Seasonality of Cholera in Kolkata and the Influence of Climate

Overview

Journal BMC Infect Dis

Publisher Biomed Central

Specialty Infectious Diseases

Date 2023 Sep 2

PMID 37660078

Authors

Debbie Shackleton

Theo Economou

Fayyaz Ali Memon

Albert Chen

Shanta Dutta

Suman Kanungo

Alok Deb

Affiliations

Soon will be listed here.

Abstract

Background: Cholera in Kolkata remains endemic and the Indian city is burdened with a high number of annual cases. Climate change is widely considered to exacerbate cholera, however the precise relationship between climate and cholera is highly heterogeneous in space and considerable variation can be observed even within the Indian subcontinent. To date, relatively few studies have been conducted regarding the influence of climate on cholera in Kolkata.

Methods: We considered 21 years of confirmed cholera cases from the Infectious Disease Hospital in Kolkata during the period of 1999-2019. We used Generalised Additive Modelling (GAM) to extract the non-linear relationship between cholera and different climatic factors; temperature, rainfall and sea surface temperature (SST). Peak associated lag times were identified using cross-correlation lag analysis.

Results: Our findings revealed a bi-annual pattern of cholera cases with two peaks coinciding with the increase in temperature in summer and the onset of monsoon rains. Variables selected as explanatory variables in the GAM model were temperature and rainfall. Temperature was the only significant factor associated with summer cholera (mean temperature of 30.3 °C associated with RR of 3.8) while rainfall was found to be the main driver of monsoon cholera (550 mm total monthly rainfall associated with RR of 3.38). Lag time analysis revealed that the association between temperature and cholera cases in the summer had a longer peak lag time compared to that between rainfall and cholera during the monsoon. We propose several mechanisms by which these relationships are mediated.

Conclusions: Kolkata exhibits a dual-peak phenomenon with independent mediating factors. We suggest that the summer peak is due to increased bacterial concentration in urban water bodies, while the monsoon peak is driven by contaminated flood waters. Our results underscore the potential utility of preventative strategies tailored to these seasonal and climatic patterns, including efforts to reduce direct contact with urban water bodies in summer and to protect residents from flood waters during monsoon.

Citing Articles

Spatio-temporal patterns of cholera outbreak in rural settings of Ethiopia, 2023.

Tesfaye S, Mamo A, Berihanu W, Elias S Heliyon. 2025; 11(2):e41962.

PMID: 39897781 PMC: 11786676. DOI: 10.1016/j.heliyon.2025.e41962.

Machine learning and spatio-temporal analysis of meteorological factors on waterborne diseases in Bangladesh.

Chowdhury A, Rahman M PLoS Negl Trop Dis. 2025; 19(1):e0012800.

PMID: 39820842 PMC: 11737758. DOI: 10.1371/journal.pntd.0012800.

Identifying clustering of cholera cases using geospatial analysis in Kolkata and surrounding districts: data from patients at tertiary care referral hospitals.

Talukdar R, Kanungo S, Kitahara K, Chowdhury G, Mitra D, Mukhopadhyay A Lancet Reg Health Southeast Asia. 2024; 31:100510.

PMID: 39640000 PMC: 11617701. DOI: 10.1016/j.lansea.2024.100510.

The changing relationship between Cholera and interannual climate variables in Kolkata over the past century.

Shackleton D, Memon F, Chen A, Dutta S, Kanungo S, Deb A Gut Pathog. 2023; 15(1):42.

PMID: 37704999 PMC: 10498578. DOI: 10.1186/s13099-023-00565-w.

References

Usmani M, Brumfield K, Jamal Y, Huq A, Colwell R, Jutla A . A Review of the Environmental Trigger and Transmission Components for Prediction of Cholera. Trop Med Infect Dis. 2021; 6(3). PMC: 8396309. DOI: 10.3390/tropicalmed6030147. View

Singleton F, Attwell R, Jangi S, Colwell R . Effects of temperature and salinity on Vibrio cholerae growth. Appl Environ Microbiol. 1982; 44(5):1047-58. PMC: 242147. DOI: 10.1128/aem.44.5.1047-1058.1982. View

Sur D, Deen J, Manna B, Niyogi S, Deb A, Kanungo S . The burden of cholera in the slums of Kolkata, India: data from a prospective, community based study. Arch Dis Child. 2005; 90(11):1175-81. PMC: 1720149. DOI: 10.1136/adc.2004.071316. View

Wu J, Yunus M, Ali M, Escamilla V, Emch M . Influences of heatwave, rainfall, and tree cover on cholera in Bangladesh. Environ Int. 2018; 120:304-311. PMC: 6690386. DOI: 10.1016/j.envint.2018.08.012. View

