Waterborne Disease Outbreaks in Nagpur During Monsoon

thenewsdirt
Jun 18
7 min read

Nagpur’s yearly monsoon not only brings relief from the summer heat, but it also brings disease.

For decades, residents across urban colonies and rural hamlets in Nagpur district have seen a sharp spike in cases of cholera, gastroenteritis, typhoid, and viral hepatitis during the rainy season.

The Vidarbha region, to which Nagpur belongs, has long witnessed this pattern, marked by contaminated water pipelines, flooded drains, and inadequate sanitation. The effects have often been fatal.

Historical Pattern of Cholera and Diarrhoeal Disease

Nagpur’s first documented large-scale cholera outbreaks go back decades, with the disease resurfacing in regular intervals during the rains. In 1993 and 1998, cholera cases in Nagpur were linked to the O139 serogroup of Vibrio cholerae.

A more serious outbreak followed in 2003, when 198 confirmed cholera cases were recorded. Most were caused by the El Tor biotype of Vibrio cholerae (serotype Ogawa).

Medical records from the time documented the rapid spread of infection in slums and low-income wards with poor drainage and erratic chlorination.

One of the worst recent rural outbreaks occurred in July 2016 in Sawargaon, a village in Nagpur district. Within days, 889 people had contracted acute diarrhoeal infections.

Water samples tested during the outbreak confirmed the presence of faecal coliform bacteria in 16 out of 18 drinking water sources, pointing directly to contamination from sewage or surface runoff.

Stool samples from patients tested positive for Vibrio cholerae O1, confirming cholera as the primary cause. Two people died. According to the Rapid Response Team deployed that year, chlorination of water supplies and door-to-door education helped control the spread within a week. Despite temporary control efforts, the city continues to see a recurring burden.

In the first half of 2024 alone, Nagpur Municipal Corporation (NMC) recorded 587 cases of diarrhoea and gastroenteritis.

Of these, over 70% occurred between April and mid-July, weeks when the monsoon began intensifying.

Hospitals across the city’s 10 administrative zones began preparing isolation wards as health authorities anticipated more cases. Treatment at NMC's isolation hospital remained free, and extra outpatient services were arranged for paediatric cases.

Doctors in private clinics across Dhantoli and Sitabuldi reported a consistent surge in patients from low-lying neighbourhoods.

In an interview with local press in July 2024, Dr Govardhan Navkhare, Municipal Epidemiologist, said, “Contaminated groundwater from unregulated borewells, poor chlorination, and mixing of sewerage with drinking pipelines continue to make the population vulnerable during rains.” Chlorine tablets were distributed in areas where piped water safety could not be ensured.

NMC also instructed licensed street food vendors to use treated water and maintain hygiene standards, a move enforced through surprise inspections.

The state-level trend echoes these warnings. In 2020, Maharashtra recorded 71 cholera cases. That number rose to 281 in 2021. In 2022, the figure jumped to 193 confirmed cases and 8 recorded deaths.

Paediatrician Dr Sanjay Khartade, based in Nagpur, expressed concern: “There were no deaths due to cholera in the last two years, but we lost eight lives this year, which means there must be something wrong with the system.”

Typhoid and Hepatitis Surges After Rainfall

Nagpur's Monsoon Disease Timeline inforgraphic — Nagpur's Monsoon Diseases

Typhoid fever, although often less visible in data, has quietly risen alongside other monsoon-triggered diseases.

In 2024, by July, Nagpur had recorded 90 typhoid cases, with 23 reported just in the first two weeks of that month.

Doctors noted that the rise coincided with the early weeks of rainfall, during which broken pipelines in many parts of the city allowed contaminated water to enter supply lines.

Paediatrician Dr Avinash Gawande confirmed that an unusual number of children were being admitted with typhoid symptoms. “Water-borne infections are more prominent these days because of unseasonal rains. Many kids are suffering from typhoid fever. It's also linked to consumption of stale food,” he said. The statement followed reports of several children falling sick after consuming roadside snacks in areas like Jaripatka and Lakadganj.

Jaundice, commonly caused by Hepatitis E or A during monsoons, has also seen periodic outbreaks.

One of the most significant incidents took place in June 2018 across the Mangalwari zone, particularly in Mohan Nagar, Gaddigodam, and the Khalasi Line locality. More than 150 cases of jaundice were confirmed in a span of days. In one case, a 42-year-old man died on 12 July 2018, the first reported fatality from hepatitis in Nagpur in over ten years.

Residents blamed contaminated municipal water. “The situation has deteriorated with rise in cases of waterborne diseases like jaundice,” said Sunita Walde, a resident of Mohan Nagar.

