Table 1.
A comprehensive analysis of foodborne and waterborne outbreaks in India (1981–2022) – Unraveling causative agents, sources, and regional impact.
| Causative/suspected pathogen | Year | Region/State | No. of cases | No of deaths | clinical symptoms | The event | Clinical and food samples investigated | Possible source | Ref |
|---|---|---|---|---|---|---|---|---|---|
| Vibrio fluvialis | 1981 | Maharashtra | 14 | _ | Vomiting, abdominal pain | Religious ceremony | 9 stool samples + ve for V. fluvialis | Food | [54] |
| Salmonella enterica serovar Typhi | 1986 | Chandigarh | 54 | _ | Fever (100 %), nausea and vomiting (46 %), loose motions and abdominal pain (13 %), and palpable splenomegaly (63 %). | Picnic | Blood cultures 81 %, Widal (1:320 or more) in 43 % and suggestive (1:160) in 25 %. Bacteriological examination of water from the likely sources revealed gross faecal contamination. |
Contaminated water | [92] |
| Salmonella Paratyphi A var Durazzo | 1995 | Maharashtra | 33 | _ | Acute diarrhea and vomiting, high grade fever | Salmonella paratyphi A var durazzo isolated from 12 faecal samples | food | [58] | |
| Yersinia enterocolitica | 1997 | Tamil Nadu | 25 | _ | Fever, loose stool, abdominal cramps, with or without vomiting | Feast | Y. enterocolitica isolated from one stool sample and borewell water samples. Serology of first paired samples revealed high anti Y. enterocolitica antibody titre. Toxin was detected from the butter milk. | food (Buttermilk) | [55] |
| Salmonella enteritidis | 1998 | Himachal Pradesh | 78 | _ | Diarrhea, vomiting, fever, headache, vertigo and abdominal cramps of varying intensity | Food consumption in a common dining hall | Salmonella enteritidis was isolated from 6 stool samples and in one blood sample. | Food (Frozen fowl) | [56] |
| Vibrio cholerae O1 | 1999 | Chandigarh | 14 | _ | Diarrhea | Water from one of the hand pump | Microscopically confirmed cases of cholera, water was positive for V. cholerae O1 biotype El Tor serotype Ogawa. | Hand pump water contamination | [93] |
| Norwalk-like viruses | 2002 | New Delhi | 130 | _ | Diarrhea | Farewell party | All six stool samples were positive by RT-nested PCR. | Food (Salad sandwiches) | [94] |
| Vibrio cholerae O1 | 2002 | Andaman and Nicobar Islands | 16 | _ | Diarrhea | Vibrio cholerae O1 El Tor was isolated from 18 of the 67 patients tested. | Effluents from ships or poachers from neighboring countries where cholera is endemic. | [95] | |
| V. parahaemolyticus O3:K6 | 2003 | Kolkata | ∼200 | Outbreak of diarrhea | Blood donation camp. | V. parahaemolyticus was isolated from the stool samples of five patients. | Food (Rice with meat) | [96] | |
| Hepatitis A | 2004 | Pune | 123 | _ | Icterus, dark-colored urine, anorexia, vomiting/nausea, abdominal pain, fever, fatigue and diarrhea. | Large-scale outbreak of hepatitis among children | Serum samples, feces and sewage samples. | Contaminated water | [97] |
| Hepatitis A | 2005 | Kerala | 540 | 2 reported from Medical college area. | Fever, diarrhea, abdominal discomfort, | History of visit to medical college hospital area. | HAV RNA was present in the feces | Non-functional sewage treatment plant and the untreated sewage was constantly overflowing and getting mixed with water canal. | [73] |
| Vibrio cholerae O1 | 2005 | Kolkata | 89 | _ | Acute watery diarrhea | Emergency medical camp and health outposts as part of a routine surveillance programme at the area. | V. cholerae O1 biotype El Tor, serotype Ogawa was isolated as a sole pathogen from 15 (15.8 %) 89 stool samples screened. Water samples showed presence of coliform bacilli with high MPN count. | Leakage in the main pipeline supplying drinking water to the area. | [98] |
| Vibrio cholerae O1 | 2005 | Odisha | 62 cases in Chasapada 51 cases in Tentuliapatna |
