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1
Kaper, J. B., J. G. Morris, and M. M. Levine. "Cholera." Clinical Microbiology Reviews 8, no. 1 (January 1995): 48–86. http://dx.doi.org/10.1128/cmr.8.1.48.
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Despite more than a century of study, cholera still presents challenges and surprises to us. Throughout most of the 20th century, cholera was caused by Vibrio cholerae of the O1 serogroup and the disease was largely confined to Asia and Africa. However, the last decade of the 20th century has witnessed two major developments in the history of this disease. In 1991, a massive outbreak of cholera started in South America, the one continent previously untouched by cholera in this century. In 1992, an apparently new pandemic caused by a previously unknown serogroup of V. cholerae (O139) began in India and Bangladesh. The O139 epidemic has been occurring in populations assumed to be largely immune to V. cholerae O1 and has rapidly spread to many countries including the United States. In this review, we discuss all aspects of cholera, including the clinical microbiology, epidemiology, pathogenesis, and clinical features of the disease. Special attention will be paid to the extraordinary advances that have been made in recent years in unravelling the molecular pathogenesis of this infection and in the development of new generations of vaccines to prevent it.
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Daniszewski, Piotr. "Vibrio cholerae - As Biological Weapons." International Letters of Social and Humanistic Sciences 9 (September 2013): 65–73. http://dx.doi.org/10.18052/www.scipress.com/ilshs.9.65.
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Terrorism is defined as use of unlawful violence or threat of unlawful violence to indulge fear; intended to coerce or to intimidate governments or societies in the pursuit of goals that are generally political, social or religious. Bioterrorism is terrorism by intentional release or dissemination of biological agents, mainly bacteria or viruses. Use of biological weapons is attractive from the terrorists’ point of view because of low production costs, major range and easiness of transmission. The first mention of the use of primitive biological weapons date back to the 6th century. Use of plague-infested corpses as offensive means in the 14th century caused a spread of bubonic plague through the whole Europe. The biggest development of biological weapons took place in the interwar period and in the cold war era. Biological weapon trails and research were conducted by super powers such as USSR, UK, USA and Japan. At the beginning of the 20th century a new form of bioterrorism occurred, which put humanity in the face of a terrifying threat. Cholera is a deadly disease that has caused a worldwide phenomenon throughout history. Its imperative weapon, the Vibrio cholerae bacterium, has allowed cholera to seize control and wipe out a huge percentage of the human population. V. cholerae’s toxins are the primary causes of cholera’s lethal symptoms. The bacterium contains toxins that help it accomplish its job of invading the human system and defeating the body’s powerful immune system. With its sibling bacterium Escherichia coli, V. cholerae has become one of the most dominant pathogens in the known world. V. cholerae’s strategies in causing the infamous deadly diarrhea have been widely studied, from the irritation of the intestinal epithelium to the stimulation of capillary leakage, as well as the internal effects of the disease such as the Peyer’s patches on the intestinal walls. Overall, the Vibrio cholera bacterium has made cholera a tough disease to overcome, and because of its deadly virulence factors, cholera has become one of the most frightening diseases a human body could ever encounter. Vibrio cholerae is a Gram-negative, comma-shaped bacterium. Some strains of V. cholerae cause the disease cholera. V. cholerae is facultatively anaerobic and has a flagellum at one cell pole. V. cholerae was first isolated as the cause of cholera by Italian anatomist Filippo Pacini in 1854, but his discovery was not widely known until Robert Koch, working independently 30 years later, publicized the knowledge and the means of fighting the disease. V. cholerae pathogenicity genes code for proteins directly or indirectly involved in the virulence of the bacteria. During infection, V. cholerae secretes cholera toxin, a protein that causes profuse, watery diarrhea. Colonization of the small intestine also requires the toxin coregulated pilus (TCP), a thin, flexible, filamentous appendage on the surface of bacterial cells.
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LaRocque, Regina C., Bryan Krastins, Jason B. Harris, Lauren M. Lebrun, Kenneth C. Parker, Michael Chase, Edward T. Ryan, Firdausi Qadri, David Sarracino, and Stephen B. Calderwood. "Proteomic Analysis of Vibrio cholerae in Human Stool." Infection and Immunity 76, no. 9 (June 30, 2008): 4145–51. http://dx.doi.org/10.1128/iai.00585-08.
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ABSTRACT An effective vaccine for Vibrio cholerae is not yet available for use in the developing world, where the burden of cholera disease is highest. Characterizing the proteins that are expressed by V. cholerae in the human host environment may provide insight into the pathogenesis of cholera and assist with the development of an improved vaccine. We analyzed the V. cholerae proteins present in the stools of 32 patients with clinical cholera. The V. cholerae outer membrane porin, OmpU, was identified in all of the human stool samples, and many V. cholerae proteins were repeatedly identified in separate patient samples. The majority of V. cholerae proteins identified in human stool are involved in protein synthesis and energy metabolism. A number of proteins involved in the pathogenesis of cholera, including the A and B subunits of cholera toxin and the toxin-coregulated pilus, were identified in human stool. In a subset of stool specimens, we also assessed which in vivo expressed V. cholerae proteins were recognized uniquely by convalescent-phase as opposed to acute-phase serum from cholera patients. We identified a number of these in vivo expressed proteins as immunogenic during human infection. To our knowledge, this is the first characterization of the proteome of a pathogenic bacteria recovered from a natural host.
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Maurice Bilung, Lesley, Mintra Prommani Etriam, Ahmad Syatir Tahar, Teng Sing Tung, and Kasing Apun. "Detection of Cholera Toxin-Producing Vibrio cholerae in Phytoplankton from Santubong and Samariang Estuaries." Borneo Journal of Resource Science and Technology 9, no. 1 (June 30, 2019): 36–43. http://dx.doi.org/10.33736/bjrst.1584.2019.
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Many cholera outbreaks worldwide were associated with cholera toxin-producing Vibrio cholerae. The bacteria are ubiquitous in aquatic environment, whilst phytoplankton is associated with adaptation of the Vibrio species. This study was conducted to detect cholera toxin-producing Vibrio cholerae, and to determine association of the selected water physicochemical parameters with the number of the bacteria. In this study, a total of ten phytoplankton samples were collected at Santubong and Samariang Estuaries in Kuching, Sarawak. Water physicochemical parameters (temperature, pH and salinity) were recorded. Vibrio bacteria were cultivated on thiosulfate citrate bile-salts sucrose selective agar and analysed for cholera toxin-producing Vibrio cholerae using polymerase chain reaction by targeting ctxA gene that encodes for virulence cholera enterotoxin subunit A. The result revealed that a range of 1.0 × 107 – 8.0 × 107 CFU/ml of yellow colonies growing on the thiosulfate citrate bile-salts sucrose agars. Inversely, no samples were positive with cholera toxin-producing Vibrio cholerae. The physicochemical parameters at Samariang Estuary were more associated with the number of bacteria in the samples compared to Santubong Estuary.
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Nasreen, Tania, Nora A. S. Hussain, Mohammad Tarequl Islam, Fabini D. Orata, Paul C. Kirchberger, Rebecca J. Case, Munirul Alam, Stephanie K. Yanow, and Yann F. Boucher. "Simultaneous Quantification of Vibrio metoecus and Vibrio cholerae with Its O1 Serogroup and Toxigenic Subpopulations in Environmental Reservoirs." Pathogens 9, no. 12 (December 16, 2020): 1053. http://dx.doi.org/10.3390/pathogens9121053.
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Vibrio metoecus is a recently described aquatic bacterium and opportunistic pathogen, closely related to and often coexisting with Vibrio cholerae. To study the relative abundance and population dynamics of both species in aquatic environments of cholera-endemic and cholera-free regions, we developed a multiplex qPCR assay allowing simultaneous quantification of total V. metoecus and V. cholerae (including toxigenic and O1 serogroup) cells. The presence of V. metoecus was restricted to samples from regions that are not endemic for cholera, where it was found at 20% of the abundance of V. cholerae. In this environment, non-toxigenic O1 serogroup V. cholerae represents almost one-fifth of the total V. cholerae population. In contrast, toxigenic O1 serogroup V. cholerae was also present in low abundance on the coast of cholera-endemic regions, but sustained in relatively high proportions throughout the year in inland waters. The majority of cells from both Vibrio species were recovered from particles rather than free-living, indicating a potential preference for attached versus planktonic lifestyles. This research further elucidates the population dynamics underpinning V. cholerae and its closest relative in cholera-endemic and non-endemic regions through culture-independent quantification from environmental samples.
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Yadav, Sachin. "A Case Report Cholera Outbreak in Gaidataar: A Lesson for Further Strengthening the Task Force for Epidemic Management in Nepal." Journal of Nepal Medical Association 56, no. 207 (September 30, 2017): 374–76. http://dx.doi.org/10.31729/jnma.3284.
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Cholera is an acute enteric infection caused by the ingestion of bacterium Vibrio cholerae1. Cholera is transmitted through contaminated food and water. Prevention and preparedness of cholera require a coordinated multi-disciplinary approach. The extremely short incubation period enhances the potentially explosive pattern of outbreaks. Cholera can lead to severe dehydration and death if left untreated. The laboratory testing is required for antimicrobial sensitivity testing and for confirming the end of an outbreak. Provision of safe drinking water, proper sanitation, and food safety are critical for preventing occurrence of cholera. Health education aims at communities adopting preventive behavior for averting contamination. Specific training for all the staffs about proper case management including avoidance of noso-comial infection (like face masks, gloves, antiseptic solution, hand scrubs). Sufficient pre-positioned medical supplies for case management (diarrhoeal disease kits, iv fluids, antibiotics, safety measures). Improved access to water, effective sanitation, proper waste management and vector control. Improved communication and public information. Oral Rehydration Salts can treat 80% of cholera1. Appropriate antibiotics can reduce the duration of purging. With a well and properly managed team of health experts with all essential medicines and a good rapid response team, any outbreak can be prevented, controlled and managed.
Keywords: cholera; epidemic; ORS; rapid response team; shanchol; task force.
