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Sample records for cholera epidemics war

  1. Cholera epidemics, war and disasters around Goma and Lake Kivu: an eight-year survey.

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    Didier Bompangue

    Full Text Available BACKGROUND: During the last eight years, North and South Kivu, located in a lake area in Eastern Democratic Republic of Congo, have been the site of a major volcano eruption and of numerous complex emergencies with population displacements. These conditions have been suspected to favour emergence and spread of cholera epidemics. METHODOLOGY/PRINCIPAL FINDINGS: In order to assess the influence of these conditions on outbreaks, reports of cholera cases were collected weekly from each health district of North Kivu (4,667,699 inhabitants and South Kivu (4,670,121 inhabitants from 2000 through 2007. A geographic information system was established, and in each health district, the relationships between environmental variables and the number of cholera cases were assessed using regression techniques and time series analysis. We further checked for a link between complex emergencies and cholera outbreaks. Finally, we analysed data collected during an epidemiological survey that was implemented in Goma after Nyiragongo eruption. A total of 73,605 cases and 1,612 deaths of cholera were reported. Time series decomposition showed a greater number of cases during the rainy season in South Kivu but not in North Kivu. Spatial distribution of cholera cases exhibited a higher number of cases in health districts bordering lakes (Odds Ratio 7.0, Confidence Interval range 3.8-12.9. Four epidemic reactivations were observed in the 12-week periods following war events, but simulations indicate that the number of reactivations was not larger than that expected during any random selection of period with no war. Nyiragongo volcanic eruption was followed by a marked decrease of cholera incidence. CONCLUSION/SIGNIFICANCE: Our study points out the crucial role of some towns located in lakeside areas in the persistence of cholera in Kivu. Even if complex emergencies were not systematically followed by cholera epidemics, some of them enabled cholera spreading.

  2. Cholera epidemic threatens Sierra Leone.

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    Dyer, O

    1995-07-08

    Sierra Leone faces the threat of a major epidemic of cholera with the onset of the rainy season, according to the World Health Organization (WHO). The situation is particularly grave for the two million people displaced by the country's civil war. Already 1709 cases of cholera have been registered in Freetown, with 57 deaths. Freetown's population has doubled since the start of the war in 1991 with 750,000 refugees camping out in the town. The insurgent Revolutionary United Front is now within 32 km of the capital. Provinces are cut off from the capital, medical supplies are scarce. Doctors and aid workers are forced to rely on a private helicopter service for personal transport. As many as 10,000 people were affected by the disease last year. WHO experts predict that pneumonia is likely to claim the lives of many children, and a highly drug resistant strain of Plasmodium falciparum malaria is also looming. The greatest problems are the lack of safe drinking water and the attendant risks of cholera and dysentery. At one site in Freetown the 6000 refugees have to fetch water from a well and have no latrines. As a result there have been 277 cases of cholera and 2 deaths already among that group. The health department has set up five centers to treat cholera in Freetown and is organizing mobile clinics. WHO's Sierra Leone office is assisting the government mobile health teams, which provide free primary care to displaced people. Medicines and vaccines, however, are lacking. Many of the staff of the 13 district health authorities have been displaced to Freetown. Aid agencies such as Medecins Sans Frontieres and Oxfam have stepped into the role in many districts. Ironically, one of the Revolutionary United Front's main demands is for a free national health service.

  3. Epidemic cholera spreads like wildfire

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    Roy, Manojit; Zinck, Richard D.; Bouma, Menno J.; Pascual, Mercedes

    2014-01-01

    Cholera is on the rise globally, especially epidemic cholera which is characterized by intermittent and unpredictable outbreaks that punctuate periods of regional disease fade-out. These epidemic dynamics remain however poorly understood. Here we examine records for epidemic cholera over both contemporary and historical timelines, from Africa (1990-2006) and former British India (1882-1939). We find that the frequency distribution of outbreak size is fat-tailed, scaling approximately as a power-law. This pattern which shows strong parallels with wildfires is incompatible with existing cholera models developed for endemic regions, as it implies a fundamental role for stochastic transmission and local depletion of susceptible hosts. Application of a recently developed forest-fire model indicates that epidemic cholera dynamics are located above a critical phase transition and propagate in similar ways to aggressive wildfires. These findings have implications for the effectiveness of control measures and the mechanisms that ultimately limit the size of outbreaks.

  4. Widespread epidemic cholera caused by a restricted subset of Vibrio cholerae clones.

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    Moore, S; Thomson, N; Mutreja, A; Piarroux, R

    2014-05-01

    Since 1817, seven cholera pandemics have plagued humankind. As the causative agent, Vibrio cholerae, is autochthonous in the aquatic ecosystem and some studies have revealed links between outbreaks and fluctuations in climatic and aquatic conditions, it has been widely assumed that cholera epidemics are triggered by environmental factors that promote the growth of local bacterial reservoirs. However, mounting epidemiological findings and genome sequence analysis of clinical isolates have indicated that epidemics are largely unassociated with most of the V. cholerae strains in aquatic ecosystems. Instead, only a specific subset of V. cholerae El Tor 'types' appears to be responsible for current epidemics. A recent report examining the evolution of a variety of V. cholerae strains indicates that the current pandemic is monophyletic and originated from a single ancestral clone that has spread globally in successive waves. In this review, we examine the clonal nature of the disease, with the example of the recent history of cholera in the Americas. Epidemiological data and genome sequence-based analysis of V. cholerae isolates demonstrate that the cholera epidemics of the 1990s in South America were triggered by the importation of a pathogenic V. cholerae strain that gradually spread throughout the region until local outbreaks ceased in 2001. Latin America remained almost unaffected by the disease until a new toxigenic V. cholerae clone was imported into Haiti in 2010. Overall, cholera appears to be largely caused by a subset of specific V. cholerae clones rather than by the vast diversity of V. cholerae strains in the environment.

  5. Spatially explicit modelling of cholera epidemics

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    Finger, F.; Bertuzzo, E.; Mari, L.; Knox, A. C.; Gatto, M.; Rinaldo, A.

    2013-12-01

    Epidemiological models can provide crucial understanding about the dynamics of infectious diseases. Possible applications range from real-time forecasting and allocation of health care resources to testing alternative intervention mechanisms such as vaccines, antibiotics or the improvement of sanitary conditions. We apply a spatially explicit model to the cholera epidemic that struck Haiti in October 2010 and is still ongoing. The dynamics of susceptibles as well as symptomatic and asymptomatic infectives are modelled at the scale of local human communities. Dissemination of Vibrio cholerae through hydrological transport and human mobility along the road network is explicitly taken into account, as well as the effect of rainfall as a driver of increasing disease incidence. The model is calibrated using a dataset of reported cholera cases. We further model the long term impact of several types of interventions on the disease dynamics by varying parameters appropriately. Key epidemiological mechanisms and parameters which affect the efficiency of treatments such as antibiotics are identified. Our results lead to conclusions about the influence of different intervention strategies on the overall epidemiological dynamics.

  6. The Role of Cyanobacteria Blooms in Cholera Epidemic in Bangladesh

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    Sagir Ahmed, Md.; Raknuzzaman, Md.; Akther, Hafeza; Ahmed, Sumaiya

    A study was conducted on association of Vibrio cholerae with plankton specially emphasis on cyanobacteria in relation to some physico-chemical parameters in the River Buriganga, Dhaka, from January to December 2002. Monthly abundance of phytoplankton and zooplankton varied from 457 to 14166 and from 169 to 1055 individual L-1, respectively. Monthly average of faecal coliform in water, zooplankton and phytoplankton samples were 3.99x109, 4.54x103 and 4.28x102 (CFU L-1), respectively. During epidemics, toxigenic V. cholerae 01 and 0139 were isolated from the patients as well as from the surface water. V. cholerae 01 and 0139 were also isolated from plankton samples. More over, it was observed that ctx (cholera toxic) positive in water and phytoplankton samples of the river. A bloom of Oscillatoria sp. (1.6x104 individual L-1) occurred in the upper reaches of the River Buriganga in May 2002. Methanol-water extract of bloom sample was analyzed by high performance liquid chromatography with UV detection and Mass Spectrum (MS) detected microcystin-RR. Cyanobacteria are abundant in the aquatic environment of Bangladesh and it was established that V. cholerae maintain a symbiotic relationship with these algae particularly mucilaginous cyanobacteria. During epidemics, patients symptoms included diarrhea, vomiting and hemorrhagic enteritis and in severe cases hemorrhagic diarrhea. So, question has arisen that which is responsible, microcystins or cholera for death of cholera/diarrhea patients in Bangladesh. Future research should be directed to isolate microcystins and cholera toxins from the epidemic areas to clarify the fact.

  7. Cost-effectiveness of oral cholera vaccine in a stable refugee population at risk for epidemic cholera and in a population with endemic cholera.

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    Murray, J.; McFarland, D. A.; Waldman, R. J.

    1998-01-01

    Recent large epidemics of cholera with high incidence and associated mortality among refugees have raised the question of whether oral cholera vaccines should be considered as an additional preventive measure in high-risk populations. The potential impact of oral cholera vaccines on populations prone to seasonal endemic cholera has also been questioned. This article reviews the potential cost-effectiveness of B-subunit, killed whole-cell (BS-WC) oral cholera vaccine in a stable refugee popula...

  8. On the probability of extinction of the Haiti cholera epidemic

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    Bertuzzo, Enrico; Finger, Flavio; Mari, Lorenzo; Gatto, Marino; Rinaldo, Andrea

    2014-05-01

    Nearly 3 years after its appearance in Haiti, cholera has already exacted more than 8,200 deaths and 670,000 reported cases and it is feared to become endemic. However, no clear evidence of a stable environmental reservoir of pathogenic Vibrio cholerae, the infective agent of the disease, has emerged so far, suggesting that the transmission cycle of the disease is being maintained by bacteria freshly shed by infected individuals. Thus in principle cholera could possibly be eradicated from Haiti. Here, we develop a framework for the estimation of the probability of extinction of the epidemic based on current epidemiological dynamics and health-care practice. Cholera spreading is modelled by an individual-based spatially-explicit stochastic model that accounts for the dynamics of susceptible, infected and recovered individuals hosted in different local communities connected through hydrologic and human mobility networks. Our results indicate that the probability that the epidemic goes extinct before the end of 2016 is of the order of 1%. This low probability of extinction highlights the need for more targeted and effective interventions to possibly stop cholera in Haiti.

  9. Rainfall mediations in the spreading of epidemic cholera

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    Righetto, L.; Bertuzzo, E.; Mari, L.; Schild, E.; Casagrandi, R.; Gatto, M.; Rodriguez-Iturbe, I.; Rinaldo, A.

    2013-10-01

    Following the empirical evidence of a clear correlation between rainfall events and cholera resurgence that was observed in particular during the recent outbreak in Haiti, a spatially explicit model of epidemic cholera is re-examined. Specifically, we test a multivariate Poisson rainfall generator, with parameters varying in space and time, as a driver of enhanced disease transmission. The relevance of the issue relates to the key insight that predictive mathematical models may provide into the course of an ongoing cholera epidemic aiding emergency management (say, in allocating life-saving supplies or health care staff) or in evaluating alternative management strategies. Our model consists of a set of dynamical equations (SIRB-like i.e. subdivided into the compartments of Susceptible, Infected and Recovered individuals, and including a balance of Bacterial concentrations in the water reservoir) describing a connected network of human communities where the infection results from the exposure to excess concentrations of pathogens in the water. These, in turn, are driven by rainfall washout of open-air defecation sites or cesspool overflows, hydrologic transport through waterways and by mobility of susceptible and infected individuals. We perform an a posteriori analysis (from the beginning of the epidemic in October 2010 until December 2011) to test the model reliability in predicting cholera cases and in testing control measures, involving vaccination and sanitation campaigns, for the ongoing epidemic. Even though predicting reliably the timing of the epidemic resurgence proves difficult due to rainfall inter-annual variability, we find that the model can reasonably quantify the total number of reported infection cases in the selected time-span. We then run a multi-seasonal prediction of the course of the epidemic until December 2015, to investigate conditions for further resurgences and endemicity of cholera in the region with a view to policies which may bring to

  10. Cholera

    OpenAIRE

    Harris, Jason B.; LaRocque, Regina C; Qadri, Firdausi; Edward T. Ryan; Calderwood, Stephen B.

    2012-01-01

    Cholera is an acute, secretory diarrhea caused by infection with Vibrio cholerae of the O1 and O139 serogroups. Cholera is endemic in over 50 countries and also causes large epidemics. Since 1817, seven cholera pandemics have spread from Asia to much of the world. The 7th pandemic began in 1961 and affects 3–5 million people each year, killing 120,000. Although mild cholera may be indistinguishable from other diarrheal illnesses, the presentation of severe cholera is distinct, with dramatic d...

  11. Validation and characterization of a human volunteer challenge model for cholera by using frozen bacteria of the new Vibrio cholerae epidemic serotype, O139

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    Cohen, MB; Giannella, RA; Losonsky, GA; Lang, DR; Parker, S; Hawkins, JA; Gunther, C; Schiff, GA

    1999-01-01

    Until recently, all epidemic strains of Vibrio cholerae were of the O1 serotype. Current epidemics have also been caused by a new serotype, Vibrio cholerae O139. Although the pathogenesis and clinical features of O139 cholera are similar to those of O1 cholera, immunity to serotype O1 does not confe

  12. Epidemiological description of unmitigated cholera epidemics in 19th century Denmark

    DEFF Research Database (Denmark)

    Phelps, Matthew David; Perner, Mads Linnet; Davidsen, Emma;

    Background. Cholera epidemics devastated 19th century European cities in multiple outbreaks during 1830-1900. Most Danish cities experienced only a single epidemic in 1853 and detailed data are available. This uniquely allows study of unmitigated epidemic cholera in a fully susceptible population...

  13. An epidemic model for the future progression of the current Haiti cholera epidemic

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    Bertuzzo, E.; Mari, L.; Righetto, L.; Casagrandi, R.; Gatto, M.; Rodriguez-Iturbe, I.; Rinaldo, A.

    2012-04-01

    As a major cholera epidemic progresses in Haiti, and the figures of the infection, up to December 2011, climb to 522,000 cases and 7,000 deaths, the development of general models to track and predict the evolution of the outbreak, so as to guide the allocation of medical supplies and staff, is gaining notable urgency. We propose here a spatially explicit epidemic model that accounts for the dynamics of susceptible and infected individuals as well as the redistribution of Vibrio cholera, the causative agent of the disease, among different human communities. In particular, we model two spreading pathways: the advection of pathogens through hydrologic connections and the dissemination due to human mobility described by means of a gravity-like model. To this end the country has been divided into hydrologic units based on drainage directions derived from a digital terrain model. Moreover the population of each unit has been estimated from census data downscaled to 1 km x 1 km resolution via remotely sensed geomorphological information (LandScan project). The model directly accounts for the role of rainfall patterns in driving the seasonality of cholera outbreaks. The two main outbreaks in fact occurred during the rainy seasons (October and May) when extensive floodings severely worsened the sanitation conditions and, in turn, raised the risk of infection. The model capability to reproduce the spatiotemporal features of the epidemic up to date grants robustness to the foreseen future development. To this end, we generate realistic scenario of future precipitation in order to forecast possible epidemic paths up to the end of the 2013. In this context, the duration of acquired immunity, a hotly debated topic in the scientific community, emerges as a controlling factor for progression of the epidemic in the near future. The framework presented here can straightforwardly be used to evaluate the effectiveness of alternative intervention strategies like mass vaccinations

  14. Genome-wide study of the defective sucrose fermenter strain of Vibrio cholerae from the Latin American cholera epidemic.

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    Garza, D.R.; Thompson, C.C.; Loureiro, E.C.; Dutilh, B.E.; Inada, D.T.; Junior, E.C.; Cardoso, J.F.; Nunes, M.R.; Lima, C.P. de; Silvestre, R.V.; Nunes, K.N.; Santos, E.C.; Edwards, R.A.; Vicente, A.C.; Sá Morais, L.L. de

    2012-01-01

    The 7th cholera pandemic reached Latin America in 1991, spreading from Peru to virtually all Latin American countries. During the late epidemic period, a strain that failed to ferment sucrose dominated cholera outbreaks in the Northern Brazilian Amazon region. In order to understand the genomic char

  15. [The 1853-1856 cholera epidemic in the Portuguese press].

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    Almeida, Maria Antónia Pires de

    2011-12-01

    The article examines science and technology communication aimed at a non-specialized audience, using the general press as the main source in this endeavor to capture an image of the popularization of science in Portugal. Based on the fact that the nineteenth-century press was overtly concerned with garnering an audience and spreading knowledge, the study uses news, articles, and advertisements about the 1853-1856 cholera epidemic to assess the era's scientific knowledge (especially about prevention and treatment) and how this information was conveyed to society and used by it.

  16. [On the epidemic of cholera and its prevention and control by the railway authorities in 1932].

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    Huang, H P; Song, M H

    2016-01-28

    In 1932, the epidemic of cholera in China was serious, spreading to all provinces nationwide, causing heavy casualties. In order to prevent cholera epidemics spread along the railway line, the National Government Ministry of Railways and the local railway administration had taken all countermeasures, including the promulgation of epidemic prevention laws and regulations, quarantine, isolated check-up, disinfection, vaccination and even interruption of traffic. The measures of railway authorities had achieved a certain success. In August 1932, cholera epidemic began to subside gradually.

  17. Genome-wide study of the defective sucrose fermenter strain of Vibrio cholerae from the Latin American cholera epidemic.

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    Daniel Rios Garza

    Full Text Available The 7th cholera pandemic reached Latin America in 1991, spreading from Peru to virtually all Latin American countries. During the late epidemic period, a strain that failed to ferment sucrose dominated cholera outbreaks in the Northern Brazilian Amazon region. In order to understand the genomic characteristics and the determinants of this altered sucrose fermenting phenotype, the genome of the strain IEC224 was sequenced. This paper reports a broad genomic study of this strain, showing its correlation with the major epidemic lineage. The potentially mobile genomic regions are shown to possess GC content deviation, and harbor the main V. cholera virulence genes. A novel bioinformatic approach was applied in order to identify the putative functions of hypothetical proteins, and was compared with the automatic annotation by RAST. The genome of a large bacteriophage was found to be integrated to the IEC224's alanine aminopeptidase gene. The presence of this phage is shown to be a common characteristic of the El Tor strains from the Latin American epidemic, as well as its putative ancestor from Angola. The defective sucrose fermenting phenotype is shown to be due to a single nucleotide insertion in the V. cholerae sucrose-specific transportation gene. This frame-shift mutation truncated a membrane protein, altering its structural pore-like conformation. Further, the identification of a common bacteriophage reinforces both the monophyletic and African-Origin hypotheses for the main causative agent of the 1991 Latin America cholera epidemics.

  18. Survivability and molecular variation in Vibrio cholerae from epidemic sites in China.

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    Li, X Q; Wang, M; Deng, Z A; Shen, J C; Zhang, X Q; Liu, Y F; Cai, Y S; Wu, X W; DI, B

    2015-01-01

    The survival behaviour of Vibrio cholerae in cholera epidemics, together with its attributes of virulence-associated genes and molecular fingerprints, are significant for managing cholera epidemics. Here, we selected five strains representative of V. cholerae O1 and O139 involved in cholera events, examined their survival capacity in large volumes of water sampled from epidemic sites of a 2005 cholera outbreak, and determined virulence-associated genes and molecular subtype changes of the surviving isolates recovered. The five strains exhibited different survival capacities varying from 17 to 38 days. The virulence-associated genes of the surviving isolates remained unchanged, while their pulsotypes underwent slight variation. In particular, one waterway-isolated strain maintained virulence-associated genes and evolved to share the same pulsotype as patient strains, highlighting its role in the cholera outbreak. The strong survival capacity and molecular attributes of V. cholerae might account for its persistence in environmental waters and the long duration of the cholera outbreak, allowing effective control measures.

