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Note on cholera in the United Provinces


, : Note on cholera in the United Provinces. Indian Jour Med Res 39(1): 17-40

The epidemiology of cholera in the United Provinces (India) is discussed on the basis of 72 years' (1877-1948)data. The avg. annual death rate is 1.11 per 1000 and is 3.61% of the total mortality from all causes. There has been a gradual reduction in cholera mortality since 1922. Rural areas suffer more. Cholera in U. P. occurs at irregular intervals and its periodic explosiveness is largely influenced by big fairs like Kumbhs at Allahabad and Hardwar. The annual cholera wave is a single wave with its peak in summer (June). The incidence is low in winter. Factors playing a significant part in the seasonal incidence are mentioned. The seasonal incidence closely follows the absolute humidity curve. Prevalence of cholera in different sections of the province is discussed. Sub-Himalyan districts bordering Nepal and eastern districts bordering Bihar show the highest mortality. The eastern part is first to be affected. In the majority of cases the disease is imported in Feb. or March by pilgrims from Nepal, Bihar or Bengal. A study was made of districtwise monthly figures for 1921 to 1948. On the 2 criteria suggested in India for the determination of endemic areas (percentage of months without cholera should be less than 30% and mean length in months of intervals between prevalence of cholera should be less than 2.5) it was found that the districts of Gorakhpur (including Deoria), Basti and Faizabad fall in the endemic group. It is suggested that before these can be labelled "endemic" it will be necessary to study vital statistics and to carry out field investigations to find out the true incidence of cholera during the winter, when it is at its lowest In all probability there is no true endemic focus of cholera in U. P. Evaluation of compulsory inoculation of pilgrims as a measure of control in fairs and festivals has been made. It has proved satisfactory. Organization and control of cholera by improvement of environmental hygiene and permanent sanitary measures in endemic areas, if any, are stressed.

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PMID: 14888257


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