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Alam, Munirul, Marzia Sultana, G. Balakrish Nair, R. Bradley Sack, David A. Sack, A. K. Siddique, Afsar Ali, Anwar Huq, and Rita R. Colwell. "Toxigenic Vibrio cholerae in the Aquatic Environment of Mathbaria, Bangladesh." Applied and Environmental Microbiology 72, no. 4 (April 2006): 2849–55. http://dx.doi.org/10.1128/aem.72.4.2849-2855.2006.
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ABSTRACT Toxigenic Vibrio cholerae, rarely isolated from the aquatic environment between cholera epidemics, can be detected in what is now understood to be a dormant stage, i.e., viable but nonculturable when standard bacteriological methods are used. In the research reported here, biofilms have proved to be a source of culturable V. cholerae, even in nonepidemic periods. Biweekly environmental surveillance for V. cholerae was carried out in Mathbaria, an area of cholera endemicity adjacent to the Bay of Bengal, with the focus on V. cholerae O1 and O139 Bengal. A total of 297 samples of water, phytoplankton, and zooplankton were collected between March and December 2004, yielding eight V. cholerae O1 and four O139 Bengal isolates. A combination of culture methods, multiplex-PCR, and direct fluorescent antibody (DFA) counting revealed the Mathbaria aquatic environment to be a reservoir for V. cholerae O1 and O139 Bengal. DFA results showed significant clumping of the bacteria during the interepidemic period for cholera, and the fluorescent micrographs revealed large numbers of V. cholerae O1 in thin films of exopolysaccharides (biofilm). A similar clumping of V. cholerae O1 was also observed in samples collected from Matlab, Bangladesh, where cholera also is endemic. Thus, the results of the study provided in situ evidence for V. cholerae O1 and O139 in the aquatic environment, predominantly as viable but nonculturable cells and culturable cells in biofilm consortia. The biofilm community is concluded to be an additional reservoir of cholera bacteria in the aquatic environment between seasonal epidemics of cholera in Bangladesh.
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Vanden Broeck, Davy, Caroline Horvath, and Marc J. S. De Wolf. "Vibrio cholerae: Cholera toxin." International Journal of Biochemistry & Cell Biology 39, no. 10 (2007): 1771–75. http://dx.doi.org/10.1016/j.biocel.2007.07.005.
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Nalin, D. R. "Cholera or Choleric?" Clinical Infectious Diseases 46, no. 1 (January 1, 2008): 150. http://dx.doi.org/10.1086/524088.
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Moskvitina, E. A., E. G. Yanovich, M. I. Kurilenko, V. D. Kruglikov, S. V. Titova, D. A. Levchenko, A. S. Vodop’yanov, et al. "Cholera: Monitoring of Epidemiological Situation around the World and in Russia (2010–2019). Forecast for 2020." Problems of Particularly Dangerous Infections, no. 2 (July 12, 2020): 38–47. http://dx.doi.org/10.21055/0370-1069-2020-2-38-47.
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Objective of the study was to monitor the spread of cholera in the world, in the CIS countries and in Russia with an assessment of risks and emergencies that contribute to the activation of the epidemic process. Despite the downward trend in the global incidence rate of cholera during the period between 2010 and 2019, epidemics and major outbreaks occurred in 96 countries. WHO has reported 2013 imported cases of cholera to countries in Asia, the Americas, including the Caribbean, Europe, and Australia with Oceania; cholera-endemic administrative territories are identified in 24 countries. According to WHO, cholera burden reduction in Asia and Africa is associated with large-scale vaccination. During epidemiological surveillance of cholera, 705 strains of V. cholerae O1 and O139 serogroups were isolated from surface reservoirs in 26 constituent entities of the Russian Federation, including 10 strains of V. cholerae O1 ctxA+tcpA+, 35 strains of V. cholerae O1 ctxA–tcpA+, 655 strains of V. cholerae O1 ctxA–tcpA– , and five strains of V. cholerae O139 ctxA–tcpA–. Identification of strains with unique, previously unknown INDEL genotypes testifies to their imported nature. The forecast for cholera in the world for 2020, given the proven high degree of epidemic process activation at the expense of social and environmental risks caused by emergencies of different origin, the presence of endemic foci, infection import and other risk factors is unfavorable. For Russia, the forecast for cholera will be determined by the presence of external risks created by the ongoing 7-th pandemic, possible importation of infection to constituent entities of the Russian Federation that differ by the types of epidemic manifestations.
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Silva-Valenzuela, Cecilia A., and Andrew Camilli. "Niche adaptation limits bacteriophage predation of Vibrio cholerae in a nutrient-poor aquatic environment." Proceedings of the National Academy of Sciences 116, no. 5 (January 11, 2019): 1627–32. http://dx.doi.org/10.1073/pnas.1810138116.
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Vibrio cholerae, the causative agent of cholera, has reservoirs in fresh and brackish water where it interacts with virulent bacteriophages. Phages are the most abundant biological entity on earth and coevolve with bacteria. It was reported that concentrations of phage and V. cholerae inversely correlate in aquatic reservoirs and in the human small intestine, and therefore that phages may quench cholera outbreaks. Although there is strong evidence for phage predation in cholera patients, evidence is lacking for phage predation of V. cholerae in aquatic environments. Here, we used three virulent phages, ICP1, ICP2, and ICP3, commonly shed by cholera patients in Bangladesh, as models to understand the predation dynamics in microcosms simulating aquatic environments. None of the phages were capable of predation in fresh water, and only ICP1 was able to prey on V. cholerae in estuarine water due to a requirement for salt. We conclude that ICP2 and ICP3 are better adapted for predation in a nutrient rich environment. Our results point to the evolution of niche-specific predation by V. cholerae-specific virulent phages, which complicates their use in predicting or monitoring cholera outbreaks as well as their potential use in reducing aquatic reservoirs of V. cholerae in endemic areas.
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Lomov, Yu M., N. R. Telesmanich, I. T. Andrusenko, E. A. Moskvitina, and O. A. Areshina. "PROPERTIES OF VIBRIO CHOLERAE STRAINS ISOLATED IN ASIA AND THEIR RELATIONSHIP TO THE STRAINS CIRCULATING IN OTHER CONTINENTS DURING THE SEVENTH CHOLERA PANDEMIC." Epidemiology and Infectious Diseases 17, no. 1 (February 15, 2012): 39–45. http://dx.doi.org/10.17816/eid40654.
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The review deals with the properties of Vibrio cholerae (classical, El Tor, 0139, non-01/non-0139 strains) circulating worldwide during the seventh cholera pandemic. Particular attention is given to the variability in the cholera pathogen: the replacement of classical Vibrio cholerae by the El Tor biotype and subsequently the emergence of serogroup Vibrio cholerae 0139 and genetically altered El Tor Vibrio cholerae; the causes giving rise to these changes and spread of Vibrio cholera in the countries of the Asian continent. A large genetic variability found in Asian strains suggests that there is a real possibility of the emergence of new clones with new properties, including those with an epidemic potential. The Vibrio cholerae strains, that periodically appear in Asia and have an epidemic potential and new properties, spread over all continents, by causing cholera infection. The cholera pathogen adapts to new existence conditions in some cases, by altering some properties and, by having been rooted in a certain area, causes mainly sporadic cases of the disease. These Vibrio cholerae strains, unlike the Asian strains (the pathogens of the seventh pandemic), may be virulent, by preserving the virulence genes in the genome; however, they are, in most cases, non-endemic and unable to spread widely.
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Mushayabasa, Steady, and Claver P. Bhunu. "Assessing the Impact of Increasing Antimicrobial Resistance of Vibrio cholerae on the Future Trends of Cholera Epidemic." ISRN Biomathematics 2012 (December 4, 2012): 1–10. http://dx.doi.org/10.5402/2012/127492.
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Cholera, an acute intestinal infection caused by the bacterium Vibrio cholerae, remains a major public health problem in many parts of Africa, Asia, and Latin America. A mathematical model is developed, to assess the impact of increasing antimicrobial resistance of Vibrio cholerae on the future trends of the cholera epidemic. Equilibrium states of the model are determined and their stabilities have been examined. The impacts of increasing antimicrobial resistance of Vibrio cholerae on the future trends of cholera epidemic have been investigated through the reproductive number. Numerical results are provided to support analytical findings.
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Savelieva, I. V., S. N. Tikhonov, V. N. Saveliev, D. A. Kovalev, S. V. Pisarenko, E. S. Kotenev, B. V. Babenyshev, L. S. Zinich, N. N. Pidchenko, and A. N. Kulichenko. "RETROSPECTIVE ANALYSIS OF BIOLOGICAL AND MOLECULAR-GENETIC PROPERTIES OF STRAINS - CAUSATIVE AGENTS OF CHOLERA - ISOLATED IN UKRAINE IN 1994 - 2011." Journal of microbiology epidemiology immunobiology, no. 1 (February 28, 2017): 49–55. http://dx.doi.org/10.36233/0372-9311-2017-1-49-55.
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Aim. Retrospective analysis of biological and molecular-genetic properties of strains - causative agents of cholera - isolated in the period of epidemics in Ukraine in 1994 - 2011. Materials and methods. Phenotypic and molecular-genetic properties of 5 strains of cholera vibrios, biovar El Tor isolated from cholera patients and 4 strains from the environmental samples were studied using traditional bacteriological and genetic methods. Detection of DNA for toxigenicity genes and genes characteristic for El Tor and classic biovar were carried out by PCR method using reagent kits «AmpliSens- Vibrio cholerae FRT» and «.Vibrio cholerae ctxB-rstR-rstC genes, REF» (an experimental test system). Sequencing of genomes of 4 strains of causative agents of cholera was carried out in genetic analyzer Ion Torrent Personal Genome Machine. Results. Strains of cholera vibrios identified in Ukraine in 1994 and 2011 such as a typical toxigenic biovar El Tor (V cholerae 01, El Tor, Ogawa, Hly-, ctxA+, tcpA+) contain genes of the classic cholera vibrio in their genome and are genetically altered (hybrid) variants of cholera vibrio biovar El Tor producing enterotoxin CT1 and having increased virulence, that was clinically manifested in predominance of severe forms of cholera in Mariupol of Donetsk region in 2011. Genome sequences of the 4 studied strains were deposited into the international database DDBJ/EMBL/GenBank. Conclusion. The studied isolates were established to belong to a clade of strains associated with cholera outbreaks in Haiti and Asian continent, from where genetically altered strains of cholera vibrios biovar El Tor were introduced to Haiti in 2010, based on results of comparison of genomic sequences of the studied strains with genomes of V. cholera strains from the international database GenBank.