  19. Hyperinfectivity: a critical element in the ability of V. cholerae to cause epidemics?

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    David M Hartley

    2006-01-01

    Full Text Available Cholera is an ancient disease that continues to cause epidemic and pandemic disease despite ongoing efforts to limit its spread. Mathematical models provide one means of assessing the utility of various proposed interventions. However, cholera models that have been developed to date have had limitations, suggesting that there are basic elements of cholera transmission that we still do not understand.Recent laboratory findings suggest that passage of Vibrio cholerae O1 Inaba El Tor through the gastrointestinal tract results in a short-lived, hyperinfectious state of the organism that decays in a matter of hours into a state of lower infectiousness. Incorporation of this hyperinfectious state into our disease model provides a much better fit with the observed epidemic pattern of cholera. These findings help to substantiate the clinical relevance of laboratory observations regarding the hyperinfectious state, and underscore the critical importance of human-to-human versus environment-to-human transmission in the generation of epidemic and pandemic disease.To have maximal impact on limiting epidemic spread of cholera, interventions should be targeted toward minimizing risk of transmission of the short-lived, hyperinfectious form of toxigenic Vibrio cholerae. The possibility of comparable hyperinfectious states in other major epidemic diseases also needs to be evaluated and, as appropriate, incorporated into models of disease prevention.

  20. Elevation and cholera: an epidemiological spatial analysis of the cholera epidemic in Harare, Zimbabwe, 2008-2009

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    Luque Fernandez Miguel A

    2012-06-01

    Full Text Available Abstract Background In highly populated African urban areas where access to clean water is a challenge, water source contamination is one of the most cited risk factors in a cholera epidemic. During the rainy season, where there is either no sewage disposal or working sewer system, runoff of rains follows the slopes and gets into the lower parts of towns where shallow wells could easily become contaminated by excretes. In cholera endemic areas, spatial information about topographical elevation could help to guide preventive interventions. This study aims to analyze the association between topographic elevation and the distribution of cholera cases in Harare during the cholera epidemic in 2008 and 2009. Methods We developed an ecological study using secondary data. First, we described attack rates by suburb and then calculated rate ratios using whole Harare as reference. We illustrated the average elevation and cholera cases by suburbs using geographical information. Finally, we estimated a generalized linear mixed model (under the assumption of a Poisson distribution with an Empirical Bayesian approach to model the relation between the risk of cholera and the elevation in meters in Harare. We used a random intercept to allow for spatial correlation of neighboring suburbs. Results This study identifies a spatial pattern of the distribution of cholera cases in the Harare epidemic, characterized by a lower cholera risk in the highest elevation suburbs of Harare. The generalized linear mixed model showed that for each 100 meters of increase in the topographical elevation, the cholera risk was 30% lower with a rate ratio of 0.70 (95% confidence interval=0.66-0.76. Sensitivity analysis confirmed the risk reduction with an overall estimate of the rate ratio between 20% and 40%. Conclusion This study highlights the importance of considering topographical elevation as a geographical and environmental risk factor in order to plan cholera preventive

  1. Hurricanes, climate change and the cholera epidemic in Puerto Rico of 1855-1856.

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    Christenson, Bernard

    2008-01-01

    Hurricanes and global climate changes may affect the environmental factors of cholera dynamics in warm coastal areas, vulnerable to seasonal or sporadic outbreaks. The cholera epidemic of Puerto Rico in 1855-1856 had a profound effect on the Puerto Rican society; but it was not influenced by any climatic events, such as preceding hurricanes or storms based on past documentary sources. Particularly, the environmental non-toxigenic strains of Vibrio Cholerae in Puerto Rican water sources can maintain their pathogenic potential for sporadic or erratic toxigenic cholera outbreaks--if a "perfect storm" ever occurs.

  2. Bactericidal Efficacy of Allium sativum (garlic Against Multidrug Resistant Vibrio cholerae O1 Epidemic Strains

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    Pramod Kumar

    2016-09-01

    Full Text Available In recent years, emerging trend of antibiotic resistance in Vibrio cholerae associated with cholera epidemics is a matter of serious concern for the management of the disease. Indiscriminate use of antibiotics generally results in selection of antibiotic resistant strains. Introduction of newer antibiotics is a challenging task for the researchers as bacteria soon attain resistance. Therefore, identifying natural compounds of medicinal importance for control of cholera would be the best alternative. Garlic (Allium sativum was recognised for many centuries in early Chinese, Egyptian and Indian civilisations as an herbal or traditional medicine. In present study, garlic was selected for screening of antimicrobial efficacy against V. cholerae. A total of 55 V. cholerae strains isolated from various outbreaks/epidemics were subjected to antimicrobial testing as per CLSI, USA 2010 guidelines. Antimicrobial screening of garlic extract was performed against all the multidrug resistant strains of V. cholerae. The garlic extracts showed antibacterial activity against all the V. cholerae strains tested, irrespective of their origin, multidrug resistance and virulence. Antibacterial efficacy of garlic on V. cholerae was also evident from in vivo study on sealed adult mice model. Thus, the Garlic extract harnesses the potential to control infection of multidrug resistant V. cholerae, especially in outbreak like situations in remote and under developed areas where drug supply itself is a challenge

  3. [DETERMINATION OF TYPES OF EPIDEMIC MANIFESTATIONS OF CHOLERA IN REGIONS OF THE CRIMEA FEDERAL DISTRICT (REPUBLIC OF CRIMEA)].

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    Onischenko, G G; Popova, A Yu; Moskvitina, E A; Penkovskaya, N A; Listopad, S A; Titova, S V; Kruglikov, V D

    2015-01-01

    The aim of the study was determination of the type of epidemic manifestations of cholera in the Republic of Crimea based on evaluation of epidemic manifestations of cholera risk of introduction and spread of the infection. It was concluded, that, based on the cholera outbreaks, that had taken place, contamination of surface water bodies (fresh and sea) and sewage by Vibrio cholerae O1 ctxA+ and Vibrio cholerae O1 ctXA- potential epidemic danger of introduction of the infection by various types of international transport, population migration, the presence of epidemiologic risk in realization of water pathway of transmission of cholera causative agent and several other social conditions, the Republic of Crimea remains in the group of territories of type I by epidemic manifestations of cholera.

  4. Cholera epidemic associated with raw vegetables--Lusaka, Zambia, 2003-2004.

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    2004-09-03

    Zambia experienced widespread cholera epidemics in 1991 (13,154 cases), 1992 (11,659), and 1999 (11,327). In response to the large outbreak in 1999, the Zambian Ministry of Health (ZMOH) urged use of in-home chlorination with the locally produced solution, Clorin, and the practice increased substantially Clorin had been introduced in Zambia in 1998 as part of the Safe Water System (SWS), a point-of-use water disinfection and safe-water storage strategy launched by the Society for Family Health, in partnership with ZMOH, the U.S. Agency for International Development, and CDC. Although no outbreaks were reported during 2000-2002, cholera remained endemic. Epidemic cholera returned to Zambia in November 2003, when cases of toxigenic Vibrio cholerae O1, serotype Ogawa, biotype El Tor were confirmed in the capital city, Lusaka. During November 28, 2003-January 4, 2004, an estimated 2,529 cholera cases and 128 cholera deaths (case-fatality rate [CFR] = 5.1%) occurred in Lusaka. In February 2004, the Lusaka District Health Management Team (LDHMT) invited CDC to assist in an investigation of the epidemic. This report summarizes the results of that investigation, which implicated foodborne transmission via raw vegetables and demonstrated a protective role for hand washing with soap. The results underscore the importance of hygiene, clean water, and sanitary food handling for cholera prevention.

  5. OmpU as a biomarker for rapid discrimination between toxigenic and epidemic Vibrio cholerae O1/O139 and non-epidemic Vibrio cholerae in a modified MALDI-TOF MS assay

    NARCIS (Netherlands)

    Paauw, A.; Trip, H.; Niemcewicz, M.; Sellek, R.; Heng, J.M.E.; Mars-Groenendijk, R.H.; Jong, A.L. de; Majchrzykiewicz-Koehorst, J.A.; Olsen, J.S.; Tsivtsivadze, E.

    2014-01-01

    Background Cholera is an acute diarrheal disease caused by Vibrio cholerae. Outbreaks are caused by a genetically homogenous group of strains from serogroup O1 or O139 that are able to produce the cholera toxin. Rapid detection and identification of these epidemic strains is essential for an effecti

  6. Research Spotlight: Model suggests path to ending the ongoing Haitian cholera epidemic

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    Schultz, Colin

    2011-05-01

    Since early November 2010 a deadly cholera epidemic has been spreading across the Caribbean nation of Haiti, killing thousands of people and infecting hundreds of thousands. While infection rates are being actively monitored, health organizations have been left without a clear understanding of exactly how the disease has spread across Haiti. Cholera can spread through exposure to contaminated water, and the disease travels over long distances if an infected individual moves around the country. Using representations of these two predominant dispersion mechanisms, along with information on the size of the susceptible population, the number of infected individuals, and the aquatic concentration of the cholera-causing bacteria for more than 500 communities, Bertuzzo et al. designed a model that was able to accurately reproduce the progression of the Haitian cholera epidemic. (Geophysical Research Letters, doi:10.1029/2011GL046823, 2011)

  7. Real-time modelling used for outbreak management during a cholera epidemic, Haiti, 2010-2011.

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    Abrams, J Y; Copeland, J R; Tauxe, R V; Date, K A; Belay, E D; Mody, R K; Mintz, E D

    2013-06-01

    The emergence of epidemic cholera in post-earthquake Haiti portended a public health disaster of uncertain magnitude. In order to coordinate relief efforts in an environment with limited healthcare infrastructure and stretched resources, timely and realistic projections of the extent of the cholera outbreak were crucial. Projections were shared with Government and partner organizations beginning 5 days after the first reported case and were updated using progressively more advanced methods as more surveillance data became available. The first projection estimated that 105 000 cholera cases would occur in the first year. Subsequent projections using different methods estimated up to 652 000 cases and 163 000-247 000 hospitalizations during the first year. Current surveillance data show these projections to have provided reasonable approximations of the observed epidemic. Providing the real-time projections allowed Haitian ministries and external aid organizations to better plan and implement response measures during the evolving epidemic.

  8. Epidemiological description of unmitigated cholera epidemics in 19th century Denmark

    DEFF Research Database (Denmark)

    Phelps, Matthew David; Perner, Mads Linnet; Davidsen, Emma;

    Background. Cholera epidemics devastated 19th century European cities in multiple outbreaks during 1830-1900. Most Danish cities experienced only a single epidemic in 1853 and detailed data are available. This uniquely allows study of unmitigated epidemic cholera in a fully susceptible population...... parameters needed to parameterize dynamic disease models used to gage the likely effect of interventions in contemporary disaster settings. This low-income pre-sanitation historic setting may serve as a proxy for populations in contemporary resource poor urban settings....... with severe cholera (rice water diarrhea and severe dehydration). The case fatality ratio (CFR) was 54%-68% and the overall mortality impact ranged from 3.4% to 7.7% of the population. Seniors aged 70+ years in Copenhagen had the highest mortality rates (16% died) whereas only 2.7% of children under 5 died...

  9. Human Mobility Patterns and Cholera Epidemics: a Spatially Explicit Modeling Approach

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    Mari, L.; Bertuzzo, E.; Righetto, L.; Casagrandi, R.; Gatto, M.; Rodriguez-Iturbe, I.; Rinaldo, A.

    2010-12-01

    Cholera is an acute enteric disease caused by the ingestion of water or food contaminated by the bacterium Vibrio cholerae. Although most infected individuals do not develop severe symptoms, their stool may contain huge quantities of V.~cholerae cells. Therefore, while traveling or commuting, asymptomatic carriers can be responsible for the long-range dissemination of the disease. As a consequence, human mobility is an alternative and efficient driver for the spread of cholera, whose primary propagation pathway is hydrological transport through river networks. We present a multi-layer network model that accounts for the interplay between epidemiological dynamics, hydrological transport and long-distance dissemination of V.~cholerae due to human movement. In particular, building on top of state-of-the-art spatially explicit models for cholera spread through surface waters, we describe human movement and its effects on the propagation of the disease by means of a gravity-model approach borrowed from transportation theory. Gravity-like contact processes have been widely used in epidemiology, because they can satisfactorily depict human movement when data on actual mobility patterns are not available. We test our model against epidemiological data recorded during the cholera outbreak occurred in the KwaZulu-Natal province of South Africa during years 2000--2001. We show that human mobility does actually play an important role in the formation of the spatiotemporal patterns of cholera epidemics. In particular, long-range human movement may determine inter-catchment dissemination of V.~cholerae cells, thus in turn explaining the emergence of epidemic patterns that cannot be produced by hydrological transport alone. We also show that particular attention has to be devoted to study how heterogeneously distributed drinking water supplies and sanitation conditions may affect cholera transmission.

  10. Deciphering the origin of the 2012 cholera epidemic in Guinea by integrating epidemiological and molecular analyses.

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    Stanislas Rebaudet

    2014-06-01

    Full Text Available Cholera is typically considered endemic in West Africa, especially in the Republic of Guinea. However, a three-year lull period was observed from 2009 to 2011, before a new epidemic struck the country in 2012, which was officially responsible for 7,350 suspected cases and 133 deaths. To determine whether cholera re-emerged from the aquatic environment or was rather imported due to human migration, a comprehensive epidemiological and molecular survey was conducted. A spatiotemporal analysis of the national case databases established Kaback Island, located off the southern coast of Guinea, as the initial focus of the epidemic in early February. According to the field investigations, the index case was found to be a fisherman who had recently arrived from a coastal district of neighboring Sierra Leone, where a cholera outbreak had recently occurred. MLVA-based genotype mapping of 38 clinical Vibrio cholerae O1 El Tor isolates sampled throughout the epidemic demonstrated a progressive genetic diversification of the strains from a single genotype isolated on Kaback Island in February, which correlated with spatial epidemic spread. Whole-genome sequencing characterized this strain as an "atypical" El Tor variant. Furthermore, genome-wide SNP-based phylogeny analysis grouped the Guinean strain into a new clade of the third wave of the seventh pandemic, distinct from previously analyzed African strains and directly related to a Bangladeshi isolate. Overall, these results highly suggest that the Guinean 2012 epidemic was caused by a V. cholerae clone that was likely imported from Sierra Leone by an infected individual. These results indicate the importance of promoting the cross-border identification and surveillance of mobile and vulnerable populations, including fishermen, to prevent, detect and control future epidemics in the region. Comprehensive epidemiological investigations should be expanded to better understand cholera dynamics and improve

  11. [Multilocus sequence-typing of vibrio cholerae strains with various epidemic importance].

    Science.gov (United States)

    Mironova, L V; Afanas'ev, M V; Goldapel, E G; Balakhonov, S V

    2015-01-01

    The allele polymorphism of the housekeeping genes (dnaE, lap, recA, pgm, gyrB, cat, chi, gmd) from the Vibrio cholerae strains with different epidemic importance (n = 41) isolated in Siberia and at the Far East during the cholera pandemic VII was tested. All toxigenic strains isolated at the period of epidemic complications irrespective of time and source of isolation were characterized by the identical allele profile and belonged to the same sequence-type. Nine sequence types were detected in non-epidemic isolates. The dendrogram clustering was associated with the serogroup and in some cases with the territory and time of isolation. The structure heterogeneity of the non-toxigenic V. cholerae housekeeping genes was in most cases caused by the synonymous nucleotide replacements (Dn/Ds cholerae at the analyzed genome sites. The revealed distinctions in the structure of housekeeping genes of the V. cholerae with different epidemic importance can be regarded as evidence of various evolutional directions in these strain groups.

  12. [Epidemic Cholera and American Reform Movements in the 19th Century].

    Science.gov (United States)

    Kim, Seohyung

    2015-12-01

    The 19th century was the age of great reform in American history. After constructing of the canal and railroads, the industrialization began and American society changed so rapidly. In this period, there were so many social crisis and American people tried to solve these problems within the several reform movements. These reform movements were the driving forces to control cholera during the 19th century. Cholera was the endemic disease in Bengal, India, but after the 19th century it had spread globally by the development of trade networks. The 1832 cholera in the United States was the first epidemic cholera in American history. The mortality of cholera was so high, but it was very hard to find out the cause of this fatal infectious disease. So, different social discourses happened to control epidemic cholera in the 19th century, these can be understood within the similar context of American reform movements during this period. Board of Health in New York States made a new public health act to control cholera in 1832, it was ineffective. Some people insisted that the cause of this infectious disease was the corruption of the United States. They emphasized unjust and immoral system in American society. Moral reform expanded to Nativism, because lots of Irish immigrants were the victims of cholera. So, epidemic cholera was the opportunity to spread the desire for moral reform. To control cholera in 1849, the sanitary reform in Britain had affected. The fact that it was so important to improve and maintain the water quality for the control and prevention of disease spread, the sanitary reform happened. There were two different sphere of the sanitary reform. The former was the private reform to improve sewer or privy, the latter was the public reform to build sewage facilities. The 1849 cholera had an important meaning, because the social discourse, which had emphasized the sanitation of people or home expanded to the public sphere. When cholera broke out in 1866 again

  13. Epidemic cholera in rural El Salvador: risk factors in a region covered by a cholera prevention campaign.

    Science.gov (United States)

    Quick, R E; Thompson, B L; Zuniga, A; Dominguez, G; De Brizuela, E L; De Palma, O; Almeida, S; Valencia, A; Ries, A A; Bean, N H

    1995-04-01

    In response to the Latin American cholera epidemic, El Salvador began a prevention programme in April 1991. The first case was confirmed in August, and 700 cases were reported within 3 months. A matched case-control study was conducted in rural La Libertad Department in November 1991. Illness was associated with eating cold cooked or raw seafood (odds ratio [OR] = 7.0; 95% confidence limits [CL] = 1.4, 35.0) and with drinking water outside the home (OR = 8.8; 95% CL = 1.7, 44.6). Assertion of knowledge about how to prevent cholera (OR = 0.2; 95% CL = 0.1, 0.8) and eating rice (OR = 0.2; 95% CL = 0.1, 0.8) were protective. More controls than patients regularly used soap (OR = 0.3; 95% CL = 0.1, 1.0). This study demonstrated three important points for cholera prevention: (1) seafood should be eaten cooked and hot; (2) populations at risk should be taught to treat household drinking water and to avoid drinking water outside the home unless it is known to be treated; and (3) education about hygiene can be an important tool in preventing cholera.

  14. Regional-scale climate-variability synchrony of cholera epidemics in West Africa

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    Petit Michel

    2007-03-01

    Full Text Available Abstract Background The relationship between cholera and climate was explored in Africa, the continent with the most reported cases, by analyzing monthly 20-year cholera time series for five coastal adjoining West African countries: Côte d'Ivoire, Ghana, Togo, Benin and Nigeria. Methods We used wavelet analyses and derived methods because these are useful mathematical tools to provide information on the evolution of the periodic component over time and allow quantification of non-stationary associations between time series. Results The temporal variability of cholera incidence exhibits an interannual component, and a significant synchrony in cholera epidemics is highlighted at the end of the 1980's. This observed synchrony across countries, even if transient through time, is also coherent with both the local variability of rainfall and the global climate variability quantified by the Indian Oscillation Index. Conclusion Results of this study suggest that large and regional scale climate variability influence both the temporal dynamics and the spatial synchrony of cholera epidemics in human populations in the Gulf of Guinea, as has been described for two other tropical regions of the world, western South America and Bangladesh.

