Diarrhea Outbreak in Puhpelem Village, Wonogiri, Central Java, Indonesia, 2013
On May 12, 2013, a diarrhea outbreak in Puhpelem, a rural village in Wonogiri District of Central Java, was reported. An FETP team investigated to confirm the outbreak, identify risk factors and recommend control measures.
METHODS:
We did a matched case-control study. Cases were residents of Puhpelem village who had acute diarrhea anytime from May 6 to 16, 2013. Controls were previously well residents matched for gender. Subjects were interviewed using a standard questionnaire. Stool samples from cases and water samples from spring were collected for laboratory tests.
RESULTS:
There were 52 cases with ages ranging from 1-82 years (median 33 years). 50% were male. The epidemic curve showed continuos source outbreak. Signs and symptoms of cases included diarrhea (100%), fever (71.15%), colic (65.38%),weakness (63.46%), mucoid stools (46.15%), and stool with blood (21.15%). No bacteria were found in the stool samples. Risk factors included not washing hands with soap before eating (OR 7.91, 95% CI: 1.85 – 33.75), drinking turbid water(OR 5.41, 95% CI: 1.35 – 21.75), and distance between water tank and toilet of less than 10 meters (OR 3.9, 95% CI: 1.41 – 10.82).
CONCLUSIONS:
This diarrhea outbreak was probably caused by drinking water from contaminated water sources. We recommended that public water sources be chlorinated and residents should wash their hands before eating. Toilets should be constructed at least 10 meters away from water sources.