Cholera Outbreak in Village A, Tanjung Keling, Melaka, 2007

Abstract

On 28 Feb 2007, a cholera case was notified from Village A, Melaka, Malaysia. An epidemiological investigation was conducted to assess the extent of the outbreak and establish control measures. Active case detection was conducted among the case’s family and neighbors, work contacts and related food handlers. Passive case detection was enhanced in 10 nearby clinics in the area. A case was defined as a person who developed at least three episodes of watery diarrhea with Vibrio cholerae positive stool culture. A case control study was done to identify risk factors. Controls were healthy household members or neighbors with stool culture negative for Vibrio cholerae. Water and food samples were taken for bacterial analysis. Control measures were immediately initiated and followed up. One hundred and forty two contacts were screened. Seven new diarrhea cases with epidemiological link were detected, clustered among two families with one positive stool culture with no fatality. All cases were Malays; six males and two females. Fifty percent had history of eating ice desserts prepared unhygienically by an infected food handler.  Cases were seven times more likely to consume an ice dessert (95% CI = 1.1-44.1). No other food items or water sources were implicated. Immediate control measures effectively contained the outbreak.