  15. Geographical structures and the cholera epidemic in modern Japan: Fukushima prefecture in 1882 and 1895

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    Fukui Hiromichi

    2007-06-01

    Full Text Available Abstract Background Disease diffusion patterns can provide clues for understanding geographical change. Fukushima, a rural prefecture in northeast Japan, was chosen for a case study of the late nineteenth century cholera epidemic that occurred in that country. Two volumes of Cholera Ryu-ko Kiji (Cholera Epidemic Report, published by the prefectural government in 1882 and 1895, provide valuable records for analyzing and modelling diffusion. Text descriptions and numerical evidence culled from the reports were incorporated into a temporal-spatial study framework using geographic information system (GIS and geo-statistical techniques. Results Changes in diffusion patterns between 1882 and 1895 reflect improvements in the Fukushima transportation system and growth in social-economic networks. The data reveal different diffusion systems in separate regions in which residents of Fukushima and neighboring prefectures interacted. Our model also shows that an area in the prefecture's northern interior was dominated by a mix of diffusion processes (contagious and hierarchical, that the southern coastal region was affected by a contagious process, and that other infected areas experienced relocation diffusion. Conclusion In addition to enhancing our understanding of epidemics, the spatial-temporal patterns of cholera diffusion offer opportunities for studying regional change in modern Japan. By highlighting the dynamics of regional reorganization, our findings can be used to better understand the formation of an urban hierarchy in late nineteenth century Japan.

  16. "A wild and wondrous ride": CDC field epidemiologists in the east Pakistan smallpox and cholera epidemics of 1958.

    Science.gov (United States)

    Greenough, Paul

    2011-02-01

    In mid-April of 1958 the Government of Pakistan summoned the press to announce a grave need for international aid to cope with smallpox and cholera epidemics in East Pakistan. In response, and with the backing of the US State Department, Dr. Alexander D. Langmuir, chief epidemiologist of the CDC, led a team of epidemiologists to assist authorities in Dacca strengthen their immunization programs. Langmuir's superiors hoped for a Cold War advantage, but he saw an opportunity for trainees in the Epidemic Intelligence Service to learn about public health in a developing country. Langmuir later described the episode as a "wild and wondrous ride," but it had been more like a nightmare: the East Pakistan health department had collapsed; a popular movement had taken over vaccination and squandered vaccine supplies; hostile journalists had questioned the Americans' deeper motives; and a professional rivalry opened between the Americans and a British epidemiologist named Aidan Cockburn. By the time the epidemic subsided in July 1958, 30 million Bengalis had been vaccinated for smallpox but another 20,000 had succumbed to the disease. This episode was CDC's first sustained foreign intervention, a precursor to its extensive role in the 1970s helping WHO eradicate smallpox from Bangladesh.

  17. A spatially explicit model for the future progression of the current Haiti cholera epidemic

    Science.gov (United States)

    Bertuzzo, E.; Mari, L.; Righetto, L.; Gatto, M.; Casagrandi, R.; Rodriguez-Iturbe, I.; Rinaldo, A.

    2011-12-01

    As a major cholera epidemic progresses in Haiti, and the figures of the infection, up to July 2011, climb to 385,000 cases and 5,800 deaths, the development of general models to track and predict the evolution of the outbreak, so as to guide the allocation of medical supplies and staff, is gaining notable urgency. We propose here a spatially explicit epidemic model that accounts for the dynamics of susceptible and infected individuals as well as the redistribution of textit{Vibrio cholera}, the causative agent of the disease, among different human communities. In particular, we model two spreading pathways: the advection of pathogens through hydrologic connections and the dissemination due to human mobility described by means of a gravity-like model. To this end the country has been divided into hydrologic units based on drainage directions derived from a digital terrain model. Moreover the population of each unit has been estimated from census data downscaled to 1 km x 1 km resolution via remotely sensed geomorphological information (LandScan texttrademark project). The model directly account for the role of rainfall patterns in driving the seasonality of cholera outbreaks. The two main outbreaks in fact occurred during the rainy seasons (October and May) when extensive floodings severely worsened the sanitation conditions and, in turn, raised the risk of infection. The model capability to reproduce the spatiotemporal features of the epidemic up to date grants robustness to the foreseen future development. In this context, the duration of acquired immunity, a hotly debated topic in the scientific community, emerges as a controlling factor for progression of the epidemic in the near future. The framework presented here can straightforwardly be used to evaluate the effectiveness of alternative intervention strategies like mass vaccinations, clean water supply and educational campaigns, thus emerging as an essential component of the control of future cholera

  18. On Spatially Explicit Models of Epidemic and Endemic Cholera: The Haiti and Lake Kivu Case Studies.

    Science.gov (United States)

    Rinaldo, A.; Bertuzzo, E.; Mari, L.; Finger, F.; Casagrandi, R.; Gatto, M.; Rodriguez-Iturbe, I.

    2014-12-01

    The first part of the Lecture deals with the predictive ability of mechanistic models for the Haitian cholera epidemic. Predictive models of epidemic cholera need to resolve at suitable aggregation levels spatial data pertaining to local communities, epidemiological records, hydrologic drivers, waterways, patterns of human mobility and proxies of exposure rates. A formal model comparison framework provides a quantitative assessment of the explanatory and predictive abilities of various model settings with different spatial aggregation levels. Intensive computations and objective model comparisons show that parsimonious spatially explicit models accounting for spatial connections have superior explanatory power than spatially disconnected ones for short-to intermediate calibration windows. In general, spatially connected models show better predictive ability than disconnected ones. We suggest limits and validity of the various approaches and discuss the pathway towards the development of case-specific predictive tools in the context of emergency management. The second part deals with approaches suitable to describe patterns of endemic cholera. Cholera outbreaks have been reported in the Democratic Republic of the Congo since the 1970s. Here we employ a spatially explicit, inhomogeneous Markov chain model to describe cholera incidence in eight health zones on the shore of lake Kivu. Remotely sensed datasets of chlorophyll a concentration in the lake, precipitation and indices of global climate anomalies are used as environmental drivers in addition to baseline seasonality. The effect of human mobility is also modelled mechanistically. We test several models on a multi-year dataset of reported cholera cases. Fourteen models, accounting for different environmental drivers, are selected in calibration. Among these, the one accounting for seasonality, El Nino Southern Oscillation, precipitation and human mobility outperforms the others in cross-validation.

  19. Variations in SXT elements in epidemic Vibrio cholerae O1 El Tor strains in China.

    Science.gov (United States)

    Wang, Ruibai; Yu, Dong; Yue, Junjie; Kan, Biao

    2016-03-09

    Vibrio cholerae O1 El Tor biotype strains are responsible for three multiyear epidemics of cholera in China during the seventh ongoing pandemic. The presence of the integrative conjugative element SXT is strongly correlated with resistance to nalidixic acid, tetracycline, and trimethoprim-sulfamethoxazole in these strains. Here, we sequenced the conserved genes of the SXT element, including eex, setR, and int, from 59 V. cholerae O1 El Tor strains and extracted and assembled the intact SXT sequences from the 11 genome sequenced strains. These elements had characteristics distinct from those of previously reported integrative conjugative elements (ICEs). They could be clearly divided into two types based on the clustering of conserved genes and gene structures of the elements, showing their possibly independent derivation and evolution. These two types were present before and after 2005, respectively, demonstrating the type substitution that occurred in 2005. Four to six antibiotic-resistant genes were found on the SXT elements, including genes resistant to tetracycline, trimethoprim-sulfamethoxazole, and multiple drugs. In summary, our findings demonstrated the roles of the SXT element in the emergence of multidrug resistance in epidemic O1 El Tor V. cholerae strains in China.

  20. Phenotypic Analysis Reveals that the 2010 Haiti Cholera Epidemic Is Linked to a Hypervirulent Strain.

    Science.gov (United States)

    Satchell, Karla J F; Jones, Christopher J; Wong, Jennifer; Queen, Jessica; Agarwal, Shivani; Yildiz, Fitnat H

    2016-09-01

    Vibrio cholerae O1 El Tor strains have been responsible for pandemic cholera since 1961. These strains have evolved over time, spreading globally in three separate waves. Wave 3 is caused by altered El Tor (AET) variant strains, which include the strain with the signature ctxB7 allele that was introduced in 2010 into Haiti, where it caused a devastating epidemic. In this study, we used phenotypic analysis to compare an early isolate from the Haiti epidemic to wave 1 El Tor isolates commonly used for research. It is demonstrated that the Haiti isolate has increased production of cholera toxin (CT) and hemolysin, increased motility, and a reduced ability to form biofilms. This strain also outcompetes common wave 1 El Tor isolates for colonization of infant mice, indicating that it has increased virulence. Monitoring of CT production and motility in additional wave 3 isolates revealed that this phenotypic variation likely evolved over time rather than in a single genetic event. Analysis of available whole-genome sequences and phylogenetic analyses suggested that increased virulence arose from positive selection for mutations found in known and putative regulatory genes, including hns and vieA, diguanylate cyclase genes, and genes belonging to the lysR and gntR regulatory families. Overall, the studies presented here revealed that V. cholerae virulence potential can evolve and that the currently prevalent wave 3 AET strains are both phenotypically distinct from and more virulent than many El Tor isolates.

  1. Historical report: first isolation of Vibrio Cholera serogroup 01 biovar El Tor serovar inaba during the cholerae epidemic in Peru - 1991

    OpenAIRE

    Bravo Cruz, Nora; Facultad de Ciencias Naturales y Matemática, Universidad Nacional Federico Villarreal. Bióloga. Exjefa del Departamento de Bacteriología, Centro Nacional de Salud Pública, Instituto Nacional de Salud.; Guillén, Alfredo; Facultad de Tecnología Médica, Universidad Nacional Federico Villarreal. Clínica San Borja. Médico Microbiólogo.

    2011-01-01

    20 years ago, a new diarrheal disease was introduced in Peru and the Enteropathogens Reference Laboratory of the Instituto Nacional de Salud had an outstanding role in the isolation and rapid and timely identification of Vibrio cholerae. Cholera had not been seen before, but during the last week of January 1991 an outbreak of acute diarrhea was detected, presenting intense dehydration and some deaths. The epidemic affected, in the beginning, many locations of the peruvian coast. Some work...

  2. Cholera epidemic in Guinea-Bissau (2008: the importance of "place".

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    Francisco J Luquero

    Full Text Available BACKGROUND: As resources are limited when responding to cholera outbreaks, knowledge about where to orient interventions is crucial. We describe the cholera epidemic affecting Guinea-Bissau in 2008 focusing on the geographical spread in order to guide prevention and control activities. METHODOLOGY/PRINCIPAL FINDINGS: We conducted two studies: 1 a descriptive analysis of the cholera epidemic in Guinea-Bissau focusing on its geographical spread (country level and within the capital; and 2 a cross-sectional study to measure the prevalence of houses with at least one cholera case in the most affected neighbourhood of the capital (Bairro Bandim to detect clustering of households with cases (cluster analysis. All cholera cases attending the cholera treatment centres in Guinea-Bissau who fulfilled a modified World Health Organization clinical case definition during the epidemic were included in the descriptive study. For the cluster analysis, a sample of houses was selected from a satellite photo (Google Earth™; 140 houses (and the four closest houses were assessed from the 2,202 identified structures. We applied K-functions and Kernel smoothing to detect clustering. We confirmed the clustering using Kulldorff's spatial scan statistic. A total of 14,222 cases and 225 deaths were reported in the country (AR = 0.94%, CFR = 1.64%. The more affected regions were Biombo, Bijagos and Bissau (the capital. Bairro Bandim was the most affected neighborhood of the capital (AR = 4.0. We found at least one case in 22.7% of the houses (95%CI: 19.5-26.2 in this neighborhood. The cluster analysis identified two areas within Bairro Bandim at highest risk: a market and an intersection where runoff accumulates waste (p<0.001. CONCLUSIONS/SIGNIFICANCE: Our analysis allowed for the identification of the most affected regions in Guinea-Bissau during the 2008 cholera outbreak, and the most affected areas within the capital. This information was essential for making

  3. Seroepidemiologic survey of epidemic cholera in Haiti to assess spectrum of illness and risk factors for severe disease.

    Science.gov (United States)

    Jackson, Brendan R; Talkington, Deborah F; Pruckler, James M; Fouché, M D Bernadette; Lafosse, Elsie; Nygren, Benjamin; Gómez, Gerardo A; Dahourou, Georges A; Archer, W Roodly; Payne, Amanda B; Hooper, W Craig; Tappero, Jordan W; Derado, Gordana; Magloire, Roc; Gerner-Smidt, Peter; Freeman, Nicole; Boncy, Jacques; Mintz, Eric D

    2013-10-01

    To assess the spectrum of illness from toxigenic Vibrio cholerae O1 and risk factors for severe cholera in Haiti, we conducted a cross-sectional survey in a rural commune with more than 21,000 residents. During March 22-April 6, 2011, we interviewed 2,622 residents ≥ 2 years of age and tested serum specimens from 2,527 (96%) participants for vibriocidal and antibodies against cholera toxin; 18% of participants reported a cholera diagnosis, 39% had vibriocidal titers ≥ 320, and 64% had vibriocidal titers ≥ 80, suggesting widespread infection. Among seropositive participants (vibriocidal titers ≥ 320), 74.5% reported no diarrhea and 9.0% had severe cholera (reported receiving intravenous fluids and overnight hospitalization). This high burden of severe cholera is likely explained by the lack of pre-existing immunity in this population, although the virulence of the atypical El Tor strain causing the epidemic and other factors might also play a role.

  4. Traveling wave solutions for epidemic cholera model with disease-related death.

    Science.gov (United States)

    Zhang, Tianran; Gou, Qingming

    2014-01-01

    Based on Codeço's cholera model (2001), an epidemic cholera model that incorporates the pathogen diffusion and disease-related death is proposed. The formula for minimal wave speed c (∗) is given. To prove the existence of traveling wave solutions, an invariant cone is constructed by upper and lower solutions and Schauder's fixed point theorem is applied. The nonexistence of traveling wave solutions is proved by two-sided Laplace transform. However, to apply two-sided Laplace transform, the prior estimate of exponential decrease of traveling wave solutions is needed. For this aim, a new method is proposed, which can be applied to reaction-diffusion systems consisting of more than three equations.

  5. Traveling Wave Solutions for Epidemic Cholera Model with Disease-Related Death

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    Tianran Zhang

    2014-01-01

    Full Text Available Based on Codeço’s cholera model (2001, an epidemic cholera model that incorporates the pathogen diffusion and disease-related death is proposed. The formula for minimal wave speed c∗ is given. To prove the existence of traveling wave solutions, an invariant cone is constructed by upper and lower solutions and Schauder’s fixed point theorem is applied. The nonexistence of traveling wave solutions is proved by two-sided Laplace transform. However, to apply two-sided Laplace transform, the prior estimate of exponential decrease of traveling wave solutions is needed. For this aim, a new method is proposed, which can be applied to reaction-diffusion systems consisting of more than three equations.

  6. Optimal allocation of the limited oral cholera vaccine supply between endemic and epidemic settings

    Science.gov (United States)

    Moore, Sean M.; Lessler, Justin

    2015-01-01

    The World Health Organization (WHO) recently established a global stockpile of oral cholera vaccine (OCV) to be preferentially used in epidemic response (reactive campaigns) with any vaccine remaining after 1 year allocated to endemic settings. Hence, the number of cholera cases or deaths prevented in an endemic setting represents the minimum utility of these doses, and the optimal risk-averse response to any reactive vaccination request (i.e. the minimax strategy) is one that allocates the remaining doses between the requested epidemic response and endemic use in order to ensure that at least this minimum utility is achieved. Using mathematical models, we find that the best minimax strategy is to allocate the majority of doses to reactive campaigns, unless the request came late in the targeted epidemic. As vaccine supplies dwindle, the case for reactive use of the remaining doses grows stronger. Our analysis provides a lower bound for the amount of OCV to keep in reserve when responding to any request. These results provide a strategic context for the fulfilment of requests to the stockpile, and define allocation strategies that minimize the number of OCV doses that are allocated to suboptimal situations. PMID:26423441

  7. [The cholera epidemics in Córdoba as seen through the press: the supply of preservatives and cures during the 1867-1868 epidemic].

    Science.gov (United States)

    Carbonetti, Adrián; Rodríguez, María Laura; Noelia, Rimonda; Martina, Yamila

    2007-01-01

    Disease is always represented a moment of crisis for individuals and societies. When death brought by disease hangs heavy over societies, they are lead to develop strategies to prevent and cure it. Epidemics, especially cholera epidemics, have had a strong impact on Argentine society, especially on Cordoba residents, because the first cholera outbreak was highly devastating in both demographic and social terms. In this article we analyze the supply of products that were advertised in the press during the first epidemic, which broke out in 1867-68. Our basic hypothesis is that the products available developed a widespread trade that was not the object of commercial transactions common to those social grouping during periods in which there were no epidemics. When they took place, those products were directed towards more affluent groups.

  8. [A giant field of death: medical and scientific controversies about the cholera morbus epidemic of 1855].

    Science.gov (United States)

    Santos, Luciana Dos

    2016-01-01

    The article examines the cholera morbus epidemic that afflicted the province of Pernambuco, Brazil, in 1855, focusing on the medical and scientific controversies about how the disease spread, which split medical opinion into two camps: contagion and infection. Documents and reports produced by the Society of Medicine of Pernambuco and the General Public Health Board were analyzed, based on which it was possible to describe the official medical and sanitation program, involving engineers, scientists, and physicians, designed to plan a salubrious city - a model of civilization that combined redeveloping the urban space and disseminating new habits amongst the local people. It is essentially an exercise in observing a science and a society as they take shape.

  9. Cholera.

    Science.gov (United States)

    Lippi, Donatella; Gotuzzo, Eduardo; Caini, Saverio

    2016-08-01

    Cholera is an acute disease of the gastrointestinal tract caused by Vibrio cholerae. Cholera was localized in Asia until 1817, when a first pandemic spread from India to several other regions of the world. After this appearance, six additional major pandemics occurred during the 19th and 20th centuries, the latest of which originated in Indonesia in the 1960s and is still ongoing. In 1854, a cholera outbreak in Soho, London, was investigated by the English physician John Snow (1813 to 1858). He described the time course of the outbreak, managed to understand its routes of transmission, and suggested effective measures to stop its spread, giving rise to modern infectious disease epidemiology. The germ responsible for cholera was discovered twice: first by the Italian physician Filippo Pacini during an outbreak in Florence, Italy, in 1854, and then independently by Robert Koch in India in 1883, thus favoring the germ theory over the miasma theory of disease. Unlike many other infectious diseases, such as plague, smallpox, and poliomyelitis, cholera persists as a huge public health problem worldwide, even though there are effective methods for its prevention and treatment. The main reasons for its persistence are socioeconomic rather than purely biological; cholera flourishes where there are unsatisfactory hygienic conditions and where a breakdown of already fragile sanitation and health infrastructure occurs because of natural disasters or humanitarian crises.

  10. Climate and cholera in KwaZulu-Natal, South Africa: the role of environmental factors and implications for epidemic preparedness.

    Science.gov (United States)

    Mendelsohn, Joshua; Dawson, Terry

    2008-03-01

    A cholera epidemic that took place in KwaZulu-Natal, South Africa (2000-2001) was employed to investigate the impact of climatic and environmental drivers on cholera dynamics. Precipitation (PRE), sea surface temperature (SST) and chlorophyll-a (CHL-a) data acquired from publicly available satellite and ground measurements were analysed together with disease incidence in an effort to assess the environmental contribution to the outbreak. SST (r(2)=0.749, lag=0 months) and PRE (r(2)=0.744, lag=2 months) showed strong associations with incidence. CHL-a showed a moderately strong (r(2)=0.656, lag=6 months) association with incidence while sea surface height (SSH) demonstrated a weak relationship with incidence (r(2)=0.326, lag=5 months). Our analysis tentatively supports a coastal transmission hypothesis, heavily influenced by localized PRE extremes. The role of SSH is likely attenuated by local coastal topography. Future work should clarify the mechanism linking coastal cholera reservoirs and the regional climate system to outbreaks in this region. Finally, we discuss benefits of further research in this area using extended remotely sensed and epidemiological datasets towards the development of early-warning systems and enhanced epidemic preparedness.