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Jena, Pragnya, Abha Sharma, Shalini Duggal, Tanisha Bharara, and Renu Gur. "Antibiotic Susceptibility Profile of ‘Vibrio Cholerae O1 Biotype El Tor Serotype Ogawa’ Outbreak in North Delhi, India." Journal of Pediatric Infectious Diseases 13, no. 04 (August 8, 2018): 277–82. http://dx.doi.org/10.1055/s-0038-1661389.
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Background Cholera remains a public health issue, especially in developing countries. We report a cholera outbreak in North Delhi. Objective To report the causative agent of outbreak and to characterize, biotype, and analyze antimicrobial resistance pattern of V. cholerae isolated from cholera patients admitted to our hospital. The outbreak occurred from July 2016 to August 2016. Materials and Methods A total of 179 stool samples from pediatrics department were received and processed according to the current Clinical and Laboratory Standards Institute (CLSI) guidelines. Results Out of 179 stool samples received by the laboratory, 26 samples grew Vibrio cholerae O1 Biotype El Tor. Cefotaxime and ceftriaxone were the most sensitive drugs. All isolates were resistant to cotrimoxazole followed by tetracycline. Conclusion According to the World Health Organization (WHO), cholera is becoming endemic in Delhi. Emergence of multiple antibiotic-resistant cholera isolates is a concern. Prompt identification and notification of cholera are the key measures to avert cholera outbreak. Clean water supply and improved sanitation measures should be taken for prevention of cholera.
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Khan, Ashraful Islam, Md Mahbubur Rashid, Md Taufiqul Islam, Mokibul Hassan Afrad, M. Salimuzzaman, Sonia Tara Hegde, Md Mazharul I. Zion, et al. "Epidemiology of Cholera in Bangladesh: Findings From Nationwide Hospital-based Surveillance, 2014–2018." Clinical Infectious Diseases 71, no. 7 (December 31, 2019): 1635–42. http://dx.doi.org/10.1093/cid/ciz1075.
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Abstract Background Despite advances in prevention, detection, and treatment, cholera remains a major public health problem in Bangladesh and little is known about cholera outside of limited historical sentinel surveillance sites. In Bangladesh, a comprehensive national cholera control plan is essential, although national data are needed to better understand the magnitude and geographic distribution of cholera. Methods We conducted systematic hospital-based cholera surveillance among diarrhea patients in 22 sites throughout Bangladesh from 2014 to 2018. Stool specimens were collected and tested for Vibrio cholerae by microbiological culture. Participants’ socioeconomic status and clinical, sanitation, and food history were recorded. We used generalized estimating equations to identify the factors associated with cholera among diarrhea patients. Results Among 26 221 diarrhea patients enrolled, 6.2% (n = 1604) cases were V. cholerae O1. The proportion of diarrhea patients positive for cholera in children <5 years was 2.1% and in patients ≥5 years was 9.5%. The proportion of cholera in Dhaka and Chittagong Division was consistently high. We observed biannual seasonal peaks (pre- and postmonsoon) for cholera across the country, with higher cholera positivity during the postmonsoon in western regions and during the pre–monsoon season in eastern regions. Cholera risk increased with age, occupation, and recent history of diarrhea among household members. Conclusions Cholera occurs throughout a large part of Bangladesh. Cholera-prone areas should be prioritized to control the disease by implementation of targeted interventions. These findings can help strengthen the cholera-control program and serve as the basis for future studies for tracking the impact of cholera-control interventions in Bangladesh.
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KWAN, L. C., D. K. F. CHEUNG, and K. M. KAM. "Peak occurrences of ciguatera fish poisoning precede cholera outbreaks in Hong Kong." Epidemiology and Infection 131, no. 1 (August 2003): 621–26. http://dx.doi.org/10.1017/s0950268803008665.
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Occurrences of ciguatera fish poisoning (CFP) and Vibrio cholerae infected patients in Hong Kong were reviewed for the 13-year period 1989–2001. Peak activity of CFP preceded peak activity of cholera in nine of the years except in 4 years (1990, 1991, 1992, 1996) where it was observed that the total number of cholera cases were all less than or equal to five per year (P<0·05). Average time interval was 2·4 months between peaks of CFP and Vibrio cholerae outbreaks. Findings suggested that the factors that affect cholera and ciguatera occurrences may not be operating in some years but when they are operating, they will affect both cholera and CFP. CFP peaks have consistently occurred before Vibrio cholerae peaks in our locality so much so that the occurrence of the latter can now be almost accurately predicted since 1998. CFP peaks served as an early warning for public measures to be in place before occurrence of cholera outbreaks.
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de Magny, Guillaume Constantin, Pronob K. Mozumder, Christopher J. Grim, Nur A. Hasan, M. Niamul Naser, Munirul Alam, R. Bradley Sack, Anwar Huq, and Rita R. Colwell. "Role of Zooplankton Diversity in Vibrio cholerae Population Dynamics and in the Incidence of Cholera in the Bangladesh Sundarbans." Applied and Environmental Microbiology 77, no. 17 (July 15, 2011): 6125–32. http://dx.doi.org/10.1128/aem.01472-10.
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ABSTRACTVibrio cholerae, a bacterium autochthonous to the aquatic environment, is the causative agent of cholera, a severe watery, life-threatening diarrheal disease occurring predominantly in developing countries.V. cholerae, including both serogroups O1 and O139, is found in association with crustacean zooplankton, mainly copepods, and notably in ponds, rivers, and estuarine systems globally. The incidence of cholera and occurrence of pathogenicV. choleraestrains with zooplankton were studied in two areas of Bangladesh: Bakerganj and Mathbaria. Chitinous zooplankton communities of several bodies of water were analyzed in order to understand the interaction of the zooplankton population composition with the population dynamics of pathogenicV. choleraeand incidence of cholera. Two dominant zooplankton groups were found to be consistently associated with detection ofV. choleraeand/or occurrence of cholera cases, namely, rotifers and cladocerans, in addition to copepods. Local differences indicate there are subtle ecological factors that can influence interactions betweenV. cholerae, its plankton hosts, and the incidence of cholera.
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Naser, Iftekhar Bin, Tushar Ahmed Shishir, Shah Nayeem Faruque, M. Mozammel Hoque, Anamul Hasan, and Shah M. Faruque. "Environmental prevalence of toxigenic Vibrio cholerae O1 in Bangladesh coincides with V. cholerae non-O1 non-O139 genetic variants which overproduce autoinducer-2." PLOS ONE 16, no. 7 (July 2, 2021): e0254068. http://dx.doi.org/10.1371/journal.pone.0254068.
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Prevalence of toxigenic Vibrio cholerae O1 in aquatic reservoirs in Bangladesh apparently increases coinciding with the occurrence of seasonal cholera epidemics. In between epidemics, these bacteria persist in water mostly as dormant cells, known as viable but non-culturable cells (VBNC), or conditionally viable environmental cells (CVEC), that fail to grow in routine culture. CVEC resuscitate to active cells when enriched in culture medium supplemented with quorum sensing autoinducers CAI-1 or AI-2 which are signal molecules that regulate gene expression dependent on cell density. V. cholerae O1 mutant strains with inactivated cqsS gene encoding the CAI-1 receptor has been shown to overproduce AI-2 that enhance CVEC resuscitation in water samples. Since V. cholerae non-O1 non-O139 (non-cholera-vibrios) are abundant in aquatic ecosystems, we identified and characterized naturally occurring variant strains of V. cholerae non-O1 non-O139 which overproduce AI-2, and monitored their co-occurrence with V. cholerae O1 in water samples. The nucleotide sequence and predicted protein products of the cqsS gene carried by AI-2 overproducing variant strains showed divergence from that of typical V. cholerae O1 or non-O1 strains, and their culture supernatants enhanced resuscitation of CVEC in water samples. Furthermore, prevalence of V. cholerae O1 in the aquatic environment was found to coincide with an increase in AI-2 overproducing non-O1 non-O139 strains. These results suggest a possible role of non-cholera vibrios in the environmental biology of the cholera pathogen, in which non-O1 non-O139 variant strains overproducing AI-2 presumably contribute in resuscitation of the latent pathogen, leading to seasonal cholera epidemics. Importance. Toxigenic Vibrio cholerae which causes seasonal epidemics of cholera persists in aquatic reservoirs in endemic areas. The bacteria mostly exist in a dormant state during inter-epidemic periods, but periodically resuscitate to the active form. The resuscitation is enhanced by signal molecules called autoinducers (AIs). Toxigenic V. cholerae can be recovered from water samples that normally test negative for the organism in conventional culture, by supplementing the culture medium with exogenous AIs. V. cholerae belonging to the non-O1 non-O139 serogroups which do not cause cholera are also abundant in natural waters, and they are capable of producing AIs. In this study we characterized V. cholerae non-O1 non-O139 variant strains which overproduce an autoinducer called AI-2, and found that the abundance of the cholera pathogen in aquatic reservoirs correlates with an increase in the AI-2 overproducing strains. Our results suggest a probable role of these variant strains in the environmental biology and epidemiology of toxigenic V. cholerae, and may lead to novel means for surveillance, prevention and control of cholera.
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Domman, Daryl, Marie-Laure Quilici, Matthew J. Dorman, Elisabeth Njamkepo, Ankur Mutreja, Alison E. Mather, Gabriella Delgado, et al. "Integrated view of Vibrio cholerae in the Americas." Science 358, no. 6364 (November 9, 2017): 789–93. http://dx.doi.org/10.1126/science.aao2136.
