Investigation of a Gastroenteritis Outbreak among the Students of a Medical College in North Kerala, India

Background: There was an outbreak of gastroenteritis in the campus of a Private Medical College, Wayanad, Kerala in January, 2021. This study was planned to find-out the epidemiological factors responsible for the gastroenteritis outbreak among the students of the College and recommend prevention and control measures. Methods: This study was conducted in a Private Medical College of Wayanad district Kerala in January 2021. Data was collected using a self-administered questionnaire from 11 cases and 42 controls. Water samples were collected from different sources in ladies’ hostel new block and canteen. Results: All the cases were from the ladies’ hostel new block and from phase I MBBS. The first case was on 10/01/2021, last on 15/01/2021, with peak in the incidence of cases on 12/1/21 (7 cases). Majority of the cases presented with nausea, vomiting and abdominal pain (72.7% each). There was a very strong association between consumption of canteen chutney and sambar and gastroenteritis (OR=11 for both) and both these associations were found to be statistically significant (P=0.02 for both). No statistically significant association was detected between consumption of water from any particular water source and development of gastroenteritis (P>0.15 for all). Water samples from canteen showed the presence of Klebsiella, E coli and Pseudomonas and from Ladies hostel, Pseudomonas. However, Ejikman’s test was negative. Conclusion: All the cases were from ladies’ hostel new block and were from phase I MBBS. The outbreak was a point source single exposure epidemic.Majority of the cases presented with nausea, vomiting and abdominal pain. Consumption of canteen chutney and sambar were found to have a very strong and significant association with gastroenteritis. The organisms were of non-fecal origin.