  11. Cholera outbreak--southern Sudan, 2007.

    Science.gov (United States)

    2009-04-10

    Vibrio cholerae causes cholera, an acute infectious diarrheal disease that can result in death without appropriate therapy, depending on the severity of the disease. War, poverty, inadequate sanitation, and large numbers of refugees and internally displaced persons (IDPs) are major precursors to cholera outbreaks. In 2005, Southern Sudan ended its 22-year civil war with North Sudan; as a result, IDPs and refugees are returning to the south. During April--June 2007, investigators from the Southern Sudan Field Epidemiology and Laboratory Training Program (SS-FELTP) and CDC investigated a cholera outbreak in the town of Juba, Southern Sudan. This report summarizes the results of that investigation, which found that 3,157 persons were diagnosed with suspected cholera during January--June 2007, with 74 deaths resulting from the disease. An environmental investigation revealed suboptimal hygiene practices and a lack of water and sanitation infrastructure in Juba. A case-control study indicated that persons less likely to have cholera were more likely to have consumed hot meals containing meat during the outbreak. Contaminated food or water were not identified as possible sources of the cholera outbreak in Juba. However, this might be attributed to limitations of the study, including small sample size. Cholera can reach epidemic proportions if adequate control measures are not implemented early. Mass media campaigns are important for current and new residents in Juba to understand the importance of proper food handling, clean water, and optimal hygiene practices to prevent the spread of cholera.

  12. [The characteristics of cholera prevalence and of the performance of epidemic-control measures in small settlements of Dagestan].

    Science.gov (United States)

    Terent'ev, A N; Lomov, Iu M; Karbyshev, G L; Gasaev, D G; Golubev, B P; Fetsaĭlova, O P; Bespalov, A I; Tagirov, A S; Ivanova, N G; Pasiukov, V V

    1995-01-01

    The present work deals with summarizing the experience obtained by the specialized antiepidemic brigade of the Rostov-on-Don Research Institute for Plague Control in the work on the liquidation of cholera in some regions of Daghestan with a view to discussing the problems of improvement of anticholera measures. The characteristic features of the epidemic process were its explosive character, sparseness of the foci of infection, the prevalence of its transmission through everyday contacts (family contacts and intensive tribal contacts) and essential delays in taking anticholera measures due to sudden appearance of outbreaks, remoteness of small settlements and the lack of manpower and means for carrying out anticholera measures at a given place and time, as well as delays in epidemiological analysis carried out by local health service bodies. Delays in carrying out such measures led to the spread of infection both within settlements and in the whole region and further in the republic. The epidemic process was complicated by the antibiotic resistance of V.cholerae strains circulating on this territory. All these factors formed specific epidemic situation which introduced amendments into the organization of anticholera measures.

  13. 气候变化影响霍乱流行的研究进展%Progress in research of impact of climate factor on cholera epidemic

    Institute of Scientific and Technical Information of China (English)

    王鲁茜; 阚飙

    2011-01-01

    Climate factor has great impact on the incidence and distribution of communicable diseases. The distributional pattern of cholera was characterized by "endemicity" and "seasonality". Climate and environmental factors play a driving role in the epidemic and pandemic of cholera. Time series analysis on the cholera incidence and the mathematical model based cholera dynamics analysis indicated that the climate factor and population immunity levels against cholera are key determinants for cholera epidemic; extreme climate events such as El Nino are closely associated with the incidence of cholera outbreak. This paper summarizes the development on our understanding how climate changes influence the epidemic of cholera from the aspects of epidemiology, ecology, and model based dynamics,emphasizing its significance to cholera control.%气候因素对传染病的流行产生重要影响.霍乱的流行具有季节性和一定的自然疫源性,气候和环境因素在霍乱的流行和大流行中起驱动作用.霍乱流行的时间序列分析和数学模型显示,气候因素和人群的免疫水平是决定霍乱流行的重要因素,厄尔尼诺等极端气候变化与霍乱暴发流行密切相关.本文从生态学、流行病学、统计学、数学模型等方面概述了气候和环境因素在霍乱流行中起的作用,并阐述了其对霍乱控制的意义.

  14. Implementation of an alert and response system in Haiti during the early stage of the response to the cholera epidemic.

    Science.gov (United States)

    Santa-Olalla, Patricia; Gayer, Michelle; Magloire, Roc; Barrais, Robert; Valenciano, Marta; Aramburu, Carmen; Poncelet, Jean Luc; Gustavo Alonso, Juan Carlos; Van Alphen, Dana; Heuschen, Florence; Andraghetti, Roberta; Lee, Robert; Drury, Patrick; Aldighieri, Sylvain

    2013-10-01

    The start of the cholera epidemic in Haiti quickly highlighted the necessity of the implementation of an Alert and Response (A&R) System to complement the existing national surveillance system. The national system had been able to detect and confirm the outbreak etiology but required external support to monitor the spread of cholera and coordinate response, because much of the information produced was insufficiently timely for real-time monitoring and directing of a rapid, targeted response. The A&R System was designed by the Pan American Health Organization/World Health Organization in collaboration with the Haiti Ministry of Health, and it was based on a network of partners, including any institution, structure, or individual that could identify, verify, and respond to alerts. The defined objectives were to (1) save lives through early detection and treatment of cases and (2) control the spread through early intervention at the community level. The operational structure could be broken down into three principle categories: (1) alert (early warning), (2) verification and assessment of the information, and (3) efficient and timely response in coordination with partners to avoid duplication. Information generated by the A&R System was analyzed and interpreted, and the qualitative information was critical in qualifying the epidemic and defining vulnerable areas, particularly because the national surveillance system reported incomplete data for more than one department. The A&R System detected a number of alerts unrelated to cholera and facilitated rapid access to that information. The sensitivity of the system and its ability to react quickly was shown in May of 2011, when an abnormal increase in alerts coming from several communes in the Sud-Est Department in epidemiological weeks (EWs) 17 and 18 were noted and disseminated network-wide and response activities were implemented. The national cholera surveillance system did not register the increase until EWs 21 and

  15. Rainfall-driven epidemic cholera: hydrologic controls on water-borne disease and multi-season projections

    Science.gov (United States)

    Righetto, L.; Bertuzzo, E.; Mari, L.; Casagrandi, R.; Gatto, M.; Rodriguez-Iturbe, I.; Rinaldo, A.

    2012-12-01

    Following the acknowledgement of a clear correlation between rainfall events and cholera resurgence, that was observed in Haiti starting from May 2011, we use a multi-variate Poisson generator to produce rainfall inputs, with which we force spatially explicit models of cholera spreading. Our models consist of ODE systems of equations, describing a network of human communities (divided in Susceptible, Infected and Recovered individuals) connected by river transport of pathogens and human mobility. We perform an a posteriori analysis -- from the beginning of the epidemic until December 2011 -- to assess the model reliability in predicting cholera cases and in testing control measures -- involving vaccination and sanitation campaigns. We then run a multi-seasonal prediction of the course of the epidemic until December 2015, to investigate further resurgences of cholera in the region and to evaluate, again, the effect of policies which may bring to the eradication of the disease in Haiti. We conclude that mathematical models may represent a key information tool for policy makers, as a way to preliminarly assess the possible future course of an epidemic and to test intervention policies to be deployed. Effect of intervention policies on the predicted course of the epidemic between 28/05-31/12/2011 (blue lines: simulations with the observed rainfall pattern; red lines/shaded range: median/25th-75th percentile range of simulations with generated rainfall). A) Effect of a reduction of the 20% of the contact rate , applied in one month starting from the 1st of June (dashed blue/red lines) or the 1st of July (dotted blue/red lines). B) A) Effect of a vaccination of 4 million individuals, implemented in one month starting from the 1st of June (dashed blue/red lines) or the 1st of July (dotted blue/red lines). C) Number of new cases in the period 28/05-31/12/2011 as a function of the reduction of the contact rate . D) Number of new cases in the period 28/05-31/12/2011 as a

  16. Hierarchical Bayesian modeling of the space-time diffusion patterns of cholera epidemic in Kumasi, Ghana

    NARCIS (Netherlands)

    Osei, Frank B.; Duker, Alfred A.; Stein, Alfred

    2011-01-01

    This study analyses the joint effects of the two transmission routes of cholera on the space-time diffusion dynamics. Statistical models are developed and presented to investigate the transmission network routes of cholera diffusion. A hierarchical Bayesian modelling approach is employed for a joint

  17. Cholera Transmission in Ouest Department of Haiti: Dynamic Modeling and the Future of the Epidemic

    Science.gov (United States)

    Kirpich, Alexander; Weppelmann, Thomas A.; Yang, Yang; Ali, Afsar; Morris, J. Glenn; Longini, Ira M.

    2015-01-01

    In the current study, a comprehensive, data driven, mathematical model for cholera transmission in Haiti is presented. Along with the inclusion of short cycle human-to-human transmission and long cycle human-to-environment and environment-to-human transmission, this novel dynamic model incorporates both the reported cholera incidence and remote sensing data from the Ouest Department of Haiti between 2010 to 2014. The model has separate compartments for infectious individuals that include different levels of infectivity to reflect the distribution of symptomatic and asymptomatic cases in the population. The environmental compartment, which serves as a source of exposure to toxigenic V. cholerae, is also modeled separately based on the biology of causative bacterium, the shedding of V. cholerae O1 by humans into the environment, as well as the effects of precipitation and water temperature on the concentration and survival of V. cholerae in aquatic reservoirs. Although the number of reported cholera cases has declined compared to the initial outbreak in 2010, the increase in the number of susceptible population members and the presence of toxigenic V. cholerae in the environment estimated by the model indicate that without further improvements to drinking water and sanitation infrastructures, intermittent cholera outbreaks are likely to continue in Haiti. PMID:26488620

  18. [Cholera epidemiology in Mozambique: 1973-1992].

    Science.gov (United States)

    Aragón, M; Barreto, A; Tabbard, P; Chambule, J; Santos, C; Noya, A

    1994-10-01

    The results of an epidemiological analysis of cholera in Mozambique from 1973 to 1992 are described. The project sought to assess the influence of socio-economic and ecological factors the spread of cholera in a country at war. Information about the incidence of cholera and the fatality rate were related to the rainfall and the annual average growth rate of the population in the main cities. Water supply, sanitation and food hygiene were also studied. The high annual average growth rate of the population was found to have a direct linear correlation to the incidence of cholera. The drought of 1991-1992 also played an important role in the increased number of cases of the disease. Cholera has presented an endemic-epidemic pattern determined by: a) the uncontrolled growth of urban population, b) the deterioration of sanitation in urban centers, c) the unhygienic commercialization of food and d) the drought.

  19. An Ecosocial Approach to the Epidemic of Cholera in the Marshall Islands

    Directory of Open Access Journals (Sweden)

    Wesley Palmer

    2007-04-01

    Full Text Available Abstract: A cholera outbreak occurred in the Marshall Islands in December 2000 to January 2001 with over 400 cases and six deaths. Within Kwajalein Atoll, cholera occurred on Ebeye Island, while it did not occur on Kwajalein Island, three miles away. We apply Krieger’s ecosocial approach in order to explicate the reasons for this dichotomy. We first examine how Marshallese people came to embody cholera as a disease state. Secondly, we examine the (a arrangements of power, property, production, and consumption in the Ebeye-Kwajalein complex, as well as (b human biology as it has been shaped by the ecological context in order to elucidate the pathways to the embodiment of cholera. Thirdly, we examine the cumulative interplay between exposure to cholera, as well as susceptibility and resistance to the disease at the level of individuals and the island-wide level. Fourthly, we examine who is responsible for the cholera outbreak and who describes the phenomena. We conclude that the outbreak of cholera in the Marshall Islands can be considered the biologic embodiment of disparate political and economic conditions and ecological imbalance. We suggest courses of action for those interested in addressing the inequalities and working towards health.

  20. Genomic epidemiology of the haitian cholera outbreak: a single introduction followed by rapid, extensive, and continued spread characterized the onset of the epidemic

    DEFF Research Database (Denmark)

    Eppinger, Mark; Pearson, Talima; Koenig, Sara S. K.;

    2014-01-01

    In this genomic epidemiology study, we have applied high-resolution whole-genome-based sequence typing methodologies on a comprehensive set of genome sequences that have become available in the aftermath of the Haitian cholera epidemic. These sequence resources enabled us to reassess the degree o...

  1. Notes from the Field: Chlorination Strategies for Drinking Water During a Cholera Epidemic - Tanzania, 2016.

    Science.gov (United States)

    Wang, Alice; Hardy, Colleen; Rajasingham, Anangu; Martinsen, Andrea; Templin, Lindsay; Kamwaga, Stanislaus; Sebunya, Kiwe; Jhuthi, Brenda; Habtu, Michael; Kiberiti, Stephen; Massa, Khalid; Quick, Rob; Mulungu, Jane; Eidex, Rachel; Handzel, Thomas

    2016-10-21

    Since August 2015, the Ministry of Health, Community Development, Gender, Elderly and Children (MoHCDGEC) of Tanzania has been leading the response to a widespread cholera outbreak. As of June 9, 2016, cholera had affected 23 of 25 regions in Tanzania, with 21,750 cumulative cases and 341 deaths reported (Ally Nyanga, MoHCDGEC Emergency Operations Center, personal communication, June 2016). Approximately one fourth of all cases occurred in the Dar es Salaam region on the east coast. Regions surrounding Lake Victoria, in the north, also reported high case counts, including Mwanza with 9% (Ally Nyanga, MoHCDGEC Emergency Operations Center, personal communication, June 2016). Since the start of the outbreak, MoHCDGEC and the Ministry of Water (MOW) have collaborated with the Tanzania Red Cross Society, United Nations Children's Fund (UNICEF), World Health Organization (WHO), and CDC to enhance the water, sanitation, and hygiene (WASH) response to prevent the further spread of cholera.

  2. Assessing clonal correlation of epidemic Vibrio cholerae isolates during 2011 in 16 provinces of Iran.

    Science.gov (United States)

    Hajia, Massoud; Rahbar, Mohamad; Farzami, Marjan Rahnamye; Asl, Hossein Masoumi; Dolatyar, Alireza; Imani, Mohsen; Saburian, Roghieh; Mafi, Moharam; Bakhshi, Bita

    2015-03-01

    A total of 1,187 Vibrio cholerae isolates were received during 2011 cholera outbreaks from 16 provinces in different geographical location to Iranian reference Health laboratory. A random selection was performed, and 61 isolates were subjected to further investigations. Cholera cases were come up from May with nine cases and reached to its maximum rate at August (57 cases) and continued to October after which a fall occurred in September. All of the isolates were susceptible to three antimicrobial agents including ciprofloxacin, cefixime, and ampicillin. The highest rate of resistance was seen to nalidixic acid (96.7 %) and co-trimoxazole (91.8 %). Clonality of isolates was investigated through genotyping by PFGE method. A total of seven pulsotypes were obtained from 61 isolates under study. The pulsotypes were highly related with only 1-3 bands differences. Three pulsotypes (PT5, PT6, and PT7) constituted 93.4 % of total isolates. One environmentally isolated strain showed distinct pattern from clinical specimens. This strain although had no any evidence in identified cholera infections, highlighted selecting more environmental specimens in any future outbreaks as long as human samples. In conclusion, emergence and dominance of Ogawa serotypes after about 7 years in Iran are alarming due to fear of import of new V. cholerae clones from out of the country. Approximately, one third of patients in 2011 cholera outbreak in Iran were of Afghan or Pakistani nationality which makes the hypothesis of import of Ogawa serotype strains from neighboring countries more documented and signifies the need to monitor and protect the boundaries.

  3. Preliminary survey from the antimicrobial resistance of Vibrio cholerae O1, epidemic outbreak 1998

    OpenAIRE

    Ibarra,J.O.; Flores, L. E.; R. H. García; Alvarado,D.E.

    2014-01-01

    Thirty strains of V. cholerae O1 Ogawa and 2 Inaba, isolated during the outbreak of 1998, were studied in relation to thier sensibility in front of 10 antibiotics of clinical use. Nine strains were determined (28.1%) resistant to 1 up to 6 antibiotics. The SIDS-PAGE of the studied strains exhibited similar pattern of bands. Treinta cepas de V. cholerae O1 Ogawa y 2 Inaba, aisladas durante el brote de 1998, fueron estudiados en relación a su sensibilidad frente a 10 antibióticos de uso clín...

  4. Phenotypic, Genotypic, and Antibiotic Sensitivity Patterns of Strains Isolated from the Cholera Epidemic in Zimbabwe

    NARCIS (Netherlands)

    Islam, Mohammad S.; Mahmud, Zahid H.; Ansaruzzaman, Mohammad; Faruque, Shah M.; Talukder, Kaisar A.; Qadri, Firdausi; Alam, Munirul; Islam, Shafiqul; Bardhan, Pradip K.; Mazumder, Ramendra N.; Khan, Azharul I.; Ahmed, Sirajuddin; Iqbal, Anwarul; Chitsatso, Owen; Mudzori, James; Patel, Sheetal; Midzi, Stanley M.; Charimari, Lincoln; Endtz, Hubert P.; Cravioto, Alejandro

    2011-01-01

    This paper details the phenotypic, genotypic, and antibiotic sensitivity patterns of 88 Vibrio cholerae strains from Zimbabwe. Of the 88 strains, 83 were classified as "altered El Tor" and 5 as "hybrid El Tor" strains. All of the strains were susceptible to tetracycline, doxycycline, ciprofloxacin,

  5. Mexico's other wars: epidemics, disease, and public health in Guanajuato, Mexico, 1810-1867.

    Science.gov (United States)

    Thompson, A T

    1996-01-01

    "Mexico's Other Wars" refers to the fight against disease, particularly epidemic disease, during the period when Mexico gained its independence and was involved in the very conflictive process of nation-building, from 1810-1867. Controlling and eradicating disease was an integral part of that process. In this period, fighting disease assumed the crucial political purpose of making all people healthier as one means of building an economically productive civil society. To attain this goal, early nineteenth-century local policy makers organized an increasingly secular and integrated public health system governed by municipal and state officials who legislated local public health regulations. While disease was not eradicated, the incidence and severity of epidemics decreased and likely contributed, as one of many factors, to population increase. This process was evident in the city and state of Guanajuato, the focus of this paper, for Guanajuato's population almost doubled in this period despite war and intermittent armed conflict.

  6. [The analysis of possibility to apply new preparations in serologic diagnostic of agent of cholera in working activity of specialized anti-epidemic brigades].

    Science.gov (United States)

    Mazrukho, A B; Tatarenko, O A; Alekseyeva, L P; Agafonova, V V; Shaly, O A; Pisanov, R V; Aiydinov, G V; Stupina, N A

    2013-05-01

    The approbation of diagnostic preparations on the substrate of monoclonal antibodies developed in the institute was carried out during tactical specialized exercise with building up of units on the basis of mobile complex of specialized anti-epidemic brigades. It is established that diagnostic agglutinating and fluorescent monoclonal immunoglobulins by their sensitivity are equal to polyclonal commercial preparations and can be used at the stages of laboratory diagnostic of cholera both in conditions of stationary laboratory and mobile complex of specialized anti-epidemic brigades. The method of dot immunoanalysis on the substrate of monoclonal antibodies can, on a par with such common methods as immunofluorescence, slide-agglutination and polymerase chain reaction, be applied in complex of methods of express-diagnostic of cholera.

