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Epidemic Dynamics Post-Cyclone and Tidal Surge Events in the Bay of Bengal Region Cover

Epidemic Dynamics Post-Cyclone and Tidal Surge Events in the Bay of Bengal Region

Annals of Global Health
Volume 91 (2025): Issue 1
By: Sajda Khatoon,  Paramita Bhattacharya,  Nirmalya Mukherjee,  Pranay Lal and  Martin W. Bloem  
Open Access
|Jul 2025
Figures & tables

Figures & Tables

Figure 1

Conceptual framework.

Figure 2

Location of the study area.

Figure 3

(a) Average prevalence rate of waterborne diseases in cyclonic years, Sundarbans (2010–2021) and (b) Average prevalence rate of waterborne diseases in non‑cyclonic years, Sundarbans (2010–2021).

Figure 4

(a) Average prevalence rate of vector‑borne diseases in cyclonic years, Sundarbans (2010–2021) and (b) Average prevalence rate of vector‑borne diseases in non‑cyclonic years, Sundarbans (2010–2021).

Figure 5

Seasonal distribution of diseases (2009–2021).

Appendix I

Cyclone affecting the Indian Sundarbans (2009–2024).

S. NO.YEARCYCLONES AFFECTING THE INDIAN SUNDARBANSCATEGORY (IMD) [42]WIND SPEED IN KM/HSAFFIR–SIMPSON HURRICANE SCALE [43]
12009BijliCyclonic Storm751
2May 25,09AilaSevere Cyclonic Storm1102
32013ViyaruCyclonic Storm851
4Oct12, 13PhailinExtremely Severe Cyclonic Storm2155
5Oct12, 14HudhudExtremely Severe Cyclonic Storm1854
6July 30, 15KomenCyclonic Storm751
72018TitliVery Severe Cyclonic Storm1504
8May 03,19FaniExtremely Severe Cyclonic Storm2155
9Nov 01, 19BulbulVery Severe Cyclonic Storm1404
10May 20, 20AmphanSuper Cyclonic Storm150–2405
11May 01, 21YaasVery Severe Cyclonic Storm130–1404
12Oct 5, 22SitrangCyclonic Storm851
13May 12, 23Mocha [44]Extremely Severe Cyclonic Storm210–220 km/h gusting to 2405
14May 26, 24Remal [44]Severe Cyclonic Storm110–120 km/h gusting to 135 km/h3

[i] Sources:

[ii]

  1. Indian Meteorological Department (IMD). Cyclones. NDMA, GOI. 2024. https://ndma.gov.in/Natural-Hazards/Cyclone

  2. National Hurricane Center, Central Pacific Hurricane Center, NOAA. Saffir‑Simpson Hurricane Wind Scale. 2024. https://www.nhc.noaa.gov/aboutsshws.php?os=app&ref=app

  3. India Meteorological Department. Preliminary Report Cyclones. 2024. https://rsmcnewdelhi.imd.gov.in/report.php?internal_menu=MjY=

Appendix II

Table showing block wise vulnerability, geographic location, diseases’ prevalence, and other variables of association.

AVERAGE YEARLY DISEASE PREVALENCE RATE PER 100,000
S. NO.DISTRICTSBLOCKSVULNERABILITYGEOGRAPHIC LOCATIONWBDS (CYCLONIC YEARS)WBDS (NON‑CYCLONIC YEARS)VBDS (CYCLONIC YEARS)VBDS (NON‑CYCLONIC YEARS)HHS HAVING TOTAL SAFE DRINKING WATER (%)HHS HAVING TOILET FACILITIES (%)HHS HAVING CLOSED DRAINAGE SYSTEM (%)NO. OF MPCSSPOPULATION DENSITY (POPULATION PER SQ. KM)
1South 24 ParganasSagarVery HighCoastal1080155124490.386.90.310541
2NamkhanaVery HighCoastal7964487427299.372.80.210560
3KakdwipVery HighCoastal1717162311197.659.51.39863
4PatharpratimaHighCoastal66143945221599.359.40.112474
5KultaliVery HighCoastal288015581363910032.30.27263
6Mathurapur IMediumInland43092952958899.740.80.901503
7Mathurapur IIVery HighInland536323141883599.454.90.95771
8Jayanagar IMediumInland40292860283698.949.92.101287
9Jayanagar IIVery HighInland366928779397.432.41.102279
10Canning IHighInland59293745321499.559.13.201427
11Canning IIHighInland72444975385298.757.40.60719
12BasantiVery HighCoastal931747121384298.2400.512504
13GosabaHighCoastal21181984192296.475.30.31093
14North 24 ParganasHingalganjMediumInland222514941786.274.30.611615
15HasnabadLowInland74063289171691.463.1151318
16HaroaLowInland5258335122097.280.71.701310
17Sandeskhali IMediumInland667050001325998.264.11.611870
18Sandeskhali IIHighInland4727303034128098.955.90.712812
19MinakhanMediumInland347815701144297.2801.941263

[i] HHs = Households; WBDs = Waterborne diseases; VBDs = Vector‑borne diseases; MPCSs = Multi‑purpose cyclone shelters

Appendix III

Literature on the impact of cyclones on human health in the BOB region.