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Latin America has experienced two of the largest cholera epidemics in modern history; one in 1991 and the other in 2010. However, confusion still surrounds the relationships between globally circulating pandemic Vibrio cholerae clones and local bacterial populations. We used whole-genome sequencing to characterize cholera across the Americas over a 40-year time span. We found that both epidemics were the result of intercontinental introductions of seventh pandemic El Tor V. cholerae and that at least seven lineages local to the Americas are associated with disease that differs epidemiologically from epidemic cholera. Our results consolidate historical accounts of pandemic cholera with data to show the importance of local lineages, presenting an integrated view of cholera that is important to the design of future disease control strategies.
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Hsueh, Brian Y., and Christopher M. Waters. "Combating Cholera." F1000Research 8 (April 30, 2019): 589. http://dx.doi.org/10.12688/f1000research.18093.1.
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Cholera infections caused by the gamma-proteobacterium Vibrio cholerae have ravaged human populations for centuries, and cholera pandemics have afflicted every corner of the globe. Fortunately, interventions such as oral rehydration therapy, antibiotics/antimicrobials, and vaccines have saved countless people afflicted with cholera, and new interventions such as probiotics and phage therapy are being developed as promising approaches to treat even more cholera infections. Although current therapies are mostly effective and can reduce disease transmission, cholera outbreaks remain deadly, as was seen during recent outbreaks in Haiti, Ethiopia, and Yemen. This is due to significant underlying political and socioeconomic complications, including shortages of vaccines and clean food and water and a lack of health surveillance. In this review, we highlight the strengths and weaknesses of current cholera therapies, discuss emerging technologies, and argue that a multi-pronged, flexible approach is needed to continue to reduce the worldwide burden of cholera.
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Ramamurthy, Thandavarayan, and Amit Ghosh. "A Re-Look at Cholera Pandemics from Early Times to Now in the Current Era of Epidemiology." Journal of Disaster Research 16, no. 1 (January 30, 2021): 110–17. http://dx.doi.org/10.20965/jdr.2021.p0110.
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Cholera affects about three million people annually and kills several thousands. Since 1817 seven cholera pandemics have been described. While the nature of the strains responsible for the first four pandemics are not known, the fifth and sixth pandemics are associated with Vibrio cholerae O1 classical biotype. In the 1960s, V. cholerae El Tor replaced classical strains worldwide, ushering in the seventh pandemic. El Tor cholera is typified with less severe diarrhea, a lower case fatality rate and a higher percentage of asymptomatic cases. Historically, the Indian subcontinent was thought to be the homeland where cholera originated and has been implicated in spreading of the disease. Cholera broke out in Africa and now seems to be continuous and recurrent, leading to high morbidity and mortality in some countries. Current conflicts in the Middle East have been associated with the breakdown of healthcare systems and the emergence of cholera there in a big way. Several discoveries in the past two centuries helped us to understand and manage the disease. Some of the greatest inventions such as rehydration therapy have saved the lives of countless people afflicted with cholera. Whole genome sequencing of V. cholerae and the modern molecular epidemiology of cholera have led to advancements in understanding of the disease and also how the organism has persisted and re-emerged in new areas during the seventh pandemic. Currently, water, sanitation, and hygiene along with the new generation oral cholera vaccines are considered as important interventions and beneficial public health tools in cholera endemic countries and in areas at risk for outbreaks. This review highlights the pandemics that lead to important discoveries and also the new molecular approach in understanding the epidemiology of cholera.
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Alam, Munirul, Nur A. Hasan, Abdus Sadique, N. A. Bhuiyan, Kabir U. Ahmed, Suraia Nusrin, G. Balakrish Nair, et al. "Seasonal Cholera Caused by Vibrio cholerae Serogroups O1 and O139 in the Coastal Aquatic Environment of Bangladesh." Applied and Environmental Microbiology 72, no. 6 (June 2006): 4096–104. http://dx.doi.org/10.1128/aem.00066-06.
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ABSTRACT Since Vibrio cholerae O139 first appeared in 1992, both O1 El Tor and O139 have been recognized as the epidemic serogroups, although their geographic distribution, endemicity, and reservoir are not fully understood. To address this lack of information, a study of the epidemiology and ecology of V. cholerae O1 and O139 was carried out in two coastal areas, Bakerganj and Mathbaria, Bangladesh, where cholera occurs seasonally. The results of a biweekly clinical study (January 2004 to May 2005), employing culture methods, and of an ecological study (monthly in Bakerganj and biweekly in Mathbaria from March 2004 to May 2005), employing direct and enrichment culture, colony blot hybridization, and direct fluorescent-antibody methods, showed that cholera is endemic in both Bakerganj and Mathbaria and that V. cholerae O1, O139, and non-O1/non-O139 are autochthonous to the aquatic environment. Although V. cholerae O1 and O139 were isolated from both areas, most noteworthy was the isolation of V. cholerae O139 in March, July, and September 2004 in Mathbaria, where seasonal cholera was clinically linked only to V. cholerae O1. In Mathbaria, V. cholerae O139 emerged as the sole cause of a significant outbreak of cholera in March 2005. V. cholerae O1 reemerged clinically in April 2005 and established dominance over V. cholerae O139, continuing to cause cholera in Mathbaria. In conclusion, the epidemic potential and coastal aquatic reservoir for V. cholerae O139 have been demonstrated. Based on the results of this study, the coastal ecosystem of the Bay of Bengal is concluded to be a significant reservoir for the epidemic serogroups of V. cholerae.
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Huq, Anwar, R. Bradley Sack, Azhar Nizam, Ira M. Longini, G. Balakrish Nair, Afsar Ali, J. Glenn Morris, et al. "Critical Factors Influencing the Occurrence of Vibrio cholerae in the Environment of Bangladesh." Applied and Environmental Microbiology 71, no. 8 (August 2005): 4645–54. http://dx.doi.org/10.1128/aem.71.8.4645-4654.2005.
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ABSTRACT The occurrence of outbreaks of cholera in Africa in 1970 and in Latin America in 1991, mainly in coastal communities, and the appearance of the new serotype Vibrio cholerae O139 in India and subsequently in Bangladesh have stimulated efforts to understand environmental factors influencing the growth and geographic distribution of epidemic Vibrio cholerae serotypes. Because of the severity of recent epidemics, cholera is now being considered by some infectious disease investigators as a “reemerging” disease, prompting new work on the ecology of vibrios. Epidemiological and ecological surveillance for cholera has been under way in four rural, geographically separated locations in Bangladesh for the past 4 years, during which both clinical and environmental samples were collected at biweekly intervals. The clinical epidemiology portion of the research has been published (Sack et al., J. Infect. Dis. 187:96-101, 2003). The results of environmental sampling and analysis of the environmental and clinical data have revealed significant correlations of water temperature, water depth, rainfall, conductivity, and copepod counts with the occurrence of cholera toxin-producing bacteria (presumably V. cholerae). The lag periods between increases or decreases in units of factors, such as temperature and salinity, and occurrence of cholera correlate with biological parameters, e.g., plankton population blooms. The new information on the ecology of V. cholerae is proving useful in developing environmental models for the prediction of cholera epidemics.
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Dorman, Matthew J., Leanne Kane, Daryl Domman, Jake D. Turnbull, Claire Cormie, Mohammed-Abbas Fazal, David A. Goulding, Julie E. Russell, Sarah Alexander, and Nicholas R. Thomson. "The history, genome and biology of NCTC 30: a non-pandemic Vibrio cholerae isolate from World War One." Proceedings of the Royal Society B: Biological Sciences 286, no. 1900 (April 10, 2019): 20182025. http://dx.doi.org/10.1098/rspb.2018.2025.
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The sixth global cholera pandemic lasted from 1899 to 1923. However, despite widespread fear of the disease and of its negative effects on troop morale, very few soldiers in the British Expeditionary Forces contracted cholera between 1914 and 1918. Here, we have revived and sequenced the genome of NCTC 30, a 102-year-old Vibrio cholerae isolate, which we believe is the oldest publicly available live V. cholerae strain in existence. NCTC 30 was isolated in 1916 from a British soldier convalescent in Egypt. We found that this strain does not encode cholera toxin, thought to be necessary to cause cholera, and is not part of V. cholerae lineages responsible for the pandemic disease. We also show that NCTC 30, which predates the introduction of penicillin-based antibiotics, harbours a functional β-lactamase antibiotic resistance gene. Our data corroborate and provide molecular explanations for previous phenotypic studies of NCTC 30 and provide a new high-quality genome sequence for historical, non-pandemic V. cholerae .
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Das, Prasenjit, and Debasis Mukherjee. "Qualitative Analysis of a Cholera Bacteriophage Model." ISRN Biomathematics 2012 (May 8, 2012): 1–13. http://dx.doi.org/10.5402/2012/621939.
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Cholera still remains as a severe global threat and is currently spreading in Africa and other parts of the world. The role of lytic bacteriophage as an intervention of cholera outbreaks is investigated using a mathematical model. Dynamics of cholera is discussed on basis of the basic reproduction number . Conditions of Hopf bifurcation are also derived for a positive net growth rate of Vibrio cholerae. Stability analysis and numerical simulations suggest that bacteriophage may contribute to lessening the severity of cholera epidemics by reducing the number of Vibrio cholerae in the environment. Hence with the presence of phage virus, cholera is self-limiting in nature. By using phage as a biological control agent in endemic areas, one may also influence the temporal dynamics of cholera epidemics while reducing the excessive use of chemicals. We also performed stochastic analysis which suggests that the model system is globally asymptotically stable in probability when the strengths of white noise are less than some specific quantities.
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Savelieva, I. V., A. N. Kulichenko, V. N. Saveliev, D. A. Kovalev, O. V. Vasilieva, A. M. Zhirov, E. I. Eremenko, et al. "MLVA-TYPING OF CLINICAL STAMPS OF GENETICALLY CHANGED VIBRIO CHOLERAE BIOTYPE EL TOR INSULATED IN RUSSIA AND UKRAINE IN THE PERIOD OF SEVENTH PANDEMIC CHOLERA." Journal of microbiology epidemiology immunobiology, no. 6 (December 28, 2018): 37–43. http://dx.doi.org/10.36233/0372-9311-2018-6-37-43.