  7. Epidemic tvpe and antibiotic resistance of cholera strains isolated%霍乱疫情分离株流行菌型及耐药性分析

    Institute of Scientific and Technical Information of China (English)

    王少玲; 吴捷; 刁保卫; 崔志刚; 王衍德; 朱建华; 黄昌和; 马焱

    2012-01-01

    Objective To assess the epidemic type and antibiotic resistance of cholere strains isolated and to provide basis for clinical treatment and prevention of cholera. Methods Six samples from an outbreak of cholera epidemic were collected in Hainan province in June 2008 and analyzed by serotyping and phage-biotyping. The cholera toxin gene was detected with PCR according to the " Manual for the Prevention and Control of Cholera" (version 5). Pulsed field gel electro-phoresis( PFGE) was used for subtyping of the isolates. The antibiotic susceptibility test of the 6 strains to 17 kinds of antibacterial was determined with improved K-B method recommended by WHO. Results The 6 strains were confirmed as Vibrio cholerae El Tor biotype, with 5 strains of 01 group of Vibrio cholerae El Tor serotype Inaba lc and 1 strains was Vibrio cholerae Ogawa( lc). The cholera toxin gene was identified in all 6 strains. The mapping of the strains were belonged to two pattern by PFGE and the similarity was 100 %. The 6 strains were all resistant to streptomycin,sulphamethoxazole/trim-ethoprim, sulphafurazole, and polymyxin B. High drug susceptibility of the samples was found to 9 kinds of antibiotics such as norfloxacin.cefotaxime and cephalothin(53% ,9/17). Conclusion The bacterium type of Vibrio cholerae causing the epidemic outbreak of cholera was Ol group of Vibrio cholerae El Tor serotype Inaba lc. Norfloxacin.cefotaxime and cepha-lothin could be the choice of clinical treatment for the cases and carriers of Vibrio cholerae in Hainan province. But streptomycin, sulphamethoxazole/trimethoprim,sulphafurazole,and polymyxin B could not be used.%目的 了解霍乱疫情分离株的流行菌型及其耐药性,为霍乱疫情的快速有效控制和临床治疗提供科学依据.方法 对2008年6月海南省某地霍乱疫情采集的6株霍乱弧菌分离株进行血清学分型、噬菌体-生物分型、霍乱毒素基因检测、脉冲场凝胶电泳(PFGE)分子分型

  8. [John Snow, the cholera epidemic and the foundation of modern epidemiology].

    Science.gov (United States)

    Cerda L, Jaime; Valdivia C, Gonzalo

    2007-08-01

    John Snow (1813-1858) was a brilliant British physician. Since young he stood out for his acute observation capacity, logical thinking and perseverance, first in anesthetics and later in epidemiology. The successive outbreaks of cholera that affected London, motivated him to study this disease from a populational point of view. He related the appearance of cases to the consumption of "morbid matter", responsible for the acute diarrhea with dehydration that characterizes this disease. Bravely, Snow opposed to certain theories present at his time, sacrificing his own prestige. He was a pioneer in the use of modern epidemiological investigation methodologies such as conducting surveys and spatial epidemiology. Fairly, he is considered nowadays as father of modern epidemiology by the scientific community.

  9. Characteristics and clinical management of patients admitted to cholera wards in a regional referral hospital during the 2012 epidemic in Sierra Leone

    Directory of Open Access Journals (Sweden)

    Alexander Blacklock

    2015-01-01

    Full Text Available Background and objectives: In 2012, Sierra Leone suffered a nationwide cholera epidemic which affected the capital Freetown and also the provinces. This study aims to describe the characteristics and clinical management of patients admitted to cholera isolation wards of the main referral hospital in the Northern Province and compare management with standard guidelines. Design: All available clinical records of patients from the cholera isolation wards were reviewed retrospectively. There was no active case finding. The following data were collected from the clinical records after patients had left the ward: date of admission, demographics, symptoms, dehydration status, diagnoses, tests and treatments given, length of stay, and outcomes. Results: A total of 798 patients were admitted, of whom 443 (55.5% were female. There were 18 deaths (2.3%. Assessment of dehydration status was recorded in 517 (64.8% of clinical records. An alternative or additional diagnosis was made for 214 patients (26.8%. Intravenous (IV fluids were prescribed to 767 patients (96.1%, including 95% of 141 patients who had documentation of being not severely dehydrated. A history of vomiting was documented in 92.1% of all patients. Oral rehydration solution (ORS was given to 629 (78.8% patients. Doxycycline was given to 380 (47.6% patients, erythromycin to 34 (4.3%, and other antibiotics were used on 247 occasions. Zinc was given to 209 (26.2%. Discussion: This retrospective study highlights the need for efforts to improve the quality of triage, adherence to clinical guidance, and record keeping. Conclusions: Data collection and analysis of clinical practices during an epidemic situation would enable faster identification of those areas requiring intervention and improvement.

  10. The role of an anaesthetist in a field hospital during the cholera epidemic among Rwandan refugees in Goma.

    Science.gov (United States)

    Ginosar, Y; Shapira, S C

    1995-12-01

    In 1849 John Snow, already the leading anaesthetic practitioner and innovator of his day, made a historic contribution to the epidemiology of infectious disease by his famous study of the distribution of cholera around the area of Broad Street in London. We report on our experience as anaesthetists in a field hospital, dispatched as part of the international rescue effort to Goma, Zaire, to help combat the effects of cholera among the Rwandan refugees.

  11. Antimicrobial resistance of clinical and environmental strains of Vibrio cholerae isolated in Lima-Peru during epidemics of 1991 and 1998

    Directory of Open Access Journals (Sweden)

    J.O. Ibarra

    2007-02-01

    Full Text Available The susceptibility in vitro of 71 isolations of V. cholerae was evaluated: 24 of clinical origin and 47 strains of clinical and environmental origin collected in the epidemic of 1991 and during the outbreak epidemic of 1998 in Lima-Peru respectively. The biochemical and serological tests carried out established that 43 (60,6% corresponded to the serogroup O1 Ogawa of the 1998 epidemic; 26 (36.6% were of the serotype Inaba, being 24 of them isolated in 1991. Two strains did not belong to the serogroup O1. By means of disk diffusion method and Minimal Inhibitory Concentration (MIC, 15 strains with multi-resistance to antibiotics were determined, 10 of which were of clinical origin and 5 of natural origin, showing 9 antibiotypes with different resistance pattern. The evaluation of susceptibility in front of the vibriostatic agent O/129, demonstrated that 11.4% of the strains, collected in 1998, presented resistance to a concentration of 150 µg. A direct relationship among the resistance that presented the strains of clinical and environmental origin isolated in 1991 and 1998 was established as much for tetracycline, sulfa/trimethoprim and 0/129; 88.6% of the clinical strains of the year 1998 presented resistance to these three drugs, while 100% of clinical strains isolated in 1991 were sensitive to O/129 (150 µg, sulfa/trimethoprim and tetracycline. We conclude that V. cholerae O1 has increased its resistance to antimicrobial drugs of clinical use in the same way it is also losing susceptibility to the vibriostatic compound O/129 for what their use is not recommended for taxonomic purposes.

  12. 2002-2011年霍乱疫情分析及防控对策%Analysis and Countermeasures of Prevention of 2002-2011 Cholera Epidemic Situation

    Institute of Scientific and Technical Information of China (English)

    钟小兵; 涂传树; 张科; 许强; 涂勋成

    2012-01-01

      目的:掌握霍乱流行规律,为政府预防控制提供科学决策依据。方法:搜集2002-2011年霍乱疫情发生信息资料,分析霍乱发生的相关因素及所采取的措施,评估效果。结果:2002-2011年间安县发生的三起霍乱疫情均为农村群体聚餐,菌群为霍乱弧菌0139,菜品中均有甲鱼,在三起霍乱疫情发生中有两起怀疑感染来源于甲鱼,其中一起从同一批次的甲鱼中检出霍乱弧菌0139与病例同源,为厨师未按生熟食品分开进行加工制作,导致食品交叉污染所致。结论:加强农村群体聚餐、农村厨师的管理,规范厨师加工制作食品,避免食物交叉污染,加强居民消化道传染病预防控制知识的健康教育,加强监测,在防控策略上关口前移,重心下沉是预防控制霍乱等消化道传染病的金钥匙。%  Objective:To master the cholera epidemic law,to provide the scientific basis for prevention and control by the government.Method:The information of 2002-2011 cholera outbreak was collected.Related factors were analyzed and measures were taken,and effect wwa evaluated. Result:Analysis of occurrence during the three cholera epidemic are rural community dinners,flora for Vibrio cholerae0139,dishes have soft-shelled turtle,in the three cases of cholera outbreak occurred in two on suspicion of infection from the soft-shelled turtle,one from the same batch of soft-shelled turtle in the detection of Vibrio cholerae 0139cases with homologous,for rural cook did not according to the raw and cooked food separate processing production,leading to food contamination.Conclusion:Strengthen rural community dinners,the management of rural cooks,norm cook foods processed food,avoid cross-contamination,strengthen the residents to digestive tract infectious disease prevention and control knowledge health education,strengthen the monitoring,prevention and control strategy in col-reach,centre of gravity to sink is the golden key of

  13. Role of Ectoine in Vibrio cholerae Osmoadaptation

    OpenAIRE

    Pflughoeft, Kathryn J.; Kierek, Katharine; Paula I Watnick

    2003-01-01

    Vibrio cholerae is both an intestinal pathogen and a microbe in the estuarine community. To persist in the estuarine environment, V. cholerae must adjust to changes in ionic composition and osmolarity. These changes in the aquatic environment have been correlated with cholera epidemics. In this work, we study the response of V. cholerae to increases in environmental osmolarity. Optimal growth of V. cholerae in minimal medium requires supplementation with 200 mM NaCl and KCl. However, when the...

  14. Outbreak investigation of cholera in Bharuch city

    Directory of Open Access Journals (Sweden)

    Navneet G. Padhiyar, Jivraj Damor

    2011-01-01

    Full Text Available Introduction: Cholera is an acute diarrhoeal disease, present in India since ancient times. Cholera epidemic was reported in June 2009 in Bharuch city, Gujarat. Aim: To find out the cause of cholera epidemic and to suggest preventive and control measure. Study design: Cross sectional study. Person from high risk area were interviewed Results: Contamination of drinking water with sewage water was found to be the cause of this epidemic.

  15. Virulence Gene PCR and PFGE Genotyping analysis of Vibrio cholerae strains isolated from cholera epidemics in Hunan province from 2005 to 2010%湖南省2005年-2010年霍乱疫情分离株的毒力基因PCR及PFGE分型分析

    Institute of Scientific and Technical Information of China (English)

    夏昕; 湛志飞; 覃迪; 刘运芝; 高立冬; 胡世雄; 邓志红; 张红

    2012-01-01

    Objective; To understand the pathogenic characteristics of Vibrio cholerae 0139 strains isolated from Vibrio cholerae epidemics in Hunan province from 2005 to 2010; to study the colone relations among the strains. Methods: K - B method was employed to test drug sensitivity; ctxAB virulence gene was tested by PCR, and finally molecular typing was carried out by pulsed field gel electrophoresis ( PFGE) for representative strains isolated from Vibrio cholerae epidemics. Results; 33 Vibrio cholerae 0139 stains presented a higher drug resistance rate against doxycycline and sulphame -thoxazole of 39. 39% and 75.76% , while a sensitivity of 100% to ciprofloxacin, nor-floxacin and amikacin; The virulence gene PCR results showed all the Vibrio cholerae 0139 strains were cholera toxin genes ctxAB - positive; 24 Vibrio cholerae 0139 strains isolated from Vibrio cholerae epidemics in 2005 and 2010 showed 3 PFGE banding types,and all the strains were homology of 83% - 100% by cluster analysis. Conclusion; Vibrio cholerae 0139 strains isolated from cholera epidemic in Hunan province from 2005 to 2010 were all ctxAB positive. The strains from different years and regions were found the closely related epidemic clone group strains of cholera; Resistance monitoring and further molecular typing analysis of Cholera strains contribute to the efficient surveillance of cholera and infectious source tracking.%目的:了解2005年-2010年湖南省霍乱疫情分离到的O139群霍乱弧菌菌株的病原学特征,研究疫情分离株之间的克隆相关性.方法:采用K-B法进行药敏试验;聚合酶链反应(PCR)检测ctxAB毒力基因;脉冲场凝胶电泳对疫情分离代表株进行PFGE分型分析.结果:33株霍乱弧菌对强力霉素、复方新诺明的耐药率较高,分别为39.39%和75.76%,对环丙沙星、诺氟沙星以及丁胺卡那100%敏感;毒力基因的PCR结果显示为所有疫情分离的O139霍乱弧菌均为产毒株,即

  16. [Cholera in Europe and Denmark in the 19th century].

    Science.gov (United States)

    Bonderup, G

    1996-01-01

    There are several reasons for dealing with cholera in the 19th century: it acted as a spotlight throwing into sharp relief the darkest corners of society that are seldom mentioned in the sources. We learn about everyday life in large parts of the population, especially the poor. The fight against the disease also reveals how a society worked socially and politically. When cholera arrived in Europe -- the first time was in the 1830's and several times after that--the population reacted very violently, often by lynching doctors, while the authorities more or less let matters take their course. That is why international researchers have come to see cholera as a catalyst for the constantly latent social unrest following in the train of wars and revolutions. During my research on cholera in Denmark it became clear to me that matters were different here. There were no riots, nor any signs of social unrest--neither before nor after the outbreak of cholera. On the contrary, the authorities and the population joined forces against the epidemic. There was an atmosphere of mutual trust, and almost everybody turned out to be worthy of such trust. That points to a balanced society based on consensus, so cholera also functions as a detector of the fundamental structure of a society.

  17. Reporte histórico: Primer Aislamiento de Vibrio cholera serogrupo O1 biovar El Tor serovar Inaba durante la epidemia de cólera en el Perú ‑ 1991 Historical report: first isolation of Vibrio cholera serogroup O1 biovar El Tor serovar Inaba during the cholerae epidemic in Perú ‑ 1991

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    Nora Bravo Cruz

    2011-03-01

    Full Text Available Hace 20 años apareció una enfermedad diarreica nueva en el Perú y el Laboratorio de Referencia de Enteropatógenos del Instituto Nacional de Salud, cumplió una labor destacada en el aislamiento e identificación rápida y oportuna del Vibrio cholerae. La enfermedad del cólera no se había presentado anteriormente, pero en la última semana de enero de 1991 se detectó un brote epidémico de diarrea aguda con deshidratación intensa y algunos casos de fallecidos. La epidemia afectó, al comienzo, varias localidades del litoral peruano. Equipos de trabajo de la Oficina General de Epidemiología y de los laboratorios del Instituto Nacional de Salud obtuvieron muestras fecales de pacientes con diarrea aguda procedentes de las ciudades de Chancay, Chimbote, Piura y algunos hospitales de Lima. Las muestras colectadas en el medio de transporte de Cary y Blair fueron procesadas en el Laboratorio Nacional de Referencia de Enteropatógenos (LANARE del Instituto Nacional de Salud. De todas las muestras se aisló e identificó Vibrio cholerae serogrupo O1 biovar El Tor serovar Inaba que mostró ser sensible a la tetraciclina y a otros antibióticos. Esta investigación confirmó el primer brote epidémico de cólera en el Perú.20 years ago, a new diarrheal disease was introduced in Peru and the Enteropathogens Reference Laboratory of the Instituto Nacional de Salud had an outstanding role in the isolation and rapid and timely identification of Vibrio cholerae. Cholera had not been seen before, but during the last week of January 1991 an outbreak of acute diarrhea was detected, presenting intense dehydration and some deaths. The epidemic affected, in the beginning, many locations of the peruvian coast. Some working teams of the General Office of Epidemiology and of the Instituto Nacional de Salud obtained fecal samples from patients with acute diarrhea coming from the cities of Chancay, Chimbote, Piura and some hospitals in Lima. The collected samples

  18. Characterization of Vibrio cholerae Strains Isolated from the Nigerian Cholera Outbreak in 2010.

    Science.gov (United States)

    Dupke, Susann; Akinsinde, Kehinde A; Grunow, Roland; Iwalokun, Bamidele A; Olukoya, Daniel K; Oluwadun, Afolabi; Velavan, Thirumalaisamy P; Jacob, Daniela

    2016-10-01

    We examined clinical samples from Nigerian patients with acute watery diarrhea for Vibrio cholerae during the 2010 cholera outbreak. A total of 109 suspected isolates were characterized, but only 57 V. cholerae strains could be confirmed using multiplex real-time PCR as well as rpoB sequencing and typed as V. cholerae O:1 Ogawa biotype El Tor. This finding highlighted the need for accurate diagnosis of cholera in epidemic countries to implement life-saving interventions.

  19. High Depth, Whole-Genome Sequencing of Cholera Isolates from Haiti and the Dominican Republic

    Science.gov (United States)

    2012-09-11

    Vibrio cholerae isolates from Haiti and the Dominican Republic and three additional V. cholerae isolates to a high depth of coverage (>2000x); four of...We used whole-genome approaches to sequence four Vibrio cholerae isolates from Haiti and the Dominican Republic and three additional V. cholerae ...during an epidemic. Keywords Whole-genome sequencing, Vibrio cholerae , Haitian cholera epidemic, Microbial evolution Background Following the

  20. Comparison of Vibrio cholerae O139 with V. cholerae O1 classical and El Tor biotypes.

    OpenAIRE

    Calia, K E; Murtagh, M.; Ferraro, M J; Calderwood, S B

    1994-01-01

    Vibrio cholerae O139 is a recently identified non-O1 V. cholerae strain responsible for outbreaks of epidemic cholera in India, Bangladesh, and Thailand in the past 2 years. Other workers have demonstrated the presence of the cholera toxin genetic element in V. cholerae O139, unlike the situation for other non-O1 V. cholerae strains. We sought to compare further this strain with strains of V. cholerae O1, classical and El Tor biotypes, by classic microbiologic methods, Southern blot analysis ...

  1. The politics of underdevelopment: metered to death-how a water experiment caused riots and a cholera epidemic.

    Science.gov (United States)

    Pauw, Jacques

    2003-01-01

    Water privatization programs in South Africa, part of a government policy aimed at making people pay for the full cost of running water ("total cost recovery"), was developed by private water companies and the World Bank to finance improved water supplies and build the country's economy. Instead the programs are causing more misery than development. Millions of poor people have had their water supply cut off because of inability to pay, forcing them to get their water from polluted rivers and lakes and leading to South Africa's worst cholera outbreak--which the government paid millions of dollars to control. Residents in some townships are rebelling, and many of the private multinational water companies are reassessing their involvement in South Africa.

  2. The mortality rates and the space-time patterns of John Snow’s cholera epidemic map

    OpenAIRE

    Shiode, N; Shiode, Shino; Rod-Thatcher, E.; Rana, S.; Vinten-Johansen, P.

    2015-01-01

    Background Snow’s work on the Broad Street map is widely known as a pioneering example of spatial epidemiology. It lacks, however, two significant attributes required in contemporary analyses of disease incidence: population at risk and the progression of the epidemic over time. Despite this has been repeatedly suggested in the literature, no systematic investigation of these two aspects was previously carried out. Using a series of historical documents, this study constructs own data to revi...

  3. Modern cholera in the Americas: an opportunistic societal infection.

    Science.gov (United States)

    Cerda, Rodrigo; Lee, Patrick T

    2013-11-01

    In the Americas, the only two cholera epidemics of the past century have occurred in the past 25 years. Lessons from the 1991 Peruvian cholera epidemic can help to focus and refine the response to the current Haitian epidemic. After three years of acute epidemic response, we have an opportunity to refocus on the chronic conditions that make societies vulnerable to cholera. More importantly, even as international attention wanes in the aftermath of the earthquake and acute epidemic, we are faced with a need for continued and coordinated investment in improving Haiti's structural defenses against cholera, in particular access to improved water and sanitation.

  4. Arthur Conan Doyle (1859-1930): Physician during the typhoid epidemic in the Anglo-Boer War (1899-1902).

    Science.gov (United States)

    Cirillo, Vincent J

    2014-02-01

    When the Anglo-Boer War broke out in October 1899, Arthur Conan Doyle, a retired ophthalmologist, was already famous as the creator of Sherlock Holmes. Motivated by patriotism and adventure, Doyle joined the medical staff of a private field hospital endowed by philanthropist John Langman (1846-1928). Langman Hospital opened in Bloemfontein, South Africa, at the height of that city's typhoid fever epidemic which raged from April to June 1900. There were nearly 5000 cases of typhoid and 1000 deaths but official statistics do not truly reflect the magnitude of the suffering. Doyle argued that the British Army had made a major mistake by not making antityphoid inoculation compulsory. Because of the new vaccine's side effects, 95% of the soldiers refused immunization. Despite his strong opinions, Doyle failed to press the issue of compulsory inoculation when he testified before two Royal Commissions investigating the medical and military management of the war in South Africa. One can only imagine how the army might have benefited from the new idea of prophylactic vaccination in preventive medicine if Doyle had not let these opportunities slip away. As a consequence, antityphoid inoculation was still voluntary when Great Britain entered World War I in August 1914.

