Maramraj KK, Subbalakshmi G, Ali MS, et al. - Given 709 acute diarrheal disease (ADD) outbreaks (> 25% of all outbreaks) occurred in India in 2016, and a tribal village, Pedda-Gujjul-Thanda, reported an ADD outbreak on June 26, 2017, researchers report the epidemiology, risk factors, as well as evidence-based recommendations. Via hospital records and house-to-house survey, they identified 191 cases (65% females) (a case was defined as ≥ 3 loose stools within 24 h in Pedda-Gujjul-Thanda residents from June 24–30, 2017). The cases had a median age of 36 years (range 4–80 years). No deaths were reported. The attack-rate was reported to be 37% (191/512). Diarrhea (100%), fever (17%), vomiting (16%) and abdominal pain (13%) were experienced as symptoms. The factors that showed a significant link with illness included drinking water from the shallow bore-wells located in downhill colonies, illiteracy, good hand-washing practice and household water treatment, as revealed in the multi-variate analysis. Overall, in a remote tribal village, an ADD outbreak with a high attack rate was found to be related to drinking water from shallow downhill bore-wells, possibly contaminated by runoff from open defecation areas following heavy rains. The suggestions made by the experts led to the initiation of repair of leakages at contaminated water sources and alternative supply of purified canned drinking water to families, as well as the development of house-hold latrines and piped-water supply.