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Aim. Conduct in a comparative aspect MLVA-typing of genetically altered cholera vibrio biovar El Tor, isolated from patients during the epidemic (1994) and outbreaks (1993, 1998) in Dagestan with isolates in Mariupol (Ukraine) in 1994-2011 in Moscow (2010, 2012), India (1964, 2006, 2007), Bangladesh 1991, 1994, 2001, 2004) and to establish Phylogenetic connections between strains of cholera vibrios isolated in different years in these territories, to ascertain the source of their drift. Materials and methods. MLVA-tyP-ing was carried out in PCR at 5 variable loci of 35 clinical strains of genetically modified Vibrio cholerae byotyPe El Tor. The obtained amPlicon was studied in the system of automatic caPillary electroPhoresis ExPerion («Bio Rad Laboratories», USA). For Phylogenetic analysis, along with MLVA-genotyPes, 35 strains of Vibrio cholerae from the Institute's collection used Published genotyPes of strains isolated in India, Bangladesh, Haiti. Results. The investigated strains of cholera vibrio are referred to 21 MLVA-tyPes, divided into 2 main clades and 1 seParate branch with clonal clusters and subclusters, each of which contains closely related strains of cholera vibrio genovariants having a different degree of Phylogenetic relationshiP - full or Partial identity of allelic Profiles of five variable loci. The sources of drift of genetically modified Vibrio cholerae byotyPe El Tor to Russia and Ukraine from disadvantaged cholera of India, Bangladesh, Azerbaijan and the countries of the Middle East have been established. Conclusion. The obtained data testify to the PolymorPhism of MLVA-tyPes of genetically altered strains of cholera vibrio of the biologist El Tor, evolved in different years and caused ePidemics or outbreaks of cholera in different territories during different time Periods of the course of the seventh cholera Pandemic, and also suggest the Polyclonal origin of the Vibrio cholerae biovar El Tor and the source of their drift to the territory of the Russian Federation and Ukraine.
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Ha, Thi Quyen. "Analysis of gene encoding haemolysin A of Vibrio cholerae isolated in Vietnam." Journal of Vietnamese Environment 9, no. 4 (August 8, 2018): 202–6. http://dx.doi.org/10.13141/jve.vol9.no4.pp202-206.
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Vibrio cholerae is the cholera causing agent, divided into two biotypes, including the classical biotype and ElTor biotype. Both of these biotypes caused cholera epidemics in the world. The classical biotype caused 6th cholera pandemic (from 1921 to 1961), and ElTor biotype caused 7th cholera pandemic (from 1961 to the 70s). Haemolysin A, a hemolytic protein of V. cholerae ElT or biotype, is encoded by the hlyA gene. This gene is often used for analyzing genetic relationship between strains in the same species or between species in the same Vibrio genus. Results of analyzing nucleotide and amino acid sequences of hlyA gene of V. cholerae strain causing cholera in Vietnam (named hlyA.VN) showed that: the hlyA.VN gene sequence was similar to the hlyA gene sequences of V. cholerae strains of the 6th and 7th cholera epidemics. The hlyA gene of the 6th cholera epidemic strain was deficient in 11 nuleotides (this deficiency leading to the loss of 4 amino acids in the haemolysin A protein) comparing to hlyA.VN gene and hlyA gene of the 7th cholera epidemic strain. The results of genetic distance analysis as well as phylogenetic tree construction also confirmed V. cholerae causing cholera in Vietnam was closely relationship to the strains causing cholera pandemics in the world. It is great significance for the surveillance of molecular epidemiology to prevent cholera effectively.
Vibrio cholerae là tác nhân gây bệnh tả, được chia thành hai typ sinh học, đó là typ sinh học cổ điển và typ sinh học ElTor. Cả hai typ này đã từng gây ra các đại dịch tả trên thế giới. Typ sinh học cổ điển đã từng gây ra đại dịch tả lần thứ 6 (từ năm 1921 đến 1961), còn typ sinh học ElTor đã từng gây ra đại dịch tả lần thứ 7 (từ 1961 đến những năm 70). Haemolysin A, một protein có chức năng làm tan máu của V. cholerae typ sinh học ElTor, được mã hóa bởi gen hlyA. Gene này thường được sử dụng cho các phân tích quan hệ di truyền giữa các chủng trong cùng một loài V. cholerae hay giữa các loài trong cùng một chi Vibrio. Kết quả phân tích trình tự nucleotide và axit amin gen hlyA của chủng V. cholerae gâybệnh ở Việt Nam (hlyA.VN) cho thấy: trình tự gen hlyA.VN có sự tương đồng lớn với trình tự gen hlyA của chủng gây đại dịch tả 6 và 7. Gen hlyA của chủng gây đại dịch tả 6 bị thiếu hụt 11 nuleotide (sự thiếu hụt này dẫn tới sự mất đi 4 axit amin trong phân tử haemolysin A) so với gen hlyA.VN và gene hlyA của chủng gây đại dịch tả 7. Kết quả phân tích khoảng cách di truyền cũng như xây dựng cây phát sinh chủng loại cũng đã khẳng định: chủng gây bệnh ở Việt Nam có quan hệ rất gần với các chủng gây đại dịch tả trên thế giới. Nhận định này có ý nghĩa rất lớn đối với công tác giám sát dịch tễ học phân tử để ngăn chặn bệnh tả hiệu quả.
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Kitaoka, Maya, Sarah T. Miyata, Daniel Unterweger, and Stefan Pukatzki. "Antibiotic resistance mechanisms of Vibrio cholerae." Journal of Medical Microbiology 60, no. 4 (April 1, 2011): 397–407. http://dx.doi.org/10.1099/jmm.0.023051-0.
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As the causative agent of cholera, the bacterium Vibrio cholerae represents an enormous public health burden, especially in developing countries around the world. Cholera is a self-limiting illness; however, antibiotics are commonly administered as part of the treatment regimen. Here we review the initial identification and subsequent evolution of antibiotic-resistant strains of V. cholerae. Antibiotic resistance mechanisms, including efflux pumps, spontaneous chromosomal mutation, conjugative plasmids, SXT elements and integrons, are also discussed. Numerous multidrug-resistant strains of V. cholerae have been isolated from both clinical and environmental settings, indicating that antibiotic use has to be restricted and alternative methods for treating cholera have to be implemented.
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Laviad-Shitrit, Sivan, Rotem Sela, Leena Thorat, Yehonatan Sharaby, Ido Izhaki, Bimalendu B. Nath, and Malka Halpern. "Identification of chironomid species as natural reservoirs of toxigenic Vibrio cholerae strains with pandemic potential." PLOS Neglected Tropical Diseases 14, no. 12 (December 23, 2020): e0008959. http://dx.doi.org/10.1371/journal.pntd.0008959.
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Vibrio cholerae causes the fatal cholera diarrhea. Chironomids (Diptera; Chironomidae) are abundant in freshwater aquatic habitats and estuaries and are natural reservoirs of V. cholerae. Until now, only the non-O1/O139 serogroups of V. cholerae were identified in chironomids. Here, we explored whether chironomids are natural reservoirs of V. cholerae O1/O139 serogroups, which are associated with cholera endemics and pandemics. All four life stages of chironomids were sampled from two rivers, and a laboratory culture in Pune, India, and from a pond in Israel. In total, we analyzed 223 chironomid samples. The presence of V. cholerae O1/O139 serogroups was verified using molecular tools. Nine chironomid species were identified; of them, Chironomus circumdatus was the most abundant. The presence of V. cholerae serogroup O1 and the cholera toxin genes were detected in samples from all chironomid species. However, serogroup O139 was detected in only two chironomid species. Besides PCR to detect specific genes, a metagenomic analysis that was performed in three selected C. ramosus larvae, identified a list of virulence genes associated with V. cholerae. The findings provide evidence that chironomids are natural reservoirs of toxigenic V. cholerae O1/O139. Chironomid populations and V. cholerae show biannual peak patterns. A similar pattern is found for cholera epidemics in the Bengal Delta region. Thus, we hypothesize that monitoring chironomids in endemic areas of the disease may provide a novel tool for predicting and preventing cholera epidemics. Moreover, serogroup O139 was detected only in two chironomid species that have a restricted distribution in the Indian subcontinent, possibly explaining why the distribution of the O139 serogroup is limited.
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Bartnikowska-Biernat, Magdalena. "Wirus nieszczęścia. Plagi i choroby domu Lenartowiczów w dobie epidemii cholery w XIX-wiecznej Europie." Konteksty Kultury 17, no. 3 (2020): 273–82. http://dx.doi.org/10.4467/23531991kk.20.022.13136.
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Epidemia cholery, mająca swoje źródło w Dolinie Gangesu, dotarła do Europy w latach trzydziestych XIX wieku, by nawiedzać ją regularnie do końca stulecia. Zaraza dziesiątkowała ludzkość i spędzała sen z oczu medykom, jednak – co zaskakujące – nie zachowało się wiele relacji z epoki na temat epidemii. Jedną z nich można znaleźć w korespondencji Zofii z Szymanowskich Lenartowiczowej, podróżującej z mężem po Europie w 1865 roku, podczas kolejnego wybuchu cholery. Lata sześćdziesiąte XIX wieku były okresem wyjątkowo trudnym dla Zofii i Teofila Lenartowiczów. Pierwszą przyczyną zmartwień małżonków była ustawiczna bieda, potęgująca cierpienia wynikające z chorób, które nękały oboje. W obliczu tych nieszczęść zagrożenie cholerą nie stanowiło największego zmartwienia Lenartowiczów, co znajduje odzwierciedlenie w omawianych listach. The Misery Virus: Plagues and Diseases in the Lenartowicz Family during the 19th-Century Cholera Epidemic in Europe The cholera epidemic originating from the Ganges Valley reached Europe in the 1830s, only to plague the continent in successive bouts until the end of the century. The disease decimated the population and harrowed European physicians, though – surprisingly – not many contemporary sources describing the epidemic have been preserved. One of the few surviving accounts can be found in the letters of Zofia Lenartowicz née Szymanowska, who was travelling around Europe with her husband during the 1865 cholera outbreak. The 1860s were a particularly difficult period for Zofia and Teofil Lenartowicz. Their distress stemmed from their chronic destitution, which in turn exacerbated the suffering caused by the medical maladies experienced by both spouses. In view of this overall misery, the threat of cholera was far from the greatest worry of the Lenartowicz couple, which found a clear reflection in the content of the letters discussed in the present paper.
