Effectiveness of oral rehydration salt solution (ORS) in reduction of death during cholera epidemic.

ABSTRACT

PIP: Between July-September 1978, an outbreak of gastroenteritis among all age groups (total of 4469 reported cases) occurred in various villages in the Central District of Manipur State, India including Imphal. Upon notification of the epidemic, health workers distributed oral rehydration salt solution (ORS) generously so people could begin taking ORS as soon as any diarrhea appeared. Researchers from the National Institute of Cholera and Enteric Diseases investigated 92 active cases who were either in the hospital or the community. They collected the data from records of the Regional Medical College, the Directorate of Public Health in Imphal, Primary Health Centers in Thoubal and Kakching, and by visiting active cases at home. 45.7% of fecal samples and 47.6% of river water samples tested positive for Vibrio cholerae biotype ElTor. The case fatality rates fell significantly during the 3 months from 2% for 5 year old children to 0.7% to no deaths at all and 1.9% for 5 year old people to 0.6% to no deaths (p.05). The overall case fatality rate was just 0.8% (36 deaths), it was higher for 5 year old children than it was for 5 year old people (1% vs. 0.7%). Data on earlier cholera epidemics in Manipur were not available, but the researchers found the case fatality rates in cholera epidemics (ElTor) before ORS varied from 22-24%. In fact, they believed this cholera epidemic to be the 1st use of ORS under field conditions which happened to result in a case fatality rate of 1%.