  5. Cholera outbreaks in India.

    Science.gov (United States)

    Ramamurthy, Thandavarayan; Sharma, Naresh C

    2014-01-01

    Cholera is a global health problem as several thousands of cases and deaths occur each year. The unique epidemiologic attribute of the disease is its propensity to occur as outbreaks that may flare-up into epidemics, if not controlled. The causative bacterial pathogen Vibrio cholerae prevails in the environment and infects humans whenever there is a breakdown in the public health component. The Indian subcontinent is vulnerable to this disease due its vast coastlines with areas of poor sanitation, unsafe drinking water, and overcrowding. Recently, it was shown that climatic conditions also play a major role in the persistence and spread of cholera. Constant change in the biotypes and serotypes of V. cholerae are also important aspects that changes virulence and survival of the pathogen. Such continuous changes increase the infection ability of the pathogen affecting the susceptible population including the children. The short-term carrier status of V. cholerae has been studied well at community level and this facet significantly contributes to the recurrence of cholera. Several molecular tools recognized altering clonality of V. cholerae in relation with the advent of a serogroup or serotype. Rapid identification systems were formulated for the timely detection of the pathogen so as to identify and control the outbreak and institute proper treatment of the patients. The antimicrobials used in the past are no longer useful in the treatment of cholera as V. cholerae has acquired several mechanisms for multiple antimicrobial resistance. This upsurge in antimicrobial resistance directly influences the management of the disease. This chapter provides an overview of cholera prevalence in India, possible sources of infection, and molecular epidemiology along with antimicrobial resistance of V. cholerae.

  6. [The determinants of the low case fatality rate of the cholera epidemic in the Littoral department of Benin in 2008].

    Science.gov (United States)

    Gbary, Akpa Raphaël; Sossou, Roch Aristide; Dossou, Jean-Paul; Mongbo, Virginie; Massougbodji, Achille

    2011-01-01

    The 2008 cholera outbreak in Benin was characterized by a low case fatality rate (0.39 p.100) in the Littoral department, where 502 cases were recorded between July and December. The aim of this study was to identify the key factors associated with the low case fatality rate within the department. The cross-sectional, descriptive and analytical study conducted as part of this research used 404 patient records, focus group discussions with ten former patients, in-depth interviews with 8 health authorities involved in the response and structured face-to-face interviews with 12 health personnel involved in the treatment of patients. The data were analyzed using qualitative and quantitative content analysis based on EPIINFO 3.3.2 and EXCEL 2007 software. The results from several sources were cross-checked through triangulation. The mean age of patients was 23.72 ± 14.8 years. 39.35% patients were admitted with severe dehydration. Oral rehydration, intravenous rehydration and antibiotic therapy were given to 99.5%, 85% and 97.77% of patients, respectively. Only one hospital death was noted. The low case fatality rate was mainly due to the following factors: the high quality of care provided in a center with qualified personnel and available and free of charge treatment kits, protocols based on massive rehydration and appropriate hygiene measures, and patient compliance with the treatment plan. The response was also characterized by good coordination, wide mass and local health promotion, and selective antibiotic prophylaxis, which contributed significantly to reducing the spread of the infection.

  7. Purity and Epidemic Danger in German Occupied Poland during the First World War.

    Science.gov (United States)

    Weindling, Paul

    1997-01-01

    Explores the efforts of the German public-health authorities to cleanse occupied areas of formerly Russian Poland of pathogenic hazards during the First World War. The program used sanitary measures and educational programs to encourage a more hygienic lifestyle. Originally sympathetic to the Jewish population, it grew increasingly anti-semitic.…

  8. Molecular diagnosis of resistance to antimalarial drugs during epidemics and in war zones.

    Science.gov (United States)

    Djimdé, Abdoulaye A; Dolo, Amagana; Ouattara, Amed; Diakité, Sira; Plowe, Christopher V; Doumbo, Ogobara K

    2004-08-15

    Plasmodium falciparum mutations pfcrt K76T and the dhfr/dhps "quintuple mutant" are molecular markers of resistance to chloroquine and sulfadoxine-pyrimethamine, respectively. During an epidemic of P. falciparum malaria in an area of political unrest in northern Mali, where standard efficacy studies have been impossible, we measured the prevalence of these markers in a cross-sectional survey. In 80% of cases of infection, pfcrt K76T was detected, but none of the cases carried the dhfr/dhps quintuple mutant. On the basis of these results, chloroquine was replaced by sulfadoxine-pyrimethamine in control efforts. This example illustrates how molecular markers for drug resistance can provide timely data that inform malaria-control policy during epidemics and other emergency situations.

  9. Vibrios among patients of good socioeconomic conditions during the cholera epidemic in Recife, Brazil Vibriões coléricos e não coléricos entre pacientes de boas condições sódo-econômicas durante a epidemia de coléra no Recife, Brasil

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    Vera Magalhães

    1993-08-01

    Full Text Available Between March and July, 1992, we screened for Vibrio all fecal samples submitted for bacteriologic diagnosis at a private clinical laboratory in Recife. Of 1435 cultures examined only 1 (0.07% was positive for V.cholerae 01, biovar Eltor, serovar Inaba, but 17 (1.2% yielded non-cholera Vibrio (V.cholerae non-01; V.fluvialis; V.furnissii, V.parahaemolyticus and Vibrio spp. Thus, V.cholerae 01, differently of other enteropathogenic vibrios, spared individuals of good socioeconomic conditions even during the cholera epidemic, which made hundreds of victims in the neighboring slums.Entre março e julho de 1992, pesquisou-se Vibrio em todos os espécimes fecais enviados para diagnóstico bacteriológico a um laboratório clínico privado do Recife. De 1435 culturas examinadas apenas 1 (0.07% foi positiva para V.cholerae 01, biovar Eltor, sorovar Inaba, porém 17 (1,2% forneceram outras espécies de Vibrio (V.cholerae nao-01; V.fluvialis; V.furnissii; V.parahaemolyticus e Vibrio spp. Portanto, V.cholerae 01, diferentemente de outros vibriões entero patogênicos, poupou indivíduos de boas condições sócio-econômicas, mesmo durante uma epidemia de cólera que atingiu centenas de pessoas nas favelas vizinhas.

  10. Cholera outbreaks in Africa.

    Science.gov (United States)

    Mengel, Martin A; Delrieu, Isabelle; Heyerdahl, Leonard; Gessner, Bradford D

    2014-01-01

    During the current seventh cholera pandemic, Africa bore the major brunt of global disease burden. More than 40 years after its resurgence in Africa in 1970, cholera remains a grave public health problem, characterized by large disease burden, frequent outbreaks, persistent endemicity, and high CFRs, particularly in the region of the central African Great Lakes which might act as reservoirs for cholera. There, cases occur year round with a rise in incidence during the rainy season. Elsewhere in sub-Saharan Africa, cholera occurs mostly in outbreaks of varying size with a constant threat of widespread epidemics. Between 1970 and 2011, African countries reported 3,221,050 suspected cholera cases to the World Health Organization, representing 46 % of all cases reported globally. Excluding the Haitian epidemic, sub-Saharan Africa accounted for 86 % of reported cases and 99 % of deaths worldwide in 2011. The number of cholera cases is possibly much higher than what is reported to the WHO due to the variation in modalities, completeness, and case definition of national cholera data. One source on country specific incidence rates for Africa, adjusting for underreporting, estimates 1,341,080 cases and 160,930 deaths (52.6 % of 2,548,227 estimated cases and 79.6 % of 209,216 estimated deaths worldwide). Another estimates 1,411,453 cases and 53,632 deaths per year, respectively (50 % of 2,836,669 estimated cases and 58.6 % of 91,490 estimated deaths worldwide). Within Africa, half of all cases between 1970 and 2011 were notified from only seven countries: Angola, Democratic Republic of the Congo, Mozambique, Nigeria, Somalia, Tanzania, and South Africa. In contrast to a global trend of decreasing case fatality ratios (CFRs), CFRs have remained stable in Africa at approximately 2 %. Early propagation of cholera outbreaks depends largely on the extent of individual bacterial shedding, host and organism characteristics, the likelihood of people coming into contact with

  11. [The flu epidemic after World War I and homeopathy--an international comparison].

    Science.gov (United States)

    Jahn, Stefanie

    2014-01-01

    The "Spanish Flu" began in 1918 and was the most devastating pandemic in human history that had ever been, claiming more lives than World War I. The flu virus had not yet been discovered, and the usual therapy measures were merely symptomatic. In many parts of the world the pandemic was treated by homeopaths. At the time, homeopathic medical practices, out-patient clinics and hospitals existed in various countries. To this day homeopaths refer to the successful homeopathic treatment of the "Spanish Flu". The following paper looks at what this treatment consisted in and whether it was based on a particular concept. It also examines contemporary evaluations and figures, as well as the question as to whether homeopathy experienced a rise in demand as a consequence of its success during the pandemic.

  12. Sobremortalidade por diarréia simultânea à cólera na região Nordeste do Brasil Excess mortality by diarrhea simultaneous to a cholera epidemic in Northeastern Brazil

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    Moacir Gerolomo

    2004-08-01

    Full Text Available OBJETIVO: Avaliar a sobremortalidade por diarréia infecciosa, sem diagnóstico etiológico, simultânea à circulação do Vibrio cholerae. MÉTODOS: Foi aplicada modelagem estatística à série histórica dos óbitos ocorridos por "infecções intestinais mal definidas" (Classificação Internacional de Doenças - CID-9 e "diarréia e gastroenterite de origem infecciosa presumível" (CID-10, entre 1980 e 1998, na região Nordeste. Foi obtida a predição de valores esperados a partir de um ponto de descontinuidade. O excesso de mortalidade foi calculado pela diferença entre o observado e o estimado pelo modelo. RESULTADOS: Entre 1992 e 1994, apenas 19,3% dos óbitos por cólera foram efetivamente registrados. Em 1993, ano em que a epidemia atingiu seu ponto máximo na região, a presente modelagem leva a uma estimativa de sub-registro de 82,2%. CONCLUSÕES: Os resultados apontam um grande sub-registro da mortalidade por cólera durante a epidemia na região Nordeste.OBJECTIVE: To evaluate excess mortality due to infectious diarrhea without etiological diagnosis, occurring simultaneously to Vibrio cholerae circulation. METHODS: Statistical modeling was applied to a time series of deaths ascribed to "poorly defined intestinal infections" (International Classification of Diseases - ICD-9 and "presumably infectious diarrhea and gastroenteritis" (ICD-10, between 1980 and 1998 in the Northeast Region of Brazil. The prediction of expected values was obtained after a discontinuity point. Excess mortality was calculated as the difference between observed figures and those estimated by the model. RESULTS: Between 1992 and 1994, only 19.3% of deaths by cholera were actually notified. In 1993, the year in which the epidemic reached its peak in the area, our modeling estimated underregistration at 82.2%. CONCLUSIONS: Results indicate substantial underregistration of cholera mortality during the epidemic in Northeastern Brazil.

  13. Fish as Hosts of Vibrio cholerae

    Science.gov (United States)

    Halpern, Malka; Izhaki, Ido

    2017-01-01

    Vibrio cholerae, the causative agent of pandemic cholera, is abundant in marine and freshwater environments. Copepods and chironomids are natural reservoirs of this species. However, the ways V. cholerae is globally disseminated are as yet unknown. Here we review the scientific literature that provides evidence for the possibility that some fish species may be reservoirs and vectors of V. cholerae. So far, V. cholerae has been isolated from 30 fish species (22 freshwater; 9 marine). V. cholerae O1 was reported in a few cases. In most cases V. cholerae was isolated from fish intestines, but it has also been detected in gills, skin, kidney, liver and brain tissue. In most cases the fish were healthy but in some, they were diseased. Nevertheless, Koch postulates were not applied to prove that V. cholerae and not another agent was the cause of the disease in the fish. Evidence from the literature correlates raw fish consumption or fish handling to a few cholera cases or cholera epidemics. Thus, we can conclude that V. cholerae inhabits some marine and freshwater fish species. It is possible that fish may protect the bacteria in unfavorable habitats while the bacteria may assist the fish to digest its food. Also, fish may disseminate the bacteria in the aquatic environment and may transfer it to waterbirds that consume them. Thus, fish are reservoirs of V. cholerae and may play a role in its global dissemination. PMID:28293221

  14. Environmental Monitoring of Endemic Cholera

    Science.gov (United States)

    ElNemr, W.; Jutla, A. S.; Constantin de Magny, G.; Hasan, N. A.; Islam, M.; Sack, R.; Huq, A.; Hashem, F.; Colwell, R.

    2012-12-01

    Cholera remains a major public health threat. Since Vibrio cholerae, the causative agent of the disease, is autochthonous to riverine, estuarine, and coastal waters, it is unlikely the bacteria can be eradicated from its natural habitat. Prediction of disease, in conjunction with preventive vaccination can reduce the prevalence rate of a disease. Understanding the influence of environmental parameters on growth and proliferation of bacteria is an essential first step in developing prediction methods for outbreaks. Large scale geophysical variables, such as SST and coastal chlorophyll, are often associated with conditions favoring growth of V. cholerae. However, local environmental factors, meaning biological activity in ponds from where the bulk of populations in endemic regions derive water for daily usage, are either neglected or oversimplified. Using data collected from several sites in two geographically distinct locations in South Asia, we have identified critical local environmental factors associated with cholera outbreak. Of 18 environmental variables monitored for water sources in Mathbaria (a coastal site near the Bay of Bengal) and Bakergonj (an inland site) of Bangladesh, water depth and chlorophyll were found to be important factors associated with initiation of cholera outbreaks. Cholera in coastal regions appears to be related to intrusion. However, monsoonal flooding creates conditions for cholera epidemics in inland regions. This may be one of the first attempts to relate in-situ environmental observations with cholera. We anticipate that it will be useful for further development of prediction models in the resource constrained regions.

  15. Enzymatic electrochemical detection of epidemic-causing Vibrio cholerae with a disposable oligonucleotide-modified screen-printed bisensor coupled to a dry-reagent-based nucleic acid amplification assay.

    Science.gov (United States)

    Yu, Choo Yee; Ang, Geik Yong; Chan, Kok Gan; Banga Singh, Kirnpal Kaur; Chan, Yean Yean

    2015-08-15

    In this study, we developed a nucleic acid-sensing platform in which a simple, dry-reagent-based nucleic acid amplification assay is combined with a portable multiplex electrochemical genosensor. Preparation of an amplification reaction mix targeting multiple DNA regions of interest is greatly simplified because the lyophilized reagents need only be reconstituted with ultrapure water before the DNA sample is added. The presence of single or multiple target DNAs causes the corresponding single-stranded DNA (ssDNA) amplicons to be generated and tagged with a fluorescein label. The fluorescein-labeled ssDNA amplicons are then analyzed using capture probe-modified screen-printed gold electrode bisensors. Enzymatic amplification of the hybridization event is achieved through the catalytic production of electroactive α-naphthol by anti-fluorescein-conjugated alkaline phosphatase. The applicability of this platform as a diagnostic tool is demonstrated with the detection of toxigenic Vibrio cholerae serogroups O1 and O139, which are associated with cholera epidemics and pandemics. The platform showed excellent diagnostic sensitivity and specificity (100%) when challenged with 168 spiked stool samples. The limit of detection was low (10 colony-forming units/ml) for both toxigenic V. cholerae serogroups. A heat stability assay revealed that the dry-reagent amplification reaction mix was stable at temperatures of 4-56 °C, with an estimated shelf life of seven months. The findings of this study highlight the potential of combining a dry-reagent-based nucleic acid amplification assay with an electrochemical genosensor in a more convenient, sensitive, and sequence-specific detection strategy for multiple target nucleic acids.

  16. Proteome analysis of the total protein in epidemic and non-epidemic Vibrio cholerae O1 Serotype Ogawa strains by 2-DE%霍乱弧菌O1群稻叶型流行株和非流行株的蛋白质谱特征分析

    Institute of Scientific and Technical Information of China (English)

    林静佳; 李军涛; 邓志爱; 陈守义

    2012-01-01

    Objective To study the differences on proteins between non-epidemic strain and epidemic strain of Vibrw cholerae(V.cholerae) by two dimensional electrophoresis(2-DE) and TOF-TOF-MS. Methods Total protein was extracted from V. cholerae, and separated by 2-DE under immobilized pH gradients(IPG),and then stained with Coomassie Brilliant Blue, and analyzed by ImageMaster 2D Elite 5.0. Finally the different protein spots were identified by TOF-TOF-MS. Results High repetitive 2-DE maps were obtained.2-DE and image analysis revealed (1.081±16) protein spots,and pI value was mainly localized between 4.0 and 7.2.Matching spots were (1.057±28) in two repeats electrophoregrams, with a matching ratio of 97.85%. Conclusion The different protein spots were successfully identified with high quality and sharpness separation by 2-DE and TOF-TOF-MS, and serve as a valuable resource for proteomics research of V.cholerae.%目的 探讨霍乱弧菌O1群稻叶型流行株和非流行株的蛋白表达的差异.方法 利用裂解液处理霍乱弧菌,提取全菌蛋白;采用pH梯度等电聚焦对菌蛋白进行双向电泳;考马斯亮蓝染色后获得的双向电泳图谱,并利用ImageMaster 2D Elite 5.0图象分析软件进行分析,找出差异蛋白;在此基础上,胰蛋白酶消化这些特殊差异蛋白,并进行质谱( MALDI-TOF-MS)分析.结果 获得了(1081±16)个蛋白斑点,蛋白主要集中在pI 4.00~7.20之间,重复胶的匹配点数为(1057±28),匹配率为97,85%;发现了有明显差异的21个蛋白点,并进行了质谱鉴定.结论 获得了霍乱弧菌O1群稻叶型流行株和非流行株的差异表达蛋白.

  17. Non-toxigenic environmental Vibrio cholerae O1 strain from Haiti provides evidence of pre-pandemic cholera in Hispaniola

    Science.gov (United States)

    Azarian, Taj; Ali, Afsar; Johnson, Judith A.; Jubair, Mohammad; Cella, Eleonora; Ciccozzi, Massimo; Nolan, David J.; Farmerie, William; Rashid, Mohammad H.; Sinha-Ray, Shrestha; Alam, Meer T.; Morris, J. Glenn; Salemi, Marco

    2016-01-01

    Vibrio cholerae is ubiquitous in aquatic environments, with environmental toxigenic V. cholerae O1 strains serving as a source for recurrent cholera epidemics and pandemic disease. However, a number of questions remain about long-term survival and evolution of V. cholerae strains within these aquatic environmental reservoirs. Through monitoring of the Haitian aquatic environment following the 2010 cholera epidemic, we isolated two novel non-toxigenic (ctxA/B-negative) Vibrio cholerae O1. These two isolates underwent whole-genome sequencing and were investigated through comparative genomics and Bayesian coalescent analysis. These isolates cluster in the evolutionary tree with strains responsible for clinical cholera, possessing genomic components of 6th and 7th pandemic lineages, and diverge from “modern” cholera strains around 1548 C.E. [95% HPD: 1532–1555]. Vibrio Pathogenicity Island (VPI)-1 was present; however, SXT/R391-family ICE and VPI-2 were absent. Rugose phenotype conversion and vibriophage resistance evidenced adaption for persistence in aquatic environments. The identification of V. cholerae O1 strains in the Haitian environment, which predate the first reported cholera pandemic in 1817, broadens our understanding of the history of pandemics. It also raises the possibility that these and similar environmental strains could acquire virulence genes from the 2010 Haitian epidemic clone, including the cholera toxin producing CTXϕ. PMID:27786291

  18. Non-toxigenic environmental Vibrio cholerae O1 strain from Haiti provides evidence of pre-pandemic cholera in Hispaniola.