_ | Diarrhea | Increase of incidence of watery diarrhea in these 2 villages | Stool samples and rectal swabs. Two stool samples (one from each village) were positive for V. cholerae El Tor O1 Ogawa. | 1 Foodborne due to contamination of the milk products by dirty hands. 2. Waterborne as water well contaminated by sewerage originating from the first village. |
[99] |
| Staphylococcus aureus and Bacillus cereus | 2007 | Maharashtra | 123 | _ | Loose motions, fever, pain abdomen and vomiting | Consumed meals in the mess | Samples of the chicken, environmental swabs from the kitchen, food handlers, Stool and blood showed no bacteriological growth. | Chicken | [100] |
| Salmonella enterica serovar Typhi | 2007 | West Bengal | 103 | _ | Occurrence of fever for ≥ one week | Slum of South Dumdum municipality, West Bengal reported an increase in fever cases. | Salmonella enterica Typhi was isolated from one of four blood specimens and 65 of 103 sera were ≥ 1:80 Widal positive. | The initial foodborne outbreak of typhoid led to the contamination of the water supply resulting in a secondary, waterborne wave | [101] |
| Hepatitis A | 2007 | Himachal Pradesh | 88 | _ | – | An outbreak of viral hepatitis | The hepatitis cases were 63.2 per cent (55/88) were positive for anti-HAV IgM. HAV-RNA present in serum, sewage and water samples showed 100 per cent sequence homology. |
Contaminated water | [102] |
| Staphylococcus aureus | 2007 | Uttar Pradesh | 94 | _ | Nausea, vomiting, abdominal pain, diarrhea, weakness and fever. | Dining in the catering establishment | Coagulase positive staphylococci were cultured from the vomitus and stool samples of cases. Nasal and fingernail swabs collected from food handlers also showed staphylococcal growth. | Food (Spoiled curd) | [103] |
| Hepatitis E | 2008 | Ahmedabad | 233 | _ | Jaundice or elevated serum aminotransferase levels | Clusters of jaundice cases were reported by a civic center, Girdharnagar ward, Ahmedabad. | A total of 16 out of 17 patients investigated were positive for the hepatitis E IgM antibody. | The sewage contamination of drinking water in the distribution system. | [104] |
| Salmonella enterica serotype Weltevreden | 2009 | Karnataka | 34 | _ | Vomiting, diarrhea, abdominal pains and fever | Consumption of a Fish dish from an outside caterer | Stool samples were cultured and identified biochemically similar to Salmonella and serotyping was confirmed as Salmonella Weltevreden | Food (Fish) | [64] |
| Vibrio cholerae O1 | 2009 | West Bengal | 1076 | 14 | Diarrhea | Increased number of diarrhea cases | Vibrio cholerae El Tor Ogawa was isolated from two of five probable case patients' stool specimens. Piped water specimens and stored drinking water were positive for faecal contamination. | Non-chlorinated piped water | [105] |
| Salmonella enterica serovar Weltevreden | 2010 | Maharashtra | 150 | _ | Acute watery diarrhea, fever, abdominal cramps, nausea and vomiting. | Lunch in hostel canteen | A total of nine isolates, provisionally identified as Salmonella spp. | Food from hostel canteen | [62] |
| Vibrio cholerae O1 | 2010–11 | Gujarat | 330 | _ | Loose rice watery diarrhea | – | Nineteen patients were found to be positive for Vibrio cholerae O1 serotype Ogawa. | leakages in the pipelines near riverbanks | [106] |
| E. coli | 2011 | Tamil Nadu | 53 | _ | Loose motions, fever, headache, vomiting and abdominal pain | Eating dinner in a Military establishment | With the given clinical picture and the incubation period the possible cause to be Salmonella spp. | Food (Potato-bitter gourd) | [107] |
| Vibrio cholerae O1 | 2012 | Pondicherry | 921 | 1 | Occurrence of diarrhea of more than three loose stools per day with or without vomiting | Ingestion of water contaminated by drainage following rains during cyclone. | Nine stool samples yielded V. cholerae O1 Ogawa. | Cases were clustered around two major leakages in the water supply system | [108] |