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Constantin de Magny, Guillaume, Raghu Murtugudde, Mathew R. P. Sapiano, Azhar Nizam, Christopher W. Brown, Antonio J. Busalacchi, Mohammad Yunus, et al. "Environmental signatures associated with cholera epidemics." Proceedings of the National Academy of Sciences 105, no. 46 (November 10, 2008): 17676–81. http://dx.doi.org/10.1073/pnas.0809654105.
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The causative agent of cholera, Vibrio cholerae, has been shown to be autochthonous to riverine, estuarine, and coastal waters along with its host, the copepod, a significant member of the zooplankton community. Temperature, salinity, rainfall and plankton have proven to be important factors in the ecology of V. cholerae, influencing the transmission of the disease in those regions of the world where the human population relies on untreated water as a source of drinking water. In this study, the pattern of cholera outbreaks during 1998–2006 in Kolkata, India, and Matlab, Bangladesh, and the earth observation data were analyzed with the objective of developing a prediction model for cholera. Satellite sensors were used to measure chlorophyll a concentration (CHL) and sea surface temperature (SST). In addition, rainfall data were obtained from both satellite and in situ gauge measurements. From the analyses, a statistically significant relationship between the time series for cholera in Kolkata, India, and CHL and rainfall anomalies was determined. A statistically significant one month lag was observed between CHL anomaly and number of cholera cases in Matlab, Bangladesh. From the results of the study, it is concluded that ocean and climate patterns are useful predictors of cholera epidemics, with the dynamics of endemic cholera being related to climate and/or changes in the aquatic ecosystem. When the ecology of V. cholerae is considered in predictive models, a robust early warning system for cholera in endemic regions of the world can be developed for public health planning and decision making.
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CLARK, C. G., A. N. KRAVETZ, V. V. ALEKSEENKO, YU D. KRENDELEV, and W. M. JOHNSON. "Microbiological and epidemiological investigation of cholera epidemic in Ukraine during 1994 and 1995." Epidemiology and Infection 121, no. 1 (August 1998): 1–13. http://dx.doi.org/10.1017/s0950268898008711.
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The Ukraine cholera epidemic of 1994 and 1995 was caused by Vibrio cholerae O1, serotype Ogawa, biotype El Tor. This epidemic was centred in the area around Respublika Krim (Crimea) and Mykolajiv, and spread to include parts of southern Ukraine. Cases of cholera occurred between September and November of 1994 and between June and October of 1995. The 32 fatalities among 1370 recorded cases (case fatality ratio, 2·3%) occurred throughout the course of the epidemic. V. cholerae from patients with cholera produced cholera toxin and were resistant to multiple antibiotics, though no resistance plasmids were found. Conjugation experiments suggested that resistance to multiple antibiotics may be present on a self-transmissible genetic element. Environmental sources of V. cholerae O1 El Tor included sewage, sea and surface water, and fresh water and marine fish. All but one of the environmental V. cholerae isolated during the epidemic were very similar to selected isolates from patients at the same time, supporting the role of these environmental sources in the spread of disease.
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Usmani, Moiz, Kyle D. Brumfield, Yusuf Jamal, Anwar Huq, Rita R. Colwell, and Antarpreet Jutla. "A Review of the Environmental Trigger and Transmission Components for Prediction of Cholera." Tropical Medicine and Infectious Disease 6, no. 3 (August 5, 2021): 147. http://dx.doi.org/10.3390/tropicalmed6030147.
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Climate variables influence the occurrence, growth, and distribution of Vibrio cholerae in the aquatic environment. Together with socio-economic factors, these variables affect the incidence and intensity of cholera outbreaks. The current pandemic of cholera began in the 1960s, and millions of cholera cases are reported each year globally. Hence, cholera remains a significant health challenge, notably where human vulnerability intersects with changes in hydrological and environmental processes. Cholera outbreaks may be epidemic or endemic, the mode of which is governed by trigger and transmission components that control the outbreak and spread of the disease, respectively. Traditional cholera risk assessment models, namely compartmental susceptible-exposed-infected-recovered (SEIR) type models, have been used to determine the predictive spread of cholera through the fecal–oral route in human populations. However, these models often fail to capture modes of infection via indirect routes, such as pathogen movement in the environment and heterogeneities relevant to disease transmission. Conversely, other models that rely solely on variability of selected environmental factors (i.e., examine only triggers) have accomplished real-time outbreak prediction but fail to capture the transmission of cholera within impacted populations. Since the mode of cholera outbreaks can transition from epidemic to endemic, a comprehensive transmission model is needed to achieve timely and reliable prediction with respect to quantitative environmental risk. Here, we discuss progression of the trigger module associated with both epidemic and endemic cholera, in the context of the autochthonous aquatic nature of the causative agent of cholera, V. cholerae, as well as disease prediction.
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Kale, Swati S., Pragati A. Bulle, Durgesh G. Deshmukh, Supriya S. Tankhiwale, and Vivek M. Gujar. "An outbreak of diarrhoeal disease of El Tor Vibrio cholerae O1 Ogawa in and around Yavatmal district, Maharashtra, India in 2018." International Journal Of Community Medicine And Public Health 7, no. 4 (March 26, 2020): 1297. http://dx.doi.org/10.18203/2394-6040.ijcmph20201032.
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Background: Epidemics of cholera have been reported from various parts of India. We investigated the epidemic of cholera that occurred in and around Yavatmal district in Maharashtra, India 2018, reported during March to July.Methods: 711 stool samples collected from diarrhea patients were bacteriologically analyzed for their identification and antibiogram of Vibrio cholera.Results: The cholera outbreak was caused by V. cholerae O1 Ogawa biotype El Tor. All the V. cholerae isolates from the stool samples were sensitive to tetracycline, doxycycline, ofloxacin, ciprofloxacin gentamycin, cotrimoxazole and resistant to ampicillin and ceftazidime.Conclusions: The present outbreak was due to V. cholerae O1 Ogawa El Tor which seems to have completely replaced O139 serogroup of the previous outbreaks during the last decade.
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Kelvin, Alyson Ann. "Outbreak of Cholera in the Republic of Congo and the Democratic Republic of Congo and the global picture." Journal of Infection in Developing Countries 5, no. 10 (September 14, 2011): 688–91. http://dx.doi.org/10.3855/jidc.2246.
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Cholera is an acute intestinal disease caused by infection of the Vibrio cholerae bacterium. Often manifested as a constant diarrhoeal disease, Cholera is associated with significant mortality as well as economic loss due to the strain on health care. Cholera often affects nations with lower economic status. The recent outbreak of cholera in the Republic of Congo and the Democratic Republic of Congo has affected thousands of people. Here we review the past cholera epidemiology, molecular mechanisms of the bacterium, and the political and environmental aspects that affect the treatment and eradication of this disease.
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Harris, Aaron M., M. Saruar Bhuiyan, Fahima Chowdhury, Ashraful I. Khan, Azim Hossain, Emily A. Kendall, Atiqur Rahman, et al. "Antigen-Specific Memory B-Cell Responses to Vibrio cholerae O1 Infection in Bangladesh." Infection and Immunity 77, no. 9 (June 15, 2009): 3850–56. http://dx.doi.org/10.1128/iai.00369-09.
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ABSTRACT Cholera, caused by Vibrio cholerae, is a noninvasive dehydrating enteric disease with a high mortality rate if untreated. Infection with V. cholerae elicits long-term protection against subsequent disease in countries where the disease is endemic. Although the mechanism of this protective immunity is unknown, it has been hypothesized that a protective mucosal response to V. cholerae infection may be mediated by anamnestic responses of memory B cells in the gut-associated lymphoid tissue. To characterize memory B-cell responses to cholera, we enrolled a cohort of 39 hospitalized patients with culture-confirmed cholera and evaluated their immunologic responses at frequent intervals over the subsequent 1 year. Memory B cells to cholera antigens, including lipopolysaccharide (LPS), and the protein antigens cholera toxin B subunit (CTB) and toxin-coregulated pilus major subunit A (TcpA) were enumerated using a method of polyclonal stimulation of peripheral blood mononuclear cells followed by a standard enzyme-linked immunospot procedure. All patients demonstrated CTB, TcpA, and LPS-specific immunoglobulin G (IgG)and IgA memory responses by day 90. In addition, these memory B-cell responses persisted up to 1 year, substantially longer than other traditional immunologic markers of infection with V. cholerae. While the magnitude of the LPS-specific IgG memory B-cell response waned at 1 year, CTB- and TcpA-specific IgG memory B cells remained significantly elevated at 1 year after infection, suggesting that T-cell help may result in a more durable memory B-cell response to V. cholerae protein antigens. Such memory B cells could mediate anamnestic responses on reexposure to V. cholerae.
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Ritter, Alaina, Fahima Chowdhury, Rachel Becker, Taufiq Bhuiyan, Ashraful Khan, Edward T. Ryan, Stephen B. Calderwood, et al. "1105. Vibriocidal Titer Variation and Likelihood of Protection in Children Compared With Adults in a Cholera Endemic Area." Open Forum Infectious Diseases 5, suppl_1 (November 2018): S331. http://dx.doi.org/10.1093/ofid/ofy210.939.
