Epidemic hazard

In March 2026, BEACON received media reports regarding a Shigellosis cluster in Kerala, India. An RFI was sent to EPICORE members requesting additional information regarding the outbreak. EPICORE responders provided summary and links to additional sources providing additional information on the outbreak. BEACON then reported additional information and context regarding this outbreak. The additional context as of March 26, 2026 was: Previously, four people, including the deceased child—an anganwadi student from the Anakuzhikkara area of Kuttikkattur in Peruvayal grama panchayat—had been diagnosed with Shigella. Two of these patients are still undergoing treatment at the Government Medical College Hospital, while the fourth has been admitted to a private hospital. The 12 recently confirmed cases from Eranjikkal in Peruvayal grama panchayat were identified among 34 symptomatic contacts and relatives. Preventive activities have been intensified in Eranjikkal and neighbouring areas. The health department, accredited social health activists (ASHA workers), and panchayat authorities have set up a camp at Eranjikkal anganwadi to coordinate preventive measures. Preliminary field assessments suggest a waterborne source, likely related to local contamination of the groundwater table affecting private wells, which have since been chlorinated through house-to-house interventions. In parallel, food safety officials have begun inspections of establishments selling food and beverages, and three outlets operating in unhygienic conditions have so far been ordered to close. Serogroup information is not yet available. Recent data from Kerala indicate a shift from Shigella flexneri to S. sonnei, and in similar recent clusters in Kozhikode, S. sonnei has been identified as the predominant serogroup. The rapid onset of symptoms in the most recent cases is compatible with infection due to S. flexneri (Group B) or more virulent S. sonnei strains; however, S. dysenteriae serotype 1 cannot be ruled out at this stage. No information has yet been reported on antimicrobial susceptibility testing for this cluster. The Kerala Antimicrobial Resistance Surveillance Network (KARS-NET) monitors key priority pathogens associated with high antimicrobial resistance and common infections in India, including Shigella species. Kerala has been the first and so far only Indian state to publish a state-level antibiogram report annually since 2022, and from 2025, it has also started releasing district-level antibiograms for five districts. The suspected groundwater contamination affecting private wells represents a potential environmental reservoir that could sustain transmission beyond the initial cluster. Sustained water quality monitoring, identification of contamination sources, and ensuring all affected wells receive adequate treatment, particularly given the potential for recontamination in areas with inadequate sanitation infrastructure, remain priorities. The full BEACON report can be found here: https://beaconbio.org/en/report/?reportid=edff4033-0886-46cd-91dd-bded1caf74cd&eventid=9d0e4de2-4301-4ce7-bdbd-30ca0e522b47 Online sources: 1. https://www.manoramaonline.com/news/latest-news/2026/03/22/new-shigella-cases-confirmed-in-kozhikode.html 2. https://youtu.be/4TREb9aMm8w?si=ue6Lye19d0_M3PBI