the previous three days (OR, 2.75; 95% CI, 1.95 to 3.89), and a history of traveling in the previous five days (OR, 5.31; 95% CI, 2.21 to 9.72).
CONCLUSIONS
Consumption of vegetables and fruits has remained an unresolved risk factor in cholera outbreaks in Iran in recent years. In order to reduce the risk of cholera, sanitary standards for fruits and vegetables should be observed at all points from production to consumption, the population should be educated regarding hygienic food storage during outbreaks, and sanitary standards should be maintained when traveling during cholera outbreaks.
Summary
Citations
Citations to this article as recorded by
Cholera outbreak at a city hotel in Kenya, 2017: a retrospective cohort study Philip Ngere, Elvis Oyugi, Alexis Niyomwungere, Scolastica Wabwire, Adi Dahabo, Daniel Langat, Raphael Muli, Maurice Owiny Journal of Interventional Epidemiology and Public Health.2022;[Epub] CrossRef
Cholera outbreak investigation report in Mille woreda, Afar region, Ethiopia, 2019 Hana Mekonen, Kefyalew Amene, Dr Samrawit Bisrat, Tesfahun Abye MOJ Women s Health.2022; 11(2): 63. CrossRef
Risk Factors of Cholera Transmission in Al Hudaydah, Yemen: Case-Control Study Abdulqawi Mohammed Qaserah, Mohammed Abdullah Al Amad, Abdulwahed Abduljabbar Al Serouri, Yousef Saleh Khader JMIR Public Health and Surveillance.2021; 7(7): e27627. CrossRef
Prevention and control of cholera with household and community water, sanitation and hygiene (WASH) interventions: A scoping review of current international guidelines Lauren D’Mello-Guyett, Karin Gallandat, Rafael Van den Bergh, Dawn Taylor, Gregory Bulit, Dominique Legros, Peter Maes, Francesco Checchi, Oliver Cumming, Andrew S. Azman PLOS ONE.2020; 15(1): e0226549. CrossRef
Risk factors associated with the recent cholera outbreak in Yemen: a case-control study Fekri Dureab, Albrecht Jahn, Johannes Krisam, Asma Dureab, Omer Zain, Sameh Al-Awlaqi, Olaf Müller Epidemiology and Health.2019; 41: e2019015. CrossRef
Individual and household exposures associated with cholera transmission in case–control studies: a systematic review Matthew D. Phelps, Lone Simonsen, Peter K. M. Jensen Tropical Medicine & International Health.2019; 24(10): 1151. CrossRef
Cholera case management in Harare City, 2018: are we doing the right things right? Govha Emmanuel, Paul Musarurwa, Christine Gabaza, Taurai Masango, Shambira Gerald, Gombe Tafara Notion, Juru Tsitsi Patience, Tshimanga Mufuta
Journal of Interventional Epidemiology and Public Health
.2019;[Epub] CrossRef
H2S is a key antisecretory molecule against cholera toxin-induced diarrhoea in mice: Evidence for non-involvement of the AC/cAMP/PKA pathway and AMPK Francisca B.M. Sousa, Luan K.M. Souza, Nayara A. Sousa, Thiago S.L. Araújo, Simone de Araújo, Dvison M. Pacífico, Irismara S. Silva, Renan O. Silva, Lucas A.D. Nicolau, Fabiana M. Souza, Marcelo C. Filgueiras, Jefferson S. Oliveira, Marcellus H.L.P. Souza Nitric Oxide.2018; 76: 152. CrossRef
Individual and Household Risk Factors for Symptomatic Cholera Infection: A Systematic Review and Meta-analysis Aaron Richterman, Duarxy Rodcnel Sainvilien, Lauren Eberly, Louise C Ivers The Journal of Infectious Diseases.2018; 218(suppl_3): S154. CrossRef
Comparison of two control groups for estimation of oral cholera vaccine effectiveness using a case-control study design Molly F. Franke, J. Gregory Jerome, Wilfredo R. Matias, Ralph Ternier, Isabelle J. Hilaire, Jason B. Harris, Louise C. Ivers Vaccine.2017; 35(43): 5819. CrossRef