Record stomach flu outbreaks in India show lurking health risks

By Satviki Sanjay

Outbreaks of acute diarrheal disease surged to the highest on record in 2024, in the latest example of unusual surges of even the most common bacterial and viral ailments across the world.

India recorded over 1,000 outbreaks of acute diarrheal disease across the country as of Dec 22, according to the latest data from the federal health ministry’s surveillance program. This is the highest level since the data was made publicly available in 2009.

The health agency also reported over 300 outbreaks of food poisoning across the country, the highest since 2019. An outbreak is defined as an illness “clearly in excess of expected numbers”, according to the ministry.

While stomach-related disorders are among the most common infectious illnesses in India, the reasons behind this exceptional surge in the outbreaks are a bit of a mystery. It also shows the lurking public health risks linked to contaminated water or food sources in the world’s most-populous country.

There has been a global resurgence of diseases in the aftermath of the Covid-19 pandemic, as historical illnesses and newer complications of existing ailments become more common across the world. Factors like climate change, rising social inequality and health-care services contribute in ways hard to measure, adding to the mounting public-health challenge.

An analysis last year by Bloomberg News and disease forecasting firm Airfinity found that 44 governments have reported the resurgence of at least one infectious disease over ten times worse than the pre-pandemic baseline.

“These infections have creeped up” over the past year, according to Amey Sonavane, a gastroenterology consultant at Apollo Hospitals in Navi Mumbai. While diarrhea isn’t deadly for most patients, “there is definitely a rise in severe cases,” he said.

More Severity

Antibiotic overuse is also leading to higher severity of cases, as it compels pathogens to develop resistance to existing therapies and leads to patients staying sick for longer, Sonavane said.

Diarrhea is an infection caused by a range of bacterial and viral pathogens, according to the World Health Organization. Among the most common viral causes of diarrhea are rotavirus and norovirus, while the most common bacterial pathogens include Escherichia coli, Salmonella, Shigella and Campylobacter.

One of the potential complications of these infections is Guillain Barre Syndrome — a rare neurological disorder in which the body’s immune system mistakenly starts attacking the peripheral nerves, causing muscle weakness and sometimes, paralysis.

An outbreak of GBS has been detected in the western Indian city of Pune, with over 180 cases confirmed cases and 28 suspected ones since January — a more than 10-fold jump.

City authorities are linking the outbreak to water contaminated with the Campylobacter jejuni bacteria.

While many ailments could lead to GBS later on, Aradhana Chauhan, a neurologist at Sahyadri hospital in Pune, said most of the cases she had seen were preceded by diarrhea.