Harris I, Osborn T, Jones P, Lister D . Version 4 of the CRU TS monthly high-resolution gridded multivariate climate dataset. Sci Data. 2020; 7(1):109. PMC: 7125108. DOI: 10.1038/s41597-020-0453-3. View

Hashizume M, Faruque A, Wagatsuma Y, Hayashi T, Armstrong B . Cholera in Bangladesh: climatic components of seasonal variation. Epidemiology. 2010; 21(5):706-10. DOI: 10.1097/EDE.0b013e3181e5b053. View

Vezzulli L, Grande C, Reid P, Helaouet P, Edwards M, Hofle M . Climate influence on Vibrio and associated human diseases during the past half-century in the coastal North Atlantic. Proc Natl Acad Sci U S A. 2016; 113(34):E5062-71. PMC: 5003230. DOI: 10.1073/pnas.1609157113. View

Asadgol Z, Mohammadi H, Kermani M, Badirzadeh A, Gholami M . The effect of climate change on cholera disease: The road ahead using artificial neural network. PLoS One. 2019; 14(11):e0224813. PMC: 6834266. DOI: 10.1371/journal.pone.0224813. View

Shackleton D, Memon F, Nichols G, Phalkey R, Chen A . Mechanisms of cholera transmission via environment in India and Bangladesh: state of the science review. Rev Environ Health. 2023; 39(2):313-329. DOI: 10.1515/reveh-2022-0201. View

10.

Giebultowicz S, Ali M, Yunus M, Emch M . A comparison of spatial and social clustering of cholera in Matlab, Bangladesh. Health Place. 2011; 17(2):490-7. PMC: 3056893. DOI: 10.1016/j.healthplace.2010.12.004. View

11.

Constantin de Magny G, Murtugudde R, Sapiano M, Nizam A, Brown C, Busalacchi A . Environmental signatures associated with cholera epidemics. Proc Natl Acad Sci U S A. 2008; 105(46):17676-81. PMC: 2584748. DOI: 10.1073/pnas.0809654105. View

12.

Jha P, Banerjee S, Bhuyan P, Sudarshan M, Dewanji A . Elemental distribution in urban sediments of small waterbodies and its implications: a case study from Kolkata, India. Environ Geochem Health. 2019; 42(2):461-482. DOI: 10.1007/s10653-019-00377-5. View

13.

Ali M, Gupta S, Arora N, Khasnobis P, Venkatesh S, Sur D . Identification of burden hotspots and risk factors for cholera in India: An observational study. PLoS One. 2017; 12(8):e0183100. PMC: 5570499. DOI: 10.1371/journal.pone.0183100. View

14.

Gurbanov S, Akhmadov R, Shamkhalova G, Akhmadova S, Haley B, Colwell R . Occurrence of Vibrio cholerae in municipal and natural waters and incidence of cholera in Azerbaijan. Ecohealth. 2012; 8(4):468-77. DOI: 10.1007/s10393-012-0756-8. View

15.

Mukhopadhyay A, Deb A, Chowdhury G, Debnath F, Samanta P, Saha R . Post-monsoon waterlogging-associated upsurge of cholera cases in and around Kolkata metropolis, 2015. Epidemiol Infect. 2019; 147:e167. PMC: 6518531. DOI: 10.1017/S0950268819000529. View

16.

Nelson E, Harris J, Morris Jr J, Calderwood S, Camilli A . Cholera transmission: the host, pathogen and bacteriophage dynamic. Nat Rev Microbiol. 2009; 7(10):693-702. PMC: 3842031. DOI: 10.1038/nrmicro2204. View

17.

Dutta B, Kumar N, Meshram K, Yadav R, Sodha S, Gupta S . Cholera outbreak associated with contaminated water sources in paddy fields, Mandla District, Madhya Pradesh, India. Indian J Public Health. 2021; 65(Supplement):S46-S50. DOI: 10.4103/ijph.IJPH_1118_20. View

18.

Zhao S, Musa S, Qin J, He D . Associations between Public Awareness, Local Precipitation, and Cholera in Yemen in 2017. Am J Trop Med Hyg. 2019; 101(3):521-524. PMC: 6726958. DOI: 10.4269/ajtmh.18-1016. View

19.

Huq A, West P, Small E, Huq M, Colwell R . Influence of water temperature, salinity, and pH on survival and growth of toxigenic Vibrio cholerae serovar 01 associated with live copepods in laboratory microcosms. Appl Environ Microbiol. 1984; 48(2):420-4. PMC: 241529. DOI: 10.1128/aem.48.2.420-424.1984. View

20.

Koelle K, Rodo X, Pascual M, Yunus M, Mostafa G . Refractory periods and climate forcing in cholera dynamics. Nature. 2005; 436(7051):696-700. DOI: 10.1038/nature03820. View