NOAUTHORCYCLONE STUDIEDSTUDY AREAPOPULATIONOBJECTIVESMETHODDISEASESFINDINGS
1Giribabu, D., Muvva, V. R., Joshi, N. K., & Rao, S. S. 2021MultipleEastern coast districts, IndianoneTo evaluate the impact of WASH interventions, the prevalence of disease epidemics during cyclones in India from 2010 to 2018, and the correlation between cyclones and disease outbreaksUsed meteorological parameters, disease data from the Integrated Disease Surveillance Program, etc. from 2010 to 2018 to compile an inventory of disease outbreaks during cyclonesInfectious disorders such as acute diarrheal diseases, malaria, viral fevers, enteric fever, and food poisoning have repeatedly been reported during cyclonic occurrences and lasted for up to two weeks after the cycloneThe effectiveness of Clean India Mission was evident in recent storms like Ockhi, Titli, and Gaja, with a notable decrease in disease outbreaks
2Kabir. R, Khan. H, Ball. E & Caldwell. K., 2016Sidr & AilaAmtali Upazila of Barguna District, cyclone Aila affected Koyra Upazila, Khulna District, Bangladesh2 FGDs with max 10 members eachTo assess the impact of cyclones Sidr and Aila on the inhabitants of coastal BangladeshA qualitative study using primary data collection: Focus Group Interview was followed by a thematic analysisIt found an increase in waterborne illnesses like diarrhea, typhoid, and skin diseases due to contaminated water sources
3Mishra. S., Ram Kumar. T., & Biswas.AK., 2016Phailin (Odisha)Berhampur, Odisha, Indiachildren aged 1–14 months divided in three groups: G1 study group (n = 50); g2 control groups (n = 25); G3 control group (n = 29)To analyze the incidence of poisoning cases in children before and after Phailin, in order to assess the impact on the pediatric population1. This retrospective study used hospital data from Maharaja Krishna Chandra Gajapati Medical College and Hospital, Berhampur, Odisha. 2. Analyzed three groups: post‑Phailin Study group, pre‑Phailin Control group B, and post‑Phailin Control group C in the following year. 3. Data Analysis chi‑square tests or t‑testsSnake bites in children 1 month to 14 years18% (N = 9/50)
4Mazumdar S, Mazumdar PG, Kanjilal B, & Singh PK., 2014AilaHingalganj, Gosaba and Patharpratima, Sunadarbans, India809 individuals from 179 householdsTo evaluate the effects of Cyclone Aila on households and the subsequent strategies employed to deal with the situation in three severely impacted sub‑districts, namely Hingalganj, Gosaba, and PatharpratimaCross‑sectional household surveyNot investigated occurrence of specific health impactsAila has caused significant damage to 54% of households’ assets, leading to a lack of financial support and access to government relief, institutional credit, and mortgage or distress pawning. Typical strategies include borrowing from informal lenders, family and friends, and relying on household income
5Bhunia R, & Ghosh S., 2011AilaSundarbans, India57 cases and 171 controlsThe study aimed to ascertain the causative agent and origin of the disease outbreak, and to suggest strategies for its containmentMatched case control study: data on reported diarrhea cases was collected from January 2007 to May 2009, stool specimens for probable cases were tested, interviews with cases conducted and water tested for contaminationCholera1,076 cases resulting in 14 deaths. Attack rate:44/10,000
6Panda, S., Pati, K. K., Bhattacharya, M. K., Koley, H., Pahari, S., & Nair, G. B., 2011AilaEast‑Medinipur in West Bengal, India39 samplesThe study investigates the increase in diarrhea cases following the AILA storm in East MedinipurPrimary data were collected through field visits and stakeholder conversations, while secondary data were analyzed over three years. Laboratory examinations involved rectal swabs and chi‑square tests to evaluate temporal patterns and disparities in antibiotic usageCholera (severe form of diarrhea)The bacterium Vibrio cholerae was detected in 54% (n = 21/39) of the collected samples, providing evidence of a widespread occurrence of cholera within the community. Incidence of diarrhea increased following Cyclone Aila in June 2009, particularly in the Haldia and Egra subdivisions. The Vibrio cholerae isolates were found to be antibiotic resistant but were sensitive to norfloxacin and azithromycin. Haldia had the highest prevalence incidence of diarrhea, with an attack rate of 9 per 1000
7Bhattacharjee S, Bhattacharjee S, Bal B, Pal R, Niyogi SK, Sarkar K., 2010AilaPakhirala village of the Sundarbans, a coastal region of South 24 Parganas, India37 stool samples were tested in the labThe study investigated a watery diarrhea outbreak in Pakhirala village, Sundarbans region, analyzing morbidity, causative agents, and clinical results, comparing cases in Pakhirala and other villagesStool samples were collected from cases in Pakhirala villageDiarrhoeaJune 5–July 20, 2009, 91% (n = 3592) compared to 70% (n = 28,550) in other villages
8Chhotray G. P et al., 2002Super cycloneOdisha, India107 rectal swabs collected from hospitalized diarrhea patientsTo analyze causative agents of cholera outbreak in cyclone‑hit areas in OrissaMolecular analysis, including PCR assays and ribotyping, was conducted on V. cholerae strains. Antimicrobial susceptibility testing and genetic characterizationDiarrhoea agent: Vibrio cholera77.57% (n = 83/107) diarrhea cases
Appendix IV

