Only accepted work is recordedAboutGuidesContactSign in
CitePepCitePep
Expert panels/Rapid note
Rapid note · provisionalIssued 3 Oct 2026 after 22 hours · 3 experts · full panel due 6 Oct · Illustrative

Rapid notes: a dated expert answer in days

Is well water in flood-affected Kerala districts likely to carry cholera?

Likely in 4 districts where wells were submerged and cases are already confirmed. Treat all well water there as unsafe until tested. Low certainty: this is a 24-hour read of early data, not a full panel finding.

What “provisional” means. Three experts answered fast so action isn’t delayed. A 7-seat panel is reviewing the same question now and will replace this note on 6 Oct, keeping it on record.
Note
Answer. In Alappuzha, Kottayam, Pathanamthitta and Ernakulam, assume submerged wells are contaminated. Boil or chlorinate before use, and prioritise these districts for testing.Why. 11 confirmed cholera cases in the 4 districts since 28 Sep, all in households using wells that were under water. In the other affected districts, no cases yet.Certainty. Low. Water testing has covered fewer than 60 wells so far, and case reports lag by 2–3 days.What the full panel will add. Results from 400 wells being tested this week, and whether the advice should extend to the other 6 districts.
Evidence read in 22 hours
State surveillance, cholera cases, 28 Sep–2 Oct11 confirmed, all linked to submerged wellsSupports
Well water tests, first 58 wellsFaecal coliforms in 41; Vibrio cholerae in 6Supports
2018 Kerala floods outbreak reportSimilar pattern; cases peaked day 10–14Context
Flood extent maps, 1 OctWhich wells were submergedContext
How this note was made
2 Oct 10:00Request from the Kerala State Disaster Management Authority, 24-hour deadline
2 Oct 11:403 standing-pool experts accepted in 1 h 40 min
3 Oct 08:00Note issued: 3 of 3 agreeDone
2–6 OctFull panel: 7 seats filled, reading evidenceIn progress
6 OctFull statement replaces this note
What this note doesn’t cover
Treatment and vaccination: the note is about water safety only.Piped water supplies, which are monitored separately.Districts outside the flood area.
Rapid note · 3 expertsEach panellist’s vote and declared interests
AVReviewerInfectious disease epidemiology · leadNone declaredAgree
RNReviewerWater microbiologyNone declaredAgree
SMReviewerDisaster public healthAdvised the requester in 2023, declaredAgree
Requested by
Kerala State Disaster Management Authority · 2 Oct 2026The requester paid for the panel, did not choose its members and saw the note when it was published.
Cite this statement
CitePep Rapid Note (Varghese A., lead). Cholera risk in flood-affected wells, Kerala. Provisional, 3 Oct 2026. Superseded by the full panel statement when issued.
Have new evidence?Goes to the chair. If it changes the answer, a new dated version is issued.