Severe Diarrhea Outbreak in Indore: Urgent Protocols Needed
Diarrhea Outbreak in Indore
In the Bhagirathpura area of Indore, a serious outbreak of diarrhea linked to contaminated drinking water (mixed with sewage) has resulted in 17 fatalities since late December 2025 to January 2026. Thousands have been affected, with some cases confirming the presence of cholera-like bacteria (Vibrio cholerae).
Proposed Protocols
The suggested protocols are both practical and scientifically sound, aligning with guidelines from the WHO, CDC, and India's own waterborne disease control directives, such as the Integrated Disease Surveillance Programme (IDSP). Rapid action is essential to prevent outbreaks in densely populated areas, and delays in Bhagirathpura (such as not repairing leaks despite awareness and ignoring complaints) have cost lives.
Key Recommendations
1. Zoning and Source Control
Immediate action is crucial. Once five or more suspected cases arise, cutting off the main pipeline, declaring a red zone, and supplying chlorinated water via tankers should be mandatory. The leak was near the police station in Bhagirathpura, yet residents continued to consume contaminated water due to delays.
2. Active Case Finding and Triage
Instead of waiting for hospitals, door-to-door surveillance (with Rapid Response Teams and ASHA workers) and distributing ORS, zinc, and chlorine tablets at homes could save lives. Additionally, establishing temporary stabilization centers for IV fluids was necessary, as ambulance delays resulted in further casualties.
3. Point-of-Use (POU) Water Purification
Shock chlorination and residual chlorine testing (0.5 mg/L standard) every two hours are essential. Disposing of old water and sanitizing containers is also critical to control bacteria (E. coli, Klebsiella, etc.) immediately.
4. Environmental Engineering and Sewage Intervention
Addressing cross-contamination is vital. Immediate actions like vacuum suction, dye-tracer tests (for leak detection), and spraying calcium hypochlorite are necessary. The issues with old pipelines and sewage pressure in Bhagirathpura have persisted for years.
5. Scientific Communication
Clear warnings (using loudspeakers to announce 'Do not drink tap water'), symptom alerts (like rice-water stools), and controlling rumors are crucial. Confusion leads to delayed treatment.
6. Post-Disaster Genome Sequencing
Identifying pathogen strains (like Vibrio cholerae) can help trace sources and antibiotic resistance in the future, enhancing the protocol's effectiveness.
Summary of the White Paper
The essence of your white paper is accurate: this tragedy stems from administrative negligence and the failure of infrastructure (despite the Amrut scheme, the pipelines remain dilapidated). Official death counts reported 4-6, but local and media reports indicate up to 17, suggesting concealment in death audits. Publicizing the names of the affected raises human rights concerns.
Such protocols should be established as Standard Operating Procedures (SOPs) at both state and national levels to prevent future tragedies disguised under the guise of 'clean cities.' If this document is intended for public or policy discussion, it could lead to significant changes.
Call for Further Input
If you wish to add more details or make amendments, please let me know. This is an extremely important issue.