    Science.gov (United States)

    Azarian, Taj; Ali, Afsar; Johnson, Judith A; Jubair, Mohammad; Cella, Eleonora; Ciccozzi, Massimo; Nolan, David J; Farmerie, William; Rashid, Mohammad H; Sinha-Ray, Shrestha; Alam, Meer T; Morris, J Glenn; Salemi, Marco

    2016-10-27

    Vibrio cholerae is ubiquitous in aquatic environments, with environmental toxigenic V. cholerae O1 strains serving as a source for recurrent cholera epidemics and pandemic disease. However, a number of questions remain about long-term survival and evolution of V. cholerae strains within these aquatic environmental reservoirs. Through monitoring of the Haitian aquatic environment following the 2010 cholera epidemic, we isolated two novel non-toxigenic (ctxA/B-negative) Vibrio cholerae O1. These two isolates underwent whole-genome sequencing and were investigated through comparative genomics and Bayesian coalescent analysis. These isolates cluster in the evolutionary tree with strains responsible for clinical cholera, possessing genomic components of 6(th) and 7(th) pandemic lineages, and diverge from "modern" cholera strains around 1548 C.E. [95% HPD: 1532-1555]. Vibrio Pathogenicity Island (VPI)-1 was present; however, SXT/R391-family ICE and VPI-2 were absent. Rugose phenotype conversion and vibriophage resistance evidenced adaption for persistence in aquatic environments. The identification of V. cholerae O1 strains in the Haitian environment, which predate the first reported cholera pandemic in 1817, broadens our understanding of the history of pandemics. It also raises the possibility that these and similar environmental strains could acquire virulence genes from the 2010 Haitian epidemic clone, including the cholera toxin producing CTXϕ.

  19. How Will Climate Change Impact Cholera Outbreaks?

    Science.gov (United States)

    Nasr Azadani, F.; Jutla, A.; Rahimikolu, J.; Akanda, A. S.; Huq, A.; Colwell, R. R.

    2014-12-01

    Environmental parameters associated with cholera are well documented. However, cholera continues to be a global public health threat. Uncertainty in defining environmental processes affecting growth and multiplication of the cholera bacteria can be affected significantly by changing climate at different temporal and spatial scales, either through amplification of the hydroclimatic cycle or by enhanced variability of large scale geophysical processes. Endemic cholera in the Bengal Delta region of South Asia has a unique pattern of two seasonal peaks and there are associated with asymmetric and episodic variability in river discharge. The first cholera outbreak in spring is related with intrusion of bacteria laden coastal seawater during low river discharge. Cholera occurring during the fall season is hypothesized to be associated with high river discharge related to a cross-contamination of water resources and, therefore, a second wave of disease, a phenomenon characteristic primarily in the inland regions. Because of difficulties in establishing linkage between coarse resolutions of the Global Climate Model (GCM) output and localized disease outbreaks, the impact of climate change on diarrheal disease has not been explored. Here using the downscaling method of Support Vector Machines from HADCM3 and ECHAM models, we show how cholera outbreak patterns are changing in the Bengal Delta. Our preliminary results indicate statistically significant changes in both seasonality and magnitude in the occurrence of cholera over the next century. Endemic cholera is likely to transform into epidemic forms and new geographical areas will be at risk for cholera outbreaks.

  20. 安徽省淮南市首起0139霍乱弧菌疫情检测分析%Experimental analysis the first cases of cholera epidemic detection of 0139 of Huainan

    Institute of Scientific and Technical Information of China (English)

    余寿杰; 刘笑梅; 曹敏; 胡守奎; 胡万富

    2011-01-01

    Objective To identify the first cases of cholera in Huainan,0139 epidemic causes and biological properties. Methods Conventional methods of serological and bacteriological methods of the strains were identified by polymerase chain reaction (PCR) to detect cholera virulence genes, susceptibility testing modified KB.Results 1 ,was isolated and serum agglutination results,2 patients were all positive stool samples,6 were in close contact with all the negative rectal swab;turtle pond-like 18,5 were positive;turtle egg in battle were like 9,2 were positive ; turtle eggs 7, the positive three copies; turtle waste 11, were negative. 2, or more positive culture drug sensitivity test of the pioneer B, doxycycline resistant; to ampicillin, tetracycline in sensitive;on norfloxacin, gentamicin, ciprofloxacin sensitive. 3,or more positive cultures gene DNA PCR test results,cholera toxin(CT) ,toxin coregulated pilus (TCP) all were positive. Conclusion From the outbreak of cholera 0139 is water pollution caused by turtle ponds,The trip types of 0139 Vibrio cholera were highly homologous with that isolated from green turtle;the bacteria of the pioneer B, doxycycline resistance and carrying cta, tcpa virulence genes.%目的 探讨淮南市首起0139霍乱弧菌疫情的发生原因和生物学特性。方法 血清学及常规细菌学方法对菌株进行鉴定,聚合酶链式反应(PCR)检测霍乱毒力基因,改良K-B药敏实验。结果 (1)培养分离及血清凝集试验结果,2例患者粪便标本全部阳性,密切接触者6人肛拭子全部阴性;甲鱼塘水样18份,阳性5份;甲鱼产蛋沙场样9份,2份阳性;甲鱼蛋7份,阳性3份;甲鱼排泄物11份,均为阴性。(2)血清凝集试验阳性培养物对头孢哌酮、强力霉素耐药;对氨苄西林、四环素中敏;对氟哌酸、庆大霉素、环丙沙星等敏感。(3)血清凝集试验阳性培养物霍乱毒素(CT)、毒素协同调节菌毛(TCP)全部阳性。结论

  1. Drinking cholera

    DEFF Research Database (Denmark)

    Grant, Stephen Lawrence; Tamason, Charlotte Crim; Hoque, Bilqis Amin

    2015-01-01

    beconducive to V. cholerae survival. Furthermore, salinity levels of participant’s drinking water sourceswere all well below the levels required for optimal survival of V. cholerae. Respondents explainedthat they preferred less salty and more aesthetically pleasing drinking water. Conclusion: Theoretically, V...

  2. Biofilm formation and phenotypic variation enhance predation-driven persistence of Vibrio cholerae

    DEFF Research Database (Denmark)

    Matz, Carsten; McDougald, D.; Moreno, A.M.

    2005-01-01

    Persistence of the opportunistic bacterial pathogen Vibrio cholerae in aquatic environments is the principal cause for seasonal occurrence of cholera epidemics. This causality has been explained by postulating that V. cholerae forms biofilms in association with animate and inanimate surfaces. Alt...

  3. WAR

    DEFF Research Database (Denmark)

    Þórarinsson, Elfar; Lindgreen, Stinus

    2008-01-01

    We present an easy-to-use webserver that makes it possible to simultaneously use a number of state of the art methods for performing multiple alignment and secondary structure prediction for noncoding RNA sequences. This makes it possible to use the programs without having to download the code an...... into account is also calculated. This website is free and open to all users and there is no login requirement. The webserver can be found at: http://genome.ku.dk/resources/war....

  4. [The struggle against malaria in the Ottoman Empire during World War I and the legal regulations made to this end].

    Science.gov (United States)

    Koylu, Zafer; Doğan, Nihal

    2010-01-01

    One of the most important disadvantages of war environmental is infectious diseases. The Ottoman Empire combated infectious diseases in addition to the war because of Balkan wars and afterwards first world war. Because of increasing migrations to Anatolia after Balkan wars spread some epidemic diseases, such as cholera, typhoid fever, plaque, dysentery, syphilis. With the start of the First World War, malaria began to spread within civilian population as well as the military. The population fell from power because of illness and therefore could not process the land tax failed to pay taxes. Founded in 1914 with the fight against epidemic diseases was initiated by the Sıhhiye ministry. Quinine was formed as tablets which was imported from Germany by legal regulation and was distributed to the public by Ziraat Bank. However, malaria epidemic could not be prevented because of long war years, lack of population, insufficiency of the preventive methods and lack of quinine, and about three quarters of the population caught malaria and in four years 412.000 soldiers had malaria and 20.000 of them died despite of measures.

  5. Cholera: ancient scourge on the rise. WHO announces global plan for cholera control. (25 April 1991).

    Science.gov (United States)

    1991-04-01

    Vibrio cholerae spreads quickly via contaminated water and food, especially in areas with a poor health and sanitation infrastructure. Its enterotoxin induces vomiting and huge amounts of watery diarrhea leading to severe dehydration. 80-90% of cholera victims during an epidemic can use oral rehydration salts. A cholera epidemic is now spreading through Latin America threatening 90-120 million people (started in January 1991), particularly those in urban slums and rural/mountainous areas. As of mid April 1991, there were more than 177,000 new reported cases in 12 countries and 78% of these cases and more than 1200 deaths were limited to 5 countries: Brazil, Chile, Colombia, Ecuador, and Peru, WHO's Global Cholera Control Task Force coordinates global cholera control efforts to prevent deaths in the short term and to support infrastructure development in the long term. Its members are specialists in disease surveillance, case management, water and sanitation, food safety, emergency intervention, and information and education. WHO's Director General is asking for the support of the international community in cholera control activities. These activities' costs are considerable. For example, Peru needs about US$ 60 million in 1992 to fulfill only the most immediate demands of rehabilitation and reconstruction of the infrastructure. Costs of infrastructure capital throughout Latin America is almost US$ 5 thousand million/year over the next 10 years. It is indeed an effective infrastructure which ultimately prevents cholera. Cholera is evidence of inadequate development, so to fight it, we must also fight underdevelopment and poverty.

  6. Breast milk reduces the risk of illness in children of mothers with cholera

    DEFF Research Database (Denmark)

    Qureshi, Katja; Mølbak, Kåre; Sandström, Anita

    2006-01-01

    BACKGROUND: A protective effect of breastfeeding against cholera has been demonstrated in areas endemic of cholera. To assess the protection offered by breast milk from mothers living in an area that had been free from cholera for 7 years, we investigated mothers with cholera and their children...... during an epidemic with Vibrio cholerae El Tor in the capital of Guinea-Bissau. METHODS: Eighty mothers with clinical cholera and their children were identified, and interviewed. Blood samples for vibriocidal and antitoxin antibodies were collected from mother-and-child pairs. Breast milk samples were...... collected from lactating mothers.Cholera was defined as acute watery diarrhea during the epidemic and a vibriocidal reciprocal titer of 20 or above. RESULTS: Three (7%) of 42 breastfed children had cholera as defined above compared with 9 (24%) of 38 nonbreastfed children (RR for breastfed children, 0...

  7. Spreading of Cholera through Surface Water

    Science.gov (United States)

    Bertuzzo, E.; Casagrandi, R.; Gatto, M.; Rodriguez-Iturbe, I.; Rinaldo, A.

    2009-12-01

    Cholera epidemics are still a major public health concern to date in many areas of the world. In order to understand and forecast cholera outbreaks, one of the most important factors is the role played by the environmental matrix in which the disease spreads. We study how river networks, acting as environmental corridors for pathogens, affect the spreading of cholera epidemics. The environmental matrix in which the disease spreads is constituted by different human communities and their hydrologic interconnections. Each community is characterized by its spatial position, population size, water resources availability and hygiene conditions. By implementing a spatially explicit cholera model we seek the effects on epidemic dynamics of: i) the topology and metrics of the pathogens pathways that connect different communities; ii) the spatial distribution of the population size; and iii) the spatial distributions and quality of surface water resources and public health conditions, and how they vary with population size. The model has been applied to study the space-time evolution of a well documented cholera epidemic occurred in the KwaZulu-Natal province of South Africa. The epidemic lasted for two years and involved about 140,000 confirmed cholera cases. The model does well in reproducing the distribution of the cholera cases during the two outbreaks as well as their spatial spreading. We further extend the model by deriving the speed of propagation of traveling fronts in the case of uniformly distributed systems for different topologies: one and two dimensional lattices and river networks. The derivation of the spreading celerity proves instrumental in establishing the overall conditions for the relevance of spatially explicit models. The conditions are sought by comparison between spreading and disease timescales. Consider a cholera epidemic that starts from a point and spreads throughout a finite size system, it is possible to identify two different timescales: i

  8. Re-emergence of Cholera Vaccine.

    Science.gov (United States)

    Berger; Shapiro

    1997-06-01

    Although epidemic cholera was first described in 1817, the disease probably has been common in the Indian subcontinent since ancient times.1 Until recently, a single bacterial type (Vibrio cholerae 01) has been responsible for each of the seven recorded cholera pandemics. The current epidemic began in Celebes (Sulawesi), Indonesia, in 1961, and is currently raging through all continents.2 During the 1990s, over 1 million cholera cases have been reported from Latin America, 2000 from Ukraine and the Russian Republic during 1994 alone (GIDEON computer software, C.Y. Informatics, Ramat Hasharon, Israel). Of the 208,755 cases of cholera (5034 fatal) officially reported to the World Health Organization in 1995,3 41.1% were from Latin America, 34.0% from Africa, 24.4% from Asia, and 0.5% from Europe and Oceania. Interest in our own country of Israel stems from the popularity of tourism (over 1 million travelers exit Israel yearly) and the presence of disease in neighboring areas. Following an epidemic of 397 cases in Jerusalem during 1970, periodic outbreaks have occurred in Gaza, Judea and Samaria.4 Three tourists returned with the infection to Israel during the 1980s, all from Egypt (which officially claims to have no cholera).5 Despite universal interest in this ancient disease, medical science has long been frustrated in its search for an effective vaccine. The most important 'vaccine' against cholera is common sense, and consists of intelligent eating and drinking while in endemic areas. For example, local raw fish (ceviche) is a common source of the disease in Latin America, while shellfish (particularly oysters) are often implicated along the American Gulf Coast. Virtually all forms of water purification are effective against Vibrio cholerae. Although antibiotic prophylaxis might be considered in some circumstances (doxycycline; or a quinolone in areas of tetracycline resistance), it is not routinely advocated.

  9. "A wild and wondrous ride": CDC field epidemiologists in the east Pakistan smallpox and cholera epidemics of 1958 "Uma louca e maravilhosa jornada": epidemiologistas de campo do CDC nas epidemias de varíola e cólera do Paquistão Oriental em 1958

    Directory of Open Access Journals (Sweden)

    Paul Greenough

    2011-02-01

    Full Text Available In mid-April of 1958 the Government of Pakistan summoned the press to announce a grave need for international aid to cope with smallpox and cholera epidemics in East Pakistan. In response, and with the backing of the US State Department, Dr. Alexander D. Langmuir, chief epidemiologist of the CDC, led a team of epidemiologists to assist authorities in Dacca strengthen their immunization programs. Langmuir's superiors hoped for a Cold War advantage, but he saw an opportunity for trainees in the Epidemic Intelligence Service to learn about public health in a developing country. Langmuir later described the episode as a "wild and wondrous ride," but it had been more like a nightmare: the East Pakistan health department had collapsed; a popular movement had taken over vaccination and squandered vaccine supplies; hostile journalists had questioned the Americans' deeper motives; and a professional rivalry opened between the Americans and a British epidemiologist named Aidan Cockburn. By the time the epidemic subsided in July 1958, 30 million Bengalis had been vaccinated for smallpox but another 20,000 had succumbed to the disease. This episode was CDC's first sustained foreign intervention, a precursor to its extensive role in the 1970s helping WHO eradicate smallpox from Bangladesh.Em meados de abril de 1958, o Governo do Paquistão convocou a imprensa para anunciar a urgente necessidade de auxílio internacional para lidar com epidemias de varíola e cólera no Paquistão Oriental. Em resposta, e com o apoio do Departamento de Estado dos Estados Unidos, Dr. Alexander D. Langmuir, chefe de epidemiologia do CDC em Atlanta, liderou um time de epidemiologistas para auxiliar as autoridades em Dacca a reforçar seus programas de imunização. Os superiores de Langmuir ansiavam por demonstrações de capacidade dos EUA na Guerra Fria, mas ele vislumbrou uma chance para o Serviço de Inteligência Epidemiológica aprender sobre saúde pública em países em

  10. Cholera in Portugal, 1974. II. Transmission by bottled mineral water.

    Science.gov (United States)

    Blake, P A; Rosenberg, M L; Florencia, J; Costa, J B; do Prado Quintino, L; Gangarosa, E J

    1977-04-01

    During a cholera epidemic, Vibrio cholerae was isolated from two springs which supplied mineral water to a spa and to a commercial water bottling plant. Epidemiologic investigation found that cholera attack rates were 10-fold greater among visitors to the spa than among non-visitors. A subsequent matched-pair case-control study which excluded persons who had visted the spa showed that a history of consumption of the bottled non-carbonated water was significantly more common among bacteriologically confirmed cholera cases than among paired controls.

  11. Methods to assess the impact of mass oral cholera vaccination campaigns under real field conditions.

    Directory of Open Access Journals (Sweden)

    Jacqueline Deen

    Full Text Available There is increasing interest to use oral cholera vaccination as an additional strategy to water and sanitation interventions against endemic and epidemic cholera. There are two internationally-available and WHO-prequalified oral cholera vaccines: an inactivated vaccine containing killed whole-cells of V. cholerae O1 with recombinant cholera toxin B-subunit (WC/rBS and a bivalent inactivated vaccine containing killed whole cells of V. cholerae O1 and V. cholerae O139 (BivWC. The efficacy, effectiveness, direct and indirect (herd protection conferred by WC/rBS and BivWC are well established. Yet governments may need local evidence of vaccine impact to justify and scale-up mass oral cholera vaccination campaigns. We discuss various approaches to assess oral cholera vaccine protection, which may be useful to policymakers and public health workers considering deployment and evaluation of the vaccine.

  12. Cholera outbreaks in the classical biotype era.

    Science.gov (United States)

    Siddique, A K; Cash, Richard

    2014-01-01

    In the Indian subcontinent description of a disease resembling cholera has been mentioned in Sushruta Samita, estimated to have been written between ~400 and 500 BC. It is however not clear whether the disease known today as cholera caused by Vibrio cholerae Vibrio cholerae O1 is the evolutionary progression of the ancient disease. The modern history of cholera began in 1817 when an explosive epidemic broke out in the Ganges River Delta region of Bengal. This was the first of the seven recorded cholera pandemics cholera pandemics that affected nearly the entire world and caused hundreds of thousands of deaths. The bacterium responsible for this human disease was first recognised during the fifth pandemic and was named V. cholerae which was grouped as O1, and was further differentiated into Classical and El Tor biotypes. It is now known that the fifth and the sixth pandemics were caused by the V. cholerae O1 of the Classical biotype Classical biotype and the seventh by the El Tor biotype El Tor biotype . The El Tor biotype of V. cholerae, which originated in Indonesia Indonesia and shortly thereafter began to spread in the early 1960s. Within the span of 50 years the El Tor biotype had invaded nearly the entire world, completely displacing the Classical biotype from all the countries except Bangladesh. What prompted the earlier pandemics to begin is not clearly understood, nor do we know how and why they ended. The success of the seventh pandemic clone over the pre-existing sixth pandemic strain remains largely an unsolved mystery. Why classical biotype eventually disappeared from the world remains to be explained. For nearly three decades (1963-1991) during the Seventh cholera pandemic seventh pandemic, cholera in Bangladesh has recorded a unique history of co-existence of Classical and El Tor biotypes of V. cholerae O1 as epidemic and endemic strain. This long co-existence has provided us with great opportunity to improve our understanding of the disease itself

  13. Vibrio metschnikovii among diarrheal patients during cholera epidemic in Recife Brazil Vibrio metschnikovii entre pacientes diarréicos durante epidemia de cólera no Recife, Brasil

    Directory of Open Access Journals (Sweden)

    Vera Magalhães

    1996-02-01

    Full Text Available Although known since the last century, Vibrio metschnikovii was only appropriately described and recognized as a new species within the genus Vibrio in 1978. Rarely is the organism linked to human disease. Only once has V. metschnikovii been incriminated as responsible for human diarrhea, and affecting an old woman who suffered from diabetes and had a hepatoma. During the first two years of the present cholera epidemic, which reached Recife in March, 1992, we screened for vibrio nearly 4000 diarrheal fecal specimens submitted to a private clinical laboratory for detection of enteropathogenic microorganisms. Now, we report six cases of diarrhea associated with V. metschnikovii affecting individuals not suffering of any apparent underlying systemic illness.Embora reconhecido desde o século passado, o Vibrio metschnikovii só foi descrito e classificado de forma apropriada dentro do gênero Vibrio em 1978. Raramente, essa bactéria tem sido relacionada com doença humana, acometendo habitualmente, pacientes imunodeprimidos. Há apenas um relato de gastroenterite a V. metschnikovii. Durante a recente epidemia de cólera, que acometeu o Recife em março de 1992, todos os espécimes fecais diarréicos submetidos a um laboratório particular de patologia clínica para diagnóstico microbiológico, foram também cultivados em meio tiosulfato, citrato, sais biliares e sacarose (TCBS. Analizou-se um total de 4000 amostras fecais durante os dois anos que se seguiram a chegada da cólera ao Recife. No presente, reportamos seis casos de diarréia a V. metschnikovii ocorridos nesse período.