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Abstract Background Vibrio cholerae, the causative agent of cholera, is responsible for significant morbidity and mortality worldwide. Children less than 5 years old have the highest disease burden of cholera in endemic areas. While children develop serum vibriocidal antibody responses to cholera vaccines, they derive less protection from vaccination compared with adults. The aim of our study was to determine whether the vibriocidal immune responses to V. cholerae infection are equally accurate as markers of protection in all age groups. Methods Cholera patients and their household contacts, who are known to be at high risk of V. cholerae infection, were enrolled between 2001 and 2017 in Dhaka, Bangladesh. Baseline vibriocidal titers were measured at the time of enrollment of household contacts, and participants were followed prospectively for development of V. cholerae infection. Results We studied 50 contacts < 5 years old (“young children”), 228 contacts 5–16 years old (“older children”), and 548 contacts > 16 years old (“adults”). The baseline serum vibriocidal titer was higher in contacts who remained uninfected from all age groups than in contacts who developed cholera during the follow-up period (young children: P = 0.0092; older children: P = 0.0003, adults: P = 0.0012). Conclusion We found that higher vibriocidal antibody titers were associated with protection against V. cholerae infection across all three age categories. These findings may help increase our understanding of the protective immune response against V. cholerae infection and have importance for future vaccine development strategies. Acknowledgments: This research was supported by Massachusetts General Hospital training grant T32AI007061. Disclosures All authors: No reported disclosures.
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Gabutti, Giovanni, Andrea Rossanese, Alberto Tomasi, Sandro Giuffrida, Vincenzo Nicosia, Juan Barriga, Caterina Florescu, Federica Sandri, and Armando Stefanati. "Cholera, the Current Status of Cholera Vaccines and Recommendations for Travellers." Vaccines 8, no. 4 (October 14, 2020): 606. http://dx.doi.org/10.3390/vaccines8040606.
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Cholera is endemic in approximately 50 countries, primarily in Africa and South and Southeast Asia, and in these areas, it remains a disease associated with poverty. In developed nations, cholera is rare, and cases are typically imported from endemic areas by returning travellers. Cholera is readily preventable with the tools available to modern medicine. In developing nations, cholera transmission can be prevented through improved water, sanitation, and hygiene services and the use of oral cholera vaccines (OCVs). For travellers, risk can be mitigated by practicing regular hand hygiene and consuming food and water from safe sources. OCVs should be considered for high-risk travellers likely to be exposed to cholera patients or contaminated water and food. There are currently three World Health Organization pre-qualified OCVs, which are based on killed whole-cell strains of Vibrio cholerae. These established vaccines offer significant protection in adults and children for up to 2 years. A novel live attenuated vaccine that provides rapid-onset protection in adults and children is licensed in the USA and Europe only. Live attenuated OCVs may mimic the natural infection of V. cholerae more closely, generating rapid immune responses without the need for repeat dosing. These potential benefits have prompted the ongoing development of several additional live attenuated vaccines. The objective of this article is to provide a general review of the current landscape of OCVs, including a discussion of their appropriate use in international travellers.
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Das, Bhabatosh. "1113. Real-Time Evolution of Extensively Drug-Resistant Vibrio cholerae." Open Forum Infectious Diseases 5, suppl_1 (November 2018): S334. http://dx.doi.org/10.1093/ofid/ofy210.946.
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Abstract Background Bay of Bengal is known as the epicenter of a number of distinct waves of global transmission of cholera. Vibrio cholerae, the etiological agent of acute diarrhoeal disease cholera, has extraordinary competency to acquire exogenous DNA by horizontal gene transfer (HGT) and acclimatize them into their genome for structuring metabolic process, developing drug resistance and disease. Antimicrobial resistance (AMR) in V. cholerae is a global concern. However, little is known about the identity, source, acquisition process, and stability of the resistance traits in the genome of cholera pathogen. Methods Antibiotic susceptibility testing of V. cholerae isolated from different parts of India during 2001–2017 was performed using Discs and E-strips. Whole-genome sequencing of resistant (R), multidrug resistant (MDR), extensively drug resistant (XDR), and pandrug (PDR) resistant V. cholerae was done by next-generation DNA sequencing. Mobile genetic elements (MGEs) linked with AMR genes were tagged by allelic exchange methods. Whole-cell proteome analysis was done by iTRAQ analysis. Results Almost 99% of V. cholerae isolates (n = 438) are resistant against ≥2 antibiotics, 17.2% isolates (n = 76) are resistant against ≥10 antibiotics, and 7.5% isolates (n = 33) are resistant against ≥14 antibiotics. Highest resistance was detected against sulfamethaxozole (99.8%, n = 442). In addition, resistance to nalidixic acid (n = 429), trimethoprim (n = 421), and streptomycin (n = 409) are also very high. All the sequenced resistant isolates carrying multiple resistance genes and are linked with MGEs like integrating conjugative elements, transposons etc. Most of the resistance traits are functional and expressed even in the absence of antibiotics. Conclusion Our comprehensive analysis of 443 clinical V. cholerae isolates show that the cholera pathogen is continuously evolving to counterbalance the antimicrobial effects of antibiotics. Several MGEs linked with AMR genes and other fitness factors potentially propagate to other bacterial species through HGTs. Knowledge of the present study would be useful to understand the evolution of cholera pathogens and management of cholera by helping selection of specific drug regimen against the pathogens. Disclosures All authors: No reported disclosures.
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Faruque, Shah M., M. John Albert, and John J. Mekalanos. "Epidemiology, Genetics, and Ecology of ToxigenicVibrio cholerae." Microbiology and Molecular Biology Reviews 62, no. 4 (December 1, 1998): 1301–14. http://dx.doi.org/10.1128/mmbr.62.4.1301-1314.1998.
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SUMMARY Cholera caused by toxigenic Vibrio cholerae is a major public health problem confronting developing countries, where outbreaks occur in a regular seasonal pattern and are particularly associated with poverty and poor sanitation. The disease is characterized by a devastating watery diarrhea which leads to rapid dehydration, and death occurs in 50 to 70% of untreated patients. Cholera is a waterborne disease, and the importance of water ecology is suggested by the close association of V. cholerae with surface water and the population interacting with the water. Cholera toxin (CT), which is responsible for the profuse diarrhea, is encoded by a lysogenic bacteriophage designated CTXΦ. Although the mechanism by which CT causes diarrhea is known, it is not clear why V. cholerae should infect and elaborate the lethal toxin in the host. Molecular epidemiological surveillance has revealed clonal diversity among toxigenic V. cholerae strains and a continual emergence of new epidemic clones. In view of lysogenic conversion by CTXΦ as a possible mechanism of origination of new toxigenic clones of V. cholerae, it appears that the continual emergence of new toxigenic strains and their selective enrichment during cholera outbreaks constitute an essential component of the natural ecosystem for the evolution of epidemic V. cholerae strains and genetic elements that mediate the transfer of virulence genes. The ecosystem comprising V. cholerae, CTXΦ, the aquatic environment, and the mammalian host offers an understanding of the complex relationship between pathogenesis and the natural selection of a pathogen.
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Wei, Yan, Paolo Ocampo, and Bruce R. Levin. "An experimental study of the population and evolutionary dynamics of Vibrio cholerae O1 and the bacteriophage JSF4." Proceedings of the Royal Society B: Biological Sciences 277, no. 1698 (June 10, 2010): 3247–54. http://dx.doi.org/10.1098/rspb.2010.0651.
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Studies of Vibrio cholerae in the environment and infected patients suggest that the waning of cholera outbreaks is associated with rise in the density of lytic bacteriophage. In accordance with mathematical models, there are seemingly realistic conditions where phage predation could be responsible for declines in the incidence of cholera. Here, we present the results of experiments with the El Tor strain of V. cholerae (N16961) and a naturally occurring lytic phage (JSF4), exploring the validity of the main premise of this model: that phage predation limits the density of V. cholerae populations. At one level, the results of our experiments are inconsistent with this hypothesis. JSF4-resistant V. cholerae evolve within a short time following their confrontation with these viruses and their populations become limited by resources rather than phage predation. At a larger scale, however, the results of our experiments are not inconsistent with the hypothesis that bacteriophage modulate outbreaks of cholera. We postulate that the resistant bacteria that evolved play an insignificant role in the ecology or pathogenicity of V. cholerae . Relative to the phage-sensitive cells from whence they are derived, the evolved JSF4-resistant V. cholerae have fitness costs and other characters that are likely to impair their ability to compete with the sensitive cells in their natural habitat and may be avirulent in human hosts. The results of this in vitro study make predictions that can be tested in natural populations of V. cholerae and cholera-infected patients.
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Akter, Aklima, Meagan Kelly, Richelle C. Charles, Jason B. Harris, Stephen B. Calderwood, Taufiqur R. Bhuiyan, Rajib Biswas, et al. "Parenteral Vaccination with a Cholera Conjugate Vaccine Boosts Vibriocidal and Anti-OSP Responses in Mice Previously Immunized with an Oral Cholera Vaccine." American Journal of Tropical Medicine and Hygiene 104, no. 6 (June 2, 2021): 2024–30. http://dx.doi.org/10.4269/ajtmh.20-1511.
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Abstract.Oral cholera vaccination protects against cholera; however, responses in young children are low and of short duration. The best current correlates of protection against cholera target Vibrio cholerae O-specific polysaccharide (anti-OSP), including vibriocidal responses. A cholera conjugate vaccine has been developed that induces anti-OSP immune responses, including memory B-cell responses. To address whether cholera conjugate vaccine would boost immune responses following oral cholera vaccination, we immunized mice with oral cholera vaccine Inaba CVD 103-HgR or buffer only (placebo) on day 0, followed by parenteral boosting immunizations on days 14, 42, and 70 with cholera conjugate vaccine Inaba OSP: recombinant tetanus toxoid heavy chain fragment or phosphate buffered saline (PBS)/placebo. Compared with responses in mice immunized with oral vaccine alone or intramuscular cholera conjugate vaccine alone, mice receiving combination vaccination developed significantly higher vibriocidal, IgM OSP-specific serum responses and OSP-specific IgM memory B-cell responses. A combined vaccination approach, which includes oral cholera vaccination followed by parenteral cholera conjugate vaccine boosting, results in increased immune responses that have been associated with protection against cholera. These results suggest that such an approach should be evaluated in humans.
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Panja, Prabir. "Optimal Control Analysis of a Cholera Epidemic Model." Biophysical Reviews and Letters 14, no. 01 (March 2019): 27–48. http://dx.doi.org/10.1142/s1793048019500024.