| Salmonella enterica serovar Typhi | 2013 | Chandigarh | 18 | _ | Continuous fever, abdominal pain with or without diarrhea, hepatosplenomegaly and bradycardia and neutropenia. | – | Twenty-seven strains of Salmonella Typhi were isolated from blood cultures. | Not identified | [109] |
| Salmonella enterica serovar Weltevreden and Vibrio fluvialis | 2013 | West Bengal | 278 | _ | Acute watery diarrhea | Food served at a funeral reception | Stool specimens were positive for V. parahaemolyticus. | Mutton-ghogni | [110] |
| Hepatitis A | 2013 | Kerala | 45 | _ | Acute illness with fever or loss of appetite followed by yellowish discoloration of sclera or urine | – | All eight blood samples tested were positive for IgM HAV. | Pipe water contamination | [111] |
| Hepatitis E | 2013 | Uttarakhand | 240 | _ | Jaundice, Dark urine, fever, pain in abdomen, vomiting, and loss of appetite | History of leakages in drinking water pipelines and overflowing drains in the area. | Out of 13 serum samples, 10 were found positive for HEV IgM antibodies and three cases had IgM antibodies for both HAV and HEV. | Sewage contamination of drinking water | [112] |
| Vibrio cholerae O1 | 2013 | Andhra Pradesh | 138 | 1 | Acute diarrhea as the occurrence of ≥ 3 loose stools in a da | Report of a cluster of diarrheal disease among residents of Medipally to the state surveillance unit. | Five rectal swabs were positive for V. cholerae O1 El Tor. Five water samples had the Most Probable Number (MPN) count higher than the permissible level. | Overhead water tank | [113] |
| Hepatitis E | 2013 | Punjab | 159 | 1 | Jaundice, anorexia, nausea, vomiting, abdominal pain, or fever | An increase in jaundice cases | All 14 were positive for anti-HEV IgM and negative for anti-HAV IgM. | Contamination of the municipal drinking water supply with HEV | [114] |
| Bacillus cereus | 2015 | Tamil Nadu | 36 | _ | Diarrhea (≥3 loose stools in 24 h) or vomiting | Political rally | Stool samples showed no growth of enteric pathogens. | Food (Lemon rice) | [115] |
| Hepatitis A | 2016 | Kerala | 53 | _ | Acute onset of illness with any of the symptoms of abdominal pain, vomiting, diarrhea with/without fever | An unusual occurrence of acute gastroenteritis in Ashramam | The water samples had shown growth of Escherichia coli. Stool samples had not shown any growth. | Pipe water contamination | [116] |
| Salmonella Paratyphi A var Durazzo | 2016 | Himachal Pradesh | 43 | _ | Fever, malaise and loss of appetite | Salmonellae were isolated from blood samples of clinical suspects of enteric fever or pyrexia of unknown origin during the next 7 months period. | Not identified | [117] | |
| Hepatitis A | 2016 | Kerala | 223 | _ | An acute illness with fever or loss of appetite followed by yellowish discoloration of sclera or urine | Hotel food | [74] | ||
| Shigella sonnei | 2016 | West Bengal | 25 | _ | Diarrhea/dysentery, abdominal pain, fever, and vomiting | Housewarming party | About 8 stool samples were positive for Shigella sonnei. | Food (Tomato salad) | [118] |
| Hepatitis A | 2016 | Kerala | 562 | 3 | Icterus or dark colored urine along with one or more symptoms such as fever, loss of appetite, fatigue, right upper quadrant tenderness and vomiting | Unusual rise in hepatitis cases | Blood samples from the suspected cases showed anti-HAV IgM positivity in 74.5 % (73/98). The water samples tested.negative for HAV and HEV RNA. | Well water | [75] |
| Vibrio cholerae O1 | 2016 | Maharashtra | 889 | _ | Person experiencing at least one loose stool | Acute diarrheal disease outbreak | Two stool samples tested positive. 16 samples from multiple sources were positive for fecal coliforms. | Contaminated groundwater | [119] |
| Hepatitis A and E | 2016–17 | Chandigarh | 141 | _ | Acute jaundice, dark urine, anorexia, malaise, extreme fatigue, and right upper quadrant tenderness. | Passive surveillance in Burail, Chandigarh | 141 cases were confirmed serologically for hepatitis A and E. | Leakage in drinking water pipeline | [120] |
