Abstract
Background
Leptospirosis and Brucellosis are bacterial zoonoses prevalent in South-East-Asia. We investigated a case-cluster of these diseases reported in October 2023 from Ward X, Uttarakhand, India, identified through a One-health camp, among Van Gujjars, a rural pastoral community. We describe epidemiology of cases and possible exposures.
Methods
We extracted line-list of leptospirosis cases from the Integrated Disease Surveillance Programme, Uttarakhand, and One-health camp records from ward X. Suspect cases (leptospirosis or brucellosis) were sudden onset of fever or myalgia from 1/8/2023 to 07/01/2024 in ward X residents. Confirmed cases were suspect cases positive by IgM ELISA. We conducted an active case search in ward X. We interviewed suspect cases on socio-demographics, symptoms, and exposures (flood water contact, animal abortus contact); and frontline healthcare workers on awareness of these diseases.
Results
Among the 300 residents across 85 households in ward X, we identified 50 suspect cases, among whom 25 were confirmed. The cluster began in September 2023 following flooding and continued until January 2024, with no deaths. Confirmed cases included 13 leptospirosis, seven brucellosis, and five mixed leptospirosis-brucellosis. The median age of cases was 35 years (range 17–82), 82% females, and all were Van Gujjars. Symptoms included fever (78%), myalgia (60%), and arthralgia (58%). All reported contact with flood water, and animal abortus. Frontline healthcare workers were unaware of these diseases.
Conclusions
This mixed cluster of leptospirosis and brucellosis in ward X followed flooding, predominantly affecting female Van Gujjar dairy farmers. We sensitized the healthcare workers on identification of suspect cases to improve case detection.