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In this paper, a cholera disease transmission mathematical model has been developed. According to the transmission mechanism of cholera disease, total human population has been classified into four subpopulations such as (i) Susceptible human, (ii) Exposed human, (iii) Infected human and (iv) Recovered human. Also, the total bacterial population has been classified into two subpopulations such as (i) Vibrio Cholerae that grows in the infected human intestine and (ii) Vibrio Cholerae in the environment. It is assumed that the cholera disease can be transmitted in a human population through the consumption of contaminated food and water by Vibrio Cholerae bacterium present in the environment. Also, it is assumed that Vibrio Cholerae bacterium is spread in the environment through the vomiting and feces of infected humans. Positivity and boundedness of solutions of our proposed system have been investigated. Equilibrium points and the basic reproduction number [Formula: see text] are evaluated. Local stability conditions of disease-free and endemic equilibrium points have been discussed. A sensitivity analysis has been carried out on the basic reproduction number [Formula: see text]. To eradicate cholera disease from the human population, an optimal control problem has been formulated and solved with the help of Pontryagin’s maximum principle. Here treatment, vaccination and awareness programs have been considered as control parameters to reduce the number of infected humans from cholera disease. Finally, the optimal control and the cost-effectiveness analysis of our proposed model have been performed numerically.
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POPOVIC, TANJA, ØRJAN OLSVIK, PAUL A. BLAKE, and KAYE WACHSMUTH. "Cholera in the Americas: Foodborne Aspects." Journal of Food Protection 56, no. 9 (September 1, 1993): 811–21. http://dx.doi.org/10.4315/0362-028x-56.9.811.
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Over 100 serotypes of Vibrio cholerae exist, but generally the toxigenic strains of the serogroup O1 cause cholera and possess documented epidemic potential. The main symptom of cholera is a profuse diarrhea resulting in dehydration, that if untreated, leads to death. Seven pandemics of this contagious disease have been recorded during the last 200 years. A sick person secrets in his stool billions of organisms daily, and water and food contaminated with such a stool are the primary sources of infection during the epidemics. With the increase of the international food trade, food is often shipped from countries with endemic or epidemic cholera. With one exception, no documented cases of cholera have been reported, as a result of the internationally regulated food trade. However, during the present Latin American epidemic, inadequately cooked seafood has been implicated as a source of cholera. As a result of the epidemic, over 100 cases of cholera have occurred in the United States related to seafood consumed during a visit to Latin America or after its noncommercial transport into the country. Furthermore, V. cholerae persists as a free-living organism in environmental reservoirs in Australia and the U.S. Gulf Coast; there have been 65 domestically acquired cases of cholera in the United States since 1973. Molecular typing methods have enabled us to identify and characterize endemic and epidemic strains, and to document transmission of cholera when food was implicated epidemiologically as a vehicle of transmission.
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Selyanskaya, Nadezhda A. "MODERN PROBLEMS AND PROSPECTS IN THE DEVELOPMENT OF THE THERAPY OF CHOLERA." Epidemiology and Infectious Diseases (Russian Journal) 24, no. 1 (February 15, 2019): 25–31. http://dx.doi.org/10.18821/1560-9529-2019-24-1-25-31.
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The spread of V. cholerae strains with multiple antibiotic resistance limits the choice of effective means of etiotropic therapy for cholera, emphasizing the importance of finding ways to maintain efficacy in the face of the widespread prevalence of antibiotic-resistant bacteria. The review presents data of domestic and foreign literature on the antibiotic resistance of Vibrio cholerae and the prospects for the treatment of cholera in the modern period.
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Qadri, Firdausi, Muhammad Asaduzzaman, Christine Wennerås, Golam Mohi, M. John Albert, Mohammad Abdus Salam, R. Bradley Sack, et al. "Enterotoxin-Specific Immunoglobulin E Responses in Humans after Infection or Vaccination with Diarrhea-Causing Enteropathogens." Infection and Immunity 68, no. 10 (October 1, 2000): 6077–81. http://dx.doi.org/10.1128/iai.68.10.6077-6081.2000.
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ABSTRACT Cholera toxin (CT)-specific antibody responses of the immunoglobulin E (IgE) isotype in the sera of adult patients suffering from infection with either Vibrio cholerae O1, V. cholerae O139, or enterotoxigenic Escherichia coli(ETEC) were analyzed and compared with those in the sera of volunteers immunized with a bivalent B subunit O1/O139 whole-cell cholera vaccine. A significant IgE response to CT was observed in 90% of the patients with V. cholerae O1 infection (18 of 20; P = <0.001) and 95% of the patients with V. cholerae O139 infection (19 of 20; P = <0.001). Similarly, the majority of the patients with ETEC diarrhea (83%; 13 of 15) showed a positive IgE response to CT. Eight of 10 North American volunteers (80%) orally challenged with V. cholerae O1 showed CT-specific IgE responses (P = 0.004). In contrast, Swedish volunteers immunized with the oral cholera vaccine showed no IgE responses to CT (P value not significant). During the study period, total IgE levels in the sera of the diarrheal patients, the North American volunteers, and the Swedish cholera vaccinees alike remained unchanged. However, the total IgE levels in the sera of patients and healthy Bangladeshi controls were on average 89-fold higher than those in the sera of the healthy Swedish volunteers and 34-fold higher than those in the sera of the North American volunteers.
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LaRocque, Regina C., Jason B. Harris, Michelle Dziejman, Xiaoman Li, Ashraful I. Khan, Abu S. G. Faruque, Shah M. Faruque, et al. "Transcriptional Profiling of Vibrio cholerae Recovered Directly from Patient Specimens during Early and Late Stages of Human Infection." Infection and Immunity 73, no. 8 (August 2005): 4488–93. http://dx.doi.org/10.1128/iai.73.8.4488-4493.2005.
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ABSTRACT Understanding gene expression by bacteria during the actual course of human infection may provide important insights into microbial pathogenesis. In this study, we evaluated the transcriptional profile of Vibrio cholerae, the causative agent of cholera, in clinical specimens from cholera patients. We collected samples of human stool and vomitus that were positive by dark-field microscopy for abundant vibrios and used a microarray to compare gene expression in organisms recovered directly from specimens collected during the early and late stages of human infection. Our results reveal that V. cholerae gene expression within the human host environment differs from patterns defined in in vitro models of pathogenesis. tcpA, the major subunit of the essential V. cholerae colonization factor, was significantly more highly expressed in early than in late stages of infection; however, the genes encoding cholera toxin were not highly expressed in either phase of human infection. Furthermore, expression of the virulence regulators toxRS and tcpPH was uncoupled. Interestingly, the pattern of gene expression indicates that the human upper intestine may be a uniquely suitable environment for the transfer of genetic elements that are important in the evolution of pathogenic strains of V. cholerae. These findings provide a more detailed assessment of the transcriptome of V. cholerae in the human host than previous studies of organisms in stool alone and have implications for cholera control and the design of improved vaccines.
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Jafarova, Kh H., E. F. Vahabov, F. Sh Taghiyeva, and V. Ch Jalilov. "Epidemiological features of the seventh pandemic of cholera at stage IV and monitoring thereof." NATURE AND SCIENCE 03, no. 04 (October 27, 2020): 74–77. http://dx.doi.org/10.36719/2707-1146/04/74-77.
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The topical issues of cholera touched upon in the modern period indicate the significance of the problem at the global level. The continuing trend of an increase in morbidity, the importation of cholera leading to large outbreaks and epidemics, the presence of endemic foci on three continents of the world, the spread of genome-altered variants of El Tor cholera vibrios with epidemic and pandemic potential indicate a generally unfavorable prognosis for cholera at the global level. This dictates the need to implement a set of measures in the system of epidemiological surveillance of cholera and to ensure the readiness of the Ministry of Health institutions to carry out those regulated by international health regulations. Key words: cholera, pandemic, endemic territories, factors of distribution, Vibrio cholerae, 0139 (Bengal), prognosis
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Issahaku, Gyesi, Franklin Asiedu-Bekoe, Samuel Kwashie, Francis Broni, Paul Boateng, Holy Alomatu, Ekua Houphouet, Afua Asante, Donne Ameme, and Ernest Kenu. "Protracted cholera outbreak in the Central Region, Ghana, 2016." Ghana Medical Journal 54, no. 2 (August 31, 2020): 45–52. http://dx.doi.org/10.4314/gmj.v54i2s.8.
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Objective: On 24th October 2016, the Central Regional Health Directorate received report of a suspected cholera outbreak in the Cape Coast Metropolis (CCM). We investigated to confirm the diagnosis, identify risk factors and implement control measures.Design: We used a descriptive study followed by 1:2 unmatched case-control study.Data source: We reviewed medical records, conducted active case search and contact tracing, interviewed case-patients and their contacts and conducted environmental assessment. Case-patients' stool samples were tested with point of care test kits (SD Bioline Cholera Ag 01/0139) and sent to the Cape Coast Teaching Hospital Laboratory for confirmation.Main outcomes: Cause of outbreak, risk factors associated with spread of outbreakResults: Vibrio cholerae serotype Ogawa caused the outbreak. There was no mortality. Of 704 case-patients, 371(52.7%) were males and 55(7.8%) were aged under-five years. The median age was 23 years (interquartile range: 16-32 years). About a third 248(35.2%) of the case patients were aged 15-24 years. The University of Cape Coast subdistrict was the epicenter with 341(48.44%) cases. Compared to controls, cholera case-patients were more likely to have visited Cholera Treatment Centers (CTC) (aOR=12.1, 95%CI: 1.5-101.3), drank pipe-borne water (aOR=11.7, 95%CI: 3.3-41.8), or drank street-vended sachet water (aOR=11.0, 95%CI: 3.7-32.9). Open defecation and broken sewage pipes were observed in the epicenter.Conclusion: Vibrio cholerae serotype Ogawa caused the CCM cholera outbreak mostly affecting the youth. Visiting CTC was a major risk factor. Prompt case-management, contact tracing, health education, restricting access to CTC and implementing water sanitation and hygiene activities helped in the control.Keywords: Cholera outbreak, Vibrio cholerae serotype Ogawa, Cholera treatment center, Water sanitation and hygiene, Cape Coast MetropolisFunding: This work was supported by Ghana Field Epidemiology and Laboratory Training Program (GFELTP), University of Ghana