| Rotavirus B | 2017 | Maharashtra | 258 | _ | Occurrence of ≥3 loose stools in a day | Cases of acute gastroenteritis were reported | All fecal specimens exhibited presence of RVB. The water samples were positive for RVB. | Drinking water | [121] |
| Not identified | 2017 | Andhra Pradesh | 191 | _ | ≥3 loose stools within 24 h | Medical camp in the village | Stool samples showed no growth of enteric pathogens. Four drinking water samples from bore-wells indicated faecal contamination. |
Shallow bore-wells water contamination | [122] |
| Not identified | 2017 | Uttar Pradesh | 70 | 2 infant deaths 2 infant deaths |
three or more loose stools or vomiting within 24 h Three or more loose stools or vomiting within 24 h. |
IDSP District Surveillance | All seven stool culture specimens were negative for V. cholerae | Contaminated well water | [123] |
| Vibrio cholerae O1 | 2018 | Maharashtra | 104 | _ | Loose stool with/out vomiting and fever | Cholera was detected in the stool sample of a 3-year-old child from a slum area | The water sample were found to be negative. Two stool samples were reported to be positive. | Well water | [124] |
| Vibrio cholerae O1 | 2018 | Delhi | 129 | _ | ≥3 loose stools within 24 h | North Delhi district surveillance unit of the IDSP identified a laboratory-confirmed cholera outbreak | 6 stool samples tested positive. | Untreated municipal water | [125] |
| Enterotoxigenic Staphylococcus aureus | 2018 | Maharashtra | 75 | _ | Vomiting or diarrhea (i.e., ≥3 loose stools within 24 h) | Wedding ceremony | No pathogens were isolated from the food samples. | Food (Carrot pudding) | [50] |
| Not identified | 2018 | Punjab | 116 | _ | Case as vomiting or ≥3 loose feces in 24 h plus abdominal pain and/or fever | An acute gastroenteritis outbreak | All three water samples showed coliform contamination. | Food (Mixed vegetables) | [126] |
| Salmonella enterica serotype Typhi | 2018 | Tamil Nadu | 7 | _ | Fever with abdominal pain, diarrhea or vomiting | Eating in the restaurant | About 7 blood culture cases confirmed ceftriaxone-resistant Salmonella Typhi cases. The serum samples of the restaurant workers were negative by Widal testing, and all stool samples showed no growth of Salmonella Typhi on culture. |
Roadside eatery Food (chicken gravy) | [127] |
| Vibrio cholerae O1 | 2018 | Maharashtra | 195 | _ | More than three loose stools occurring within a day | – | V. cholerae O1 Ogawa was isolated from five referred faecal samples. | Well water | [128] |
| Enteropathogenic E.coli/Salmonella spp | 2019 | Maharashtra | 291 | _ | Diarrhea, abdominal cramps, fever with chills, and vomiting. | Religious community lunch | Stool samples showed growth of I. | Food (Green gram) | [129] |
| Vibrio cholerae | 2019 | Haryana | 196 | 2 | Case as a person ≥1 year of age with a history of three or more loose stools within a 24-h period | Death due to acute diarrheal disease | Tested samples of water from tanks, sewage effluent and stool specimens were positive for V. cholerae. | Water from tanks | [130] |
| Salmonella enteritidis | 2019 | Puducherry | 33 | _ | Cases as those who presented with GI symptoms | Restaurant | The 10 stool samples and shawarma sample were positive by culture. | Food (Chicken shawarma) | [61] |
| Vibrio cholerae O1 | 2021 | Gujarat | 37 | _ | Three or more loose, watery stools (with or without vomiting) in the past 24 h | Unusual increase in cases of diarrhea was reported in slum area of Kalol town | Three stool samples were positive for the bacterium. | Leakage in drinking water supply | [131] |
| Vibrio cholerae O1 | 2022 | Chandigarh | 118 | _ | Cases as those who presented with GI symptoms | A large number of cases of diarrhea and a suspected death as reported through a leading local newspaper. | One of the stool sample grew Vibrio cholera O1(Ogawa) and twelve water samples had high coliform counts indicating fecal contamination. | Leakage in drinking water supply | [132] |