Literature related to cyclone shelters in the BOB region.

NOAUTHORCYCLONE STUDIEDSTUDY AREAPOPULATIONOBJECTIVESMETHODFINDINGS
1Anburaja Durai et al, 2023Tamil Nadu, IndiaStudy focuses on the structural design of a circular cyclone shelter for high‑intensity cyclonesAnalyzed existing shelters using STAAD‑Pro software

  1. Circular cyclone shelters are more effective and suitable for environmental conditions compared to existing rectangular shelters

  2. Circular shelters are found to withstand extreme wind loads and provide better protection during cyclones, making them a recommended choice for establishment along the east coast of Tamil Nadu

2Jaiswal. A, et al., 2022India (AP, Odish, Gujrat) & BangladeshNATo consolidate diverse management techniques implemented in the South‑Asian region, specifically in Bangladesh and India, for MPCSs

  • Thematic or content analysis to report patterns in shelter management

  • It includes a semi‑systematic review of existing literature to map theoretical themes and identify gaps

  1. The shelter should be effectively managed and equipped for use during disaster

  2. All the equipment provided in MPCSs must be in working condition

  3. The shelter should be well maintained, to be usable when required the most

3Chowdhury et al, 2022BangladeshExamines the first‑hand experiences of females residing in cyclone shelters in Bangladesh and analyzes their physical and mental well‑being as individuals seeking refuge in these sheltersMax van Manen’s methodological approach to hermeneutic phenomenology was adopted

  1. In order to be prepared for potential cyclones, multiple cyclone shelters have been built. However, a significant number of the coastal population, particularly women, are reluctant to utilize these shelters

  2. Women found themselves in a disadvantaged position in the shelter, which was similar to the experiences of women across the globe

4Kanjilal & Bhandari, 2022Digha, West Bengal1. to understand the operation and upkeep of the current MPCS (Multi‑Purpose Community Spaces) 2. To evaluate the level of connectivity between each existing MPCS and the adjacent villages in Ramnagar‑I and II. 3. To determine the amount of space provided per individual in each MPCS, in comparison to the government’s stipulations

  • Conducting a household survey

  • The local government departments have furnished data regarding the various structural characteristics of the cyclone shelters

  • The SRTM DEM dataset from 2014 was utilized to obtain the land’s elevation. The road networks are obtained from the ISGP website

  1. Storm shelters in local areas are not distributed fairly, with essential facilities like kitchens and toilets often non‑functional due to insufficient maintenance

  2. The lack of understanding among the population and transportation issues makes people reluctant to relocate. Official rules suggest each MPCS can only accommodate 50–60% of the local population, but these shelters can only accommodate 300 people, which is insufficient to meet the needs of the large number of vulnerable people seeking refuge

5Hadi et al, 2021Amphan, Aila, Sidr, GorkyBangladesh210 participants from seven coastal districts; Males‑135, Females‑75Analyze factors that influence the decision to evacuate to cyclone shelters in Bangladesh over the past 30 years, focusing on Cyclone Amphan (2020) and historical cyclones Gorky (1991), Sidr (2007), and Aila (2009)The study used a mixed‑method approach to analyze data from literature reviews, household surveys, and phone interviews

  1. Studies on the decision to evacuate in Bangladesh’s coastal regions following Cyclone Gorky reveal that fear of property loss leads to partial evacuations, environmental cues analysis before evacuation, and finding sanctuary in neighboring houses

  2. Cyclone shelters are poorly distributed and lack amenities. Despite advancements in disaster response infrastructure, evacuation rates have not increased

  3. Among the recommendations are gender‑responsive projects to provide safe surroundings for people seeking asylum and risk‑based planning for shelters

