Noorhaida Ujang, Kamaluddin A, Kamaluddin F, Syed Sheikh SH, CM Din SNA, Ariffin A and Sulaiman A (2011). Cholera outbreak in Village A, Tanjung Keling, Melaka, 2007. OSIR 4(1): 12-19
Cholera is an acute bacterial infection of the intestine caused by ingestion of food or water containing Vibrio cholerae, serogroup O1 or O139. Its incubation period is from less than one day to five days. The bacteria release an enterotoxin that usually causes painless and copious watery diarrhea. The sudden loss of body fluid can result in severe dehydration. If left untreated, death can occur within hours. Most persons infected with V. cholerae are asymptomatic, and the bacteria may be present in their feces for seven to 14 days. Less than 20 percent of ill persons develop the typical ricewater stools with moderate to severe dehydration. Cholera is communicable if the bacteria are present in the stool. Although rare, an asymptomatic carrier state may persist for several months. Cholera case fatality rates as high as 50 percent can occur in an unprepared community. With proper oral or intravenous rehydration treatment, the case fatality rate is less than one percent1,5. An epidemic occurs when a community or region has an increase of people with an illness, a specific health related behavior, or another health related event. In Malaysia, a report of one person with cholera is considered as an outbreak. Once the presence of a cholera case in an area is confirmed, it becomes unnecessary to confirm other subsequent cases if there is an epidemiological link. During the past decade, the incidence of cholera in Malaysia had decreased from 10.88 per 100,000 population in 1995 to 1.48 per 100,000 population in 20057. On 28 Feb 2007 at 16:00, the Melaka Tengah District Health Office (MTDHO) was notified that a patient at Hospital M had a positive rectal swab for V. cholerae O1 serogroup El Tor biotype Ogawa serotype. Fellows from the Epidemic Intelligence Program (EIP) and health personnel from MTDHO conducted a joint investigation to determine the source, to assess extent of the outbreak and to establish control measures.