Water samples tested at that time confirmed contamination, yet residents continued receiving the supply through old pipelines.

BSP corporator Sanjay Burrewar accused the NMC of inaction: “Drinking water pipelines are getting contaminated due to frequent choking of sewer lines. The administration isn’t taking cognisance of this despite repeated complaints.”

According to a July 2018 surveillance update, the NMC health department recorded 57 cases of gastroenteritis and 15 cases of viral hepatitis between July 1 and 14. City health officials ordered emergency sampling of water from 23 localities and instructed all public and private hospitals to report any cases of hepatitis or typhoid immediately.

Municipal Response and Seasonal Health Management

Public health planning in Nagpur revolves around the monsoon calendar. Each year, before the rains arrive, municipal departments are directed to clean and desilt stormwater drains, repair manholes, and inspect high-risk sewerage pipelines.

These measures are expected to prevent the mixing of sewage with drinking water. However, delays in execution continue to leave many areas vulnerable.

In 2024, as part of the early response plan, officials from the Nagpur Municipal Corporation conducted water quality testing across 10 zones. The health department, under Dr Navkhare, also initiated home visits in affected slum areas, distributing chlorine tablets and checking for symptomatic cases. “We are providing treatment guidance and ensuring that infected patients receive medical attention without delay,” he said.

Despite recurring cases, government infrastructure upgrades remain slow.

In 2018, residents from Gaddigodam complained that old and rusty water pipelines, which were flagged for replacement a year earlier, had not been replaced.

Even where new lines had been laid, many were not yet functional due to incomplete connections. Slum dwellers in areas like Nari, Binaki, and Indora continued to draw water from borewells, often located near overflowing drains.

The state government has also attempted to coordinate with district administrations through regional directives.

In July 2024, a joint circular from the Vidarbha Division Commissioner’s office reminded municipal officials across Nagpur, Amravati, and Bhandara to prioritise flood control, sanitation in low-income colonies, and water testing during the rains. The circular also called for local hospitals to submit weekly disease surveillance reports.

In schools, anganwadis, and public health camps, the messaging has remained consistent: wash hands before meals, avoid uncooked food, and drink only boiled or treated water.

Civic volunteers help distribute this information in local dialects and through wall posters in high-incidence areas. NGOs in the city have occasionally supported chlorination campaigns, especially in rural outskirts like Hingna and Umred blocks, where sanitation infrastructure is limited.

Seasonal Trends and the Continuing Risk

Blue virus-like particles float against a dark purple background, highlighting the surge in waterborne diseases in Nagpur during the Monsoon season. — Seasonal Trends and the Continuing Risk

Every year, Nagpur sees a visible escalation in waterborne disease cases starting from early June, reaching their peak by late July or early August.

In some years, heavy post-monsoon rainfall extends the season into October, as seen in 2022. That year, paediatricians across Nagpur reported higher-than-normal patient load even in September, weeks after typical disease decline.

One striking aspect of the 2016 rural outbreak was the demographic data. Of the 889 affected in Sawargaon village, 51% were women, an unusual gender split for cholera cases in the region. Health officers suggested that since women more often fetched water or cooked food at home, their exposure risk was higher.

In urban centres, the pattern has followed the same script. First come the early symptoms, diarrhoea, vomiting, and fever, followed by rapid admissions to local hospitals. This is often when municipal authorities begin emergency cleaning drives and chlorination. But experts warn that this is reactive, not preventive.

Nagpur’s health department has at times taken proactive steps, including initiating street inspections, monitoring food vendors, and releasing real-time updates to the press.

Yet, repeated outbreaks in 2016, 2018, 2022, and 2024 suggest that without consistent year-round attention to water quality, sanitation infrastructure, and rapid repair of damaged pipelines, the cycle is unlikely to break.

The disease burden during monsoons is not limited to the city. Villages in rural Nagpur, especially those with hand-pump dependence and open defecation history, continue to report sporadic infections. The cholera outbreak in Sawargaon and the spike in gastro cases in the Umred block both demonstrated the vulnerability of these populations to contaminated surface and groundwater.

The Vidarbha region as a whole shows similar vulnerability, especially in flood-prone districts like Bhandara and Chandrapur.

Surveillance data have identified similar spikes in waterborne illnesses across these districts during monsoons. The coordination between district medical officers, panchayat workers, and municipal epidemiologists often determines the response speed.

The consistent pattern of seasonal outbreaks in Nagpur reveals more than just administrative shortcomings. It underscores the structural fragility of urban and rural water systems across Vidarbha, especially under the stress of monsoonal flooding.