6Mohanty. S., et al., 2021AmphanOdisha, India2 KIIsTo outline the challenges encountered in managing shelters during cyclones amidst the COVID‑19 pandemic in Odisha

  • Literature, reports and direct interviews of field professionals and practitioners

  1. The study reveals that storm shelters are typically converted into schools and managed by local communities or elected entities

  2. However, new concerns include urging vulnerable groups to evacuate, converting shelters into COVID‑19 facilities, addressing cleanliness and safety requirements, and accommodating high‑risk populations

7Dash & Walia, 2020Phailin’ (2013)
Hudhud (2014)
Titli (2018)		India5–30 FGD members across four FGD groups including people from various occupationsTo examine the precise role of MPCSs that they aim to perform after four cyclones (Phailin, Hudhud, Titli & Fani) during 2013–2019. It assesses the decision‑making criteria involved in choosing an MPCS and gains experiential knowledge of evacuees taking shelter in the MPCSs

  • Qualitative and follows multiple case study method

  • Primary data collected using Group Discussion and Interviews

  1. Feeling unsafe inside the shelter, especially at peak cyclone intensity.

  2. Poorly maintained shelter buildings leading to rainwater leaking inside the rooms and

  3. Damage to shelter buildings to varying extents: cracks on building walls, removal of fittings and iron doors, etc.

  4. Moreover, the total number of individuals housed in every MPCSs represents only a meager fraction of the inhabitants in the districts. Shortfall in CS capacity: Available shelter capacities are only 7.3% of the population in vulnerable regions

8Das.S., 2018PhailinOdisha, India320 households from coastal shelter villages in Odisha, India.The study aimed to investigate the evacuation behavior of individuals who are susceptible to cyclones and are prone to evacuating

  • A two‑stage random sampling technique to choose 320 households from shelter villages located along the shore at a distance of 1–2 km from the coastline was selected

  • A household survey was conducted and interviews conducted in the native language

  • Data analysis: descriptive statistics and logistic regression

  1. “Evacuees from all districts encountered difficulties during their stay in shelters.

  2. The issues reported include limited space (33), insufficient food supply (16), inadequate water access (13), absence of basic bathroom facilities (09), absence of prepared meals (5), electrical problems (3), and rainwater seepage”

9Seo. N, 2017All cyclones in NIO from 1990 to 2015BangladeshAll cyclones in NIO from 1990 to 2015The study aims to assess the effectiveness of the Cyclone Shelter Program (CSP) in reducing fatalities caused by cyclones, specifically focusing on its impact on high storm surges and intense windsNegative binomial regression model to quantify the impact of the CSP on reducing deaths caused by cyclonesGiven the same level of storm surge, this program is estimated to reduce fatalities by 75%
10Haider. Z, & Ahmed. F.,2014Morelgonj and Sarankhola upazila under Bagerhat district of Bangladesh144 respondents, 12 each from each of the 12 shelter catchment areas Identify income‑generating activities for cyclone shelters in Bangladesh

  • Focus Group Discussion (FGD), survey, and stakeholder consultation

  1. Each shelter has a capacity ranging from a minimum of 500 −2500 persons

  2. The entire number is insufficient to provide meaningful support for the vulnerable people affected by the disaster

  3. The current cyclone shelters in the coastal region lack adequate provisions for lighting, water, sanitary facilities, and separate rooms for women

11Mallick. B, 2014AilaSouthwest coastal area of Bangladesh308 respondents from selected villagesTo assess the necessity of constructing additional Community Shelters (CSs) in the future or explore other approaches for community‑based cyclone disaster management

  • Household survey and focus group discussions

  • A stratified random sampling procedure to select respondents from villages affected by Cyclone Aila

  • Focus group discussions were conducted with survivors to analyze mobility patterns and social mapping of institutional supports

  1. The study found that only 15.5% of early warning participants brought their family members to a community shelter, while 25.3% sought refuge in a nearby residence

  2. During the storm, two‑thirds of respondents were at home or in a nearby residence, with a significant proportion at educational facilities, religious institutions, or boats

DOI: https://doi.org/10.5334/aogh.4751 | Journal eISSN: 2214-9996
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Language: English
Submitted on: Apr 2, 2025
Accepted on: May 18, 2025
Published on: Jul 22, 2025
Published by: Ubiquity Press
In partnership with: Paradigm Publishing Services
Publication frequency: 1 issue per year
Keywords:
MPCSs,
cyclones,
climate change,
adaptation,
Sundarbans,
Bay of Bengal

© 2025 Sajda Khatoon, Paramita Bhattacharya, Nirmalya Mukherjee, Pranay Lal, Martin W. Bloem, published by Ubiquity Press
This work is licensed under the Creative Commons Attribution 4.0 License.

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