  14. Vibrio cholerae Serogroup O139: Isolation from Cholera Patients and Asymptomatic Household Family Members in Bangladesh between 2013 and 2014.

    Directory of Open Access Journals (Sweden)

    Fahima Chowdhury

    2015-11-01

    Full Text Available Cholera is endemic in Bangladesh, with outbreaks reported annually. Currently, the majority of epidemic cholera reported globally is El Tor biotype Vibrio cholerae isolates of the serogroup O1. However, in Bangladesh, outbreaks attributed to V. cholerae serogroup O139 isolates, which fall within the same phylogenetic lineage as the O1 serogroup isolates, were seen between 1992 and 1993 and in 2002 to 2005. Since then, V. cholerae serogroup O139 has only been sporadically isolated in Bangladesh and is now rarely isolated elsewhere.Here, we present case histories of four cholera patients infected with V. cholerae serogroup O139 in 2013 and 2014 in Bangladesh. We comprehensively typed these isolates using conventional approaches, as well as by whole genome sequencing. Phenotypic typing and PCR confirmed all four isolates belonging to the O139 serogroup.Whole genome sequencing revealed that three of the isolates were phylogenetically closely related to previously sequenced El Tor biotype, pandemic 7, toxigenic V. cholerae O139 isolates originating from Bangladesh and elsewhere. The fourth isolate was a non-toxigenic V. cholerae that, by conventional approaches, typed as O139 serogroup but was genetically divergent from previously sequenced pandemic 7 V. cholerae lineages belonging to the O139 or O1 serogroups.These results suggest that previously observed lineages of V. cholerae O139 persist in Bangladesh and can cause clinical disease and that a novel disease-causing non-toxigenic O139 isolate also occurs.

  15. Vibrio cholerae Serogroup O139: Isolation from Cholera Patients and Asymptomatic Household Family Members in Bangladesh between 2013 and 2014

    Science.gov (United States)

    Chowdhury, Fahima; Mather, Alison E.; Begum, Yasmin Ara; Asaduzzaman, Muhammad; Baby, Nabilah; Sharmin, Salma; Biswas, Rajib; Ikhtear Uddin, Muhammad; LaRocque, Regina C.; Harris, Jason B.; Calderwood, Stephen B.; Ryan, Edward T.; Clemens, John D.; Thomson, Nicholas R.; Qadri, Firdausi

    2015-01-01

    Background Cholera is endemic in Bangladesh, with outbreaks reported annually. Currently, the majority of epidemic cholera reported globally is El Tor biotype Vibrio cholerae isolates of the serogroup O1. However, in Bangladesh, outbreaks attributed to V. cholerae serogroup O139 isolates, which fall within the same phylogenetic lineage as the O1 serogroup isolates, were seen between 1992 and 1993 and in 2002 to 2005. Since then, V. cholerae serogroup O139 has only been sporadically isolated in Bangladesh and is now rarely isolated elsewhere. Methods Here, we present case histories of four cholera patients infected with V. cholerae serogroup O139 in 2013 and 2014 in Bangladesh. We comprehensively typed these isolates using conventional approaches, as well as by whole genome sequencing. Phenotypic typing and PCR confirmed all four isolates belonging to the O139 serogroup. Findings Whole genome sequencing revealed that three of the isolates were phylogenetically closely related to previously sequenced El Tor biotype, pandemic 7, toxigenic V. cholerae O139 isolates originating from Bangladesh and elsewhere. The fourth isolate was a non-toxigenic V. cholerae that, by conventional approaches, typed as O139 serogroup but was genetically divergent from previously sequenced pandemic 7 V. cholerae lineages belonging to the O139 or O1 serogroups. Conclusion These results suggest that previously observed lineages of V. cholerae O139 persist in Bangladesh and can cause clinical disease and that a novel disease-causing non-toxigenic O139 isolate also occurs. PMID:26562418

  16. Invasive Vibrio cholerae Infection Following Burn Injury

    Science.gov (United States)

    2008-06-01

    as asymptomatic col- onization, otitis, gastroenteritis , soft-tissue infection, sepsis, or even cerebritis. In contrast, epidemic V. cholerae (O-1 or...review of the available literature is presented in Table 1. CONCLUSION Infection with invasive Vibrio species bacteria (e.g. Vibrio vulnificus

  17. Cholera Treatment

    Science.gov (United States)

    ... Public Health in Haiti Haiti Pre-decision Brief Cholera in Haiti: One Year Later Related Links Healthy Water Global Water, Sanitation, & Hygiene (WASH) The Safe Water System Division of Foodborne, Waterborne, and Environmental Diseases Get Email Updates To receive email updates about ...

  18. Environmental surveillance for toxigenic Vibrio cholerae in surface waters of Haiti.

    Science.gov (United States)

    Kahler, Amy M; Haley, Bradd J; Chen, Arlene; Mull, Bonnie J; Tarr, Cheryl L; Turnsek, Maryann; Katz, Lee S; Humphrys, Michael S; Derado, Gordana; Freeman, Nicole; Boncy, Jacques; Colwell, Rita R; Huq, Anwar; Hill, Vincent R

    2015-01-01

    Epidemic cholera was reported in Haiti in 2010, with no information available on the occurrence or geographic distribution of toxigenic Vibrio cholerae in Haitian waters. In a series of field visits conducted in Haiti between 2011 and 2013, water and plankton samples were collected at 19 sites. Vibrio cholerae was detected using culture, polymerase chain reaction, and direct viable count methods (DFA-DVC). Cholera toxin genes were detected by polymerase chain reaction in broth enrichments of samples collected in all visits except March 2012. Toxigenic V. cholerae was isolated from river water in 2011 and 2013. Whole genome sequencing revealed that these isolates were a match to the outbreak strain. The DFA-DVC tests were positive for V. cholerae O1 in plankton samples collected from multiple sites. Results of this survey show that toxigenic V. cholerae could be recovered from surface waters in Haiti more than 2 years after the onset of the epidemic.

  19. Reporte histórico: Primer Aislamiento de Vibrio cholera serogrupo O1 biovar El Tor serovar Inaba durante la epidemia de cólera en el Perú ‑ 1991 Historical report: first isolation of Vibrio cholera serogroup O1 biovar El Tor serovar Inaba during the cholerae epidemic in Perú ‑ 1991

    OpenAIRE

    Nora Bravo Cruz; Alfredo Guillén

    2011-01-01

    Hace 20 años apareció una enfermedad diarreica nueva en el Perú y el Laboratorio de Referencia de Enteropatógenos del Instituto Nacional de Salud, cumplió una labor destacada en el aislamiento e identificación rápida y oportuna del Vibrio cholerae. La enfermedad del cólera no se había presentado anteriormente, pero en la última semana de enero de 1991 se detectó un brote epidémico de diarrea aguda con deshidratación intensa y algunos casos de fallecidos. La epidemia afectó, al comienzo, varia...

  20. [Improvement of hygiene and the combat of epidemics as Russian state concerns during World War I: Prince Alexander von Oldenburg and the POWs of the Central Powers in Russia].

    Science.gov (United States)

    Nachtigal, Reinhard

    2004-01-01

    When Russia joined the war against the Central Powers in 1914, she immediately faced problems of public health care among the masses of people who were forced to move across far distances in the country: soldiers, refugees, and prisoners of war. Because of poor organisation and the unexpectedly long duration of the war, the POWs fared worst of all war victims in Russia. Subjected to an overstrained military organisation in the rear, the fate of this broadly neglected group illustrates how and with what success Russia strove to meet its deficiencies in administrative structure during wartime. The "Evacuation and Sanitation Section" was put under the command of a member of the Imperial family, Prince Alexander of Oldenburg, a high ranking official of German origin. This amateur scientist and initiator of medical institutions was an energetic and courageous personality who became vital for the fate of millions of POWs in epidemic-stricken Russia. The role of this "silent" ally of the German and Austro-Hungarian governments has hitherto been unknown. Newly found sources in Russian archives now shed an interesting light on a weak spot of Russia's administration and a generally neglected chapter of the history of medicine, the handling of epidemics and of deficits in hygiene.

  1. Monitoring water sources for environmental reservoirs of toxigenic Vibrio cholerae O1, Haiti.

    Science.gov (United States)

    Alam, Meer T; Weppelmann, Thomas A; Weber, Chad D; Johnson, Judith A; Rashid, Mohammad H; Birch, Catherine S; Brumback, Babette A; Beau de Rochars, Valery E Madsen; Morris, J Glenn; Ali, Afsar

    2014-03-01

    An epidemic of cholera infections was documented in Haiti for the first time in more than 100 years during October 2010. Cases have continued to occur, raising the question of whether the microorganism has established environmental reservoirs in Haiti. We monitored 14 environmental sites near the towns of Gressier and Leogane during April 2012-March 2013. Toxigenic Vibrio cholerae O1 El Tor biotype strains were isolated from 3 (1.7%) of 179 water samples; nontoxigenic O1 V. cholerae was isolated from an additional 3 samples. All samples containing V. cholerae O1 also contained non-O1 V. cholerae. V. cholerae O1 was isolated only when water temperatures were ≥31°C. Our data substantiate the presence of toxigenic V. cholerae O1 in the aquatic environment in Haiti. These isolations may reflect establishment of long-term environmental reservoirs in Haiti, which may complicate eradication of cholera from this coastal country.

  2. What is cholera?

    DEFF Research Database (Denmark)

    Tamason, Charlotte Crim; Tulsiani, Suhella; Siddique, A.;

    2016-01-01

    a third ofthe respondents did not associate diarrhea with cholera or mentioned symptoms that could not be caused by cholera (29%). Approximately half of the respondents associated water with the cause of cholera (56%) and only 8% associated cholera with sanitation or hygiene. Shame and stigma (54%) were...

  3. Low detection of Vibrio cholerae carriage in healthcare workers returning to 12 Latin American countries from Haiti.

    Science.gov (United States)

    Llanes, R; Somarriba, L; Hernández, G; Bardaji, Y; Aguila, A; Mazumder, R N

    2015-04-01

    SUMMARY This investigation was undertaken to characterize the prevalence of intestinal Vibrio cholerae in healthcare workers (HCWs) returning from Haiti due to the ongoing cholera epidemic. Eight hundred and fifty asymptomatic HCWs of the Cuban Medical Brigade, who planned to leave Haiti, were studied by laboratory screening of stool culture for V. cholerae. A very low percentage (0.23%) of toxigenic V. cholerae serogroup O1, serotype Ogawa was found. To the best of our knowledge, this study represents the largest reported screening study for V. cholerae infection in asymptomatic HCWs returning from a cholera-affected country. Cholera transmission to health personnel highlights a possible risk of transmitting cholera during mobilization of the population for emergency response. Aid workers are encouraged to take precautions to reduce their risk for acquiring cholera and special care should be taken by consuming safe water and food and practising regular hand washing.

  4. Epidemiology, determinants and dynamics of cholera in Pakistan: gaps and prospects for future research.

    Science.gov (United States)

    Naseer, Maliha; Jamali, Tanzil

    2014-11-01

    Cholera is one of the notifiable endemic diseases in Pakistan, but the reporting of cholera cases is still unsatisfactory. Most of the diagnosed cases are never reported to the relevant authorities. In the year 1993 - 2005, the country did not report any single case of cholera to the WHO. The objectives of this review were to understand the epidemiology and to identify the possible determinants of cholera infection in Pakistan. Medscape, Medline, PakMedinet and PubMed, was searched, using key words, epidemiology and determinants of cholera infection in Pakistan during 1995 - 2010. Morbidity and mortality due to cholera infection during 1995 - 2010, without any language restriction. Out of 27 articles published between 1995 - 2010, 17 articles were included in the review. Vibrio cholerae O139 identified as a major cause of infection in older age group, while O1 biotype of cholera as a predominant cause of cholera among young individuals. Mainly reported determinants of cholera in Pakistan include poor sanitation and hygiene practices, increased population density in urban areas, leading to rapid and unplanned urbanization of the major cities and climate change due to increased environmental pollution in Pakistan are plausible factors for endemicity of cholera in Pakistan. Cholera reporting as a notifiable disease to the relevant departments and timely action can prevent the risk of outbreaks. There is a need to identify specific behavioral and environmental determinants responsible for outbreaks and epidemics of cholera in Pakistan which can help to design appropriate preventive and control interventions.

  5. Cholera Outbreak in Grande Comore: 1998–1999

    Science.gov (United States)

    Troeger, Christopher; Gaudart, Jean; Truillet, Romain; Sallah, Kankoe; Chao, Dennis L.; Piarroux, Renaud

    2016-01-01

    In 1998, a cholera epidemic in east Africa reached the Comoros Islands, an archipelago in the Mozambique Channel that had not reported a cholera case for more than 20 years. In just a little over 1 year (between January 1998 and March 1999), Grande Comore, the largest island in the Union of the Comoros, reported 7,851 cases of cholera, about 3% of the population. Using case reports and field observations during the medical response, we describe the epidemiology of the 1998–1999 cholera epidemic in Grande Comore. Outbreaks of infectious diseases on islands provide a unique opportunity to study transmission dynamics in a nearly closed population, and they may serve as stepping-stones for human pathogens to cross unpopulated expanses of ocean. PMID:26572869

  6. Genomic epidemiology of Vibrio cholerae O1 associated with floods, Pakistan, 2010.

    Science.gov (United States)

    Shah, Muhammad Ali; Mutreja, Ankur; Thomson, Nicholas; Baker, Stephen; Parkhill, Julian; Dougan, Gordon; Bokhari, Habib; Wren, Brendan W

    2014-01-01

    In August 2010, Pakistan experienced major floods and a subsequent cholera epidemic. To clarify the population dynamics and transmission of Vibrio cholerae in Pakistan, we sequenced the genomes of all V. cholerae O1 El Tor isolates and compared the sequences to a global collection of 146 V. cholerae strains. Within the global phylogeny, all isolates from Pakistan formed 2 new subclades (PSC-1 and PSC-2), lying in the third transmission wave of the seventh-pandemic lineage that could be distinguished by signature deletions and their antimicrobial susceptibilities. Geographically, PSC-1 isolates originated from the coast, whereas PSC-2 isolates originated from inland areas flooded by the Indus River. Single-nucleotide polymorphism accumulation analysis correlated river flow direction with the spread of PSC-2. We found at least 2 sources of cholera in Pakistan during the 2010 epidemic and illustrate the value of a global genomic data bank in contextualizing cholera outbreaks.

  7. Pathogeny of an epidemic of Vibrio cholerae in Jinzhou of Hubei Province in 2012%2012年湖北省荆州地区一起霍乱弧菌疫情分离株的病原学研究

    Institute of Scientific and Technical Information of China (English)

    张婷; 杨红梅; 陈婷; 李国明

    2015-01-01

    目的 了解2012年湖北省荆州地区一起霍乱弧菌疫情分离株的菌群分型.方法 共获得6株分离株,用传统方法(生化、制动、粘丝、血清学实验)进行鉴定.对确认的霍乱弧菌菌株进行毒力基因(霍乱肠毒素)PCR检验;用限制性内切酶Not Ⅰ、SfiⅠ分别进行酶切和脉冲场凝胶电泳(PFGE),并对电泳酶切指纹图谱进行聚类分析.结果 6株分离株经传统方法鉴定均为霍乱弧菌0139群;全部具有霍乱肠毒素;NotⅠ、SfiⅠ酶切PFGE电泳图谱条带全部一致;聚类分析结果显示,6株分离株的相似系数为100%.结论 湖北省荆州地区发生的霍乱弧菌疫情由霍乱弧菌0139群感染所致,且为相同的病原菌.%Objective To test the pathogeny of Vibrio cholerae strains of the epidemic in Jinzhou of Hubei Province.Methods Traditional methods of biochemistry,immobihzation test,string test and typing of blood serum were used to test the 6 strains isolated.The virulence gene which was cholera enterotoxin (ct) was detected by PCR.The whole genome DNA finger print of confirmed strains was analyzed by pulsed field gel electrophoresis (PFGE) after digestion respectively with two enzymes Not Ⅰ and Sfi Ⅰ.The DNA fingerprints were analyzed for clusters.Results The 6 strains of Vibrio cholerae were all O139 by traditional laboratory tests;virulence gene was detected in all 6 strains.The banding pattern was the same in the two maps of PFGE.The results of cluster analysis showed that the similarity coefficient of the six strains was 100%.Conclusion The epidemic of Vibrio cholerae is caused by the same pathogenic bacterium which is O139.

  8. Linkage of Global Water Resources, Climate, and Human Health: A Conundrum for Which Cholera Offers a Paradigm (Invited)

    Science.gov (United States)

    Colwell, R.

    2010-12-01

    An environmental source of cholera was hypothesized as early as the late nineteenth century by Robert Koch. Standard bacteriological procedures for isolation of vibrios from environmental samples, including water, between epidemics generally were unsuccessful because Vibrio cholerae, a marine vibrio, enters into a dormant, "viable but nonculturable stage," when conditions are unfavorable for growth and reproduction. An association of Vibrio cholerae with zooplankton, notably copepods, has been established. Furthermore, the sporadicity and erraticity of cholera epidemics have been correlated with El Niño. Since zooplankton harbor the bacterium and zooplankton blooms follow phytoplankton blooms, remote sensing can be employed to predict cholera epidemics from sea surface temperature (SST), ocean height (OH), chlorophyll, and turbidity data. Cholera occurs seasonally in Bangladesh, with two annual peaks in the number of cases. From clinical remote sensing data, it has been found that SST, OH, and blooms of phytoplankton and zooplankton are correlated with cholera epidemics. Thus, selected climatological factors and incidence of V. cholerae can be recorded, bringing the potential of predicting conditions conducive to cholera outbreaks to reality. A simple filtration intervention takes into account the association of V. cholerae with plankton, and has proven to be a simple solution to the age-old problem of controlling this waterborne disease for villagers in remote regions of Bangladesh.

  9. Molecular characteristics and antibiotic resistance of Vibrio cholerae O139 in Shandong province

    Institute of Scientific and Technical Information of China (English)

    袁玉起

    2014-01-01

    Objective To investigate the molecular epidemiological characteristics and antibiotic resistance profiles of Vibrio cholerae O139 in Shandong province.Methods A total of 13 strains of V.cholerae O139(9 clinical strains and 4 environmental strains)isolated from cholera epidemics in Shandong province since 1997 were recovered and confirmed with serum agglutination and biochemical reaction.Pulsed-field gel electrophoresis(PFGE)was carried out for molecular subtyping.Virulence genes and

  10. The Zymovars of Vibrio cholerae: Multilocus Enzyme Electrophoresis of Vibrio cholerae

    Directory of Open Access Journals (Sweden)

    Fernanda S Freitas

    2002-06-01

    Full Text Available Zymovars analysis also known as multilocus enzyme electrophoresis is applied here to investigate the genetic variation of Vibrio cholerae strains and characterise strains or group of strains of medical and epidemiological interest. Fourteen loci were analyzed in 171 strains of non-O1 non-O139, 32 classical and 61 El Tor from America, Africa, Europe and Asia. The mean genetic diversity was 0.339. It is shown that the same O antigen (both O1 and non-O1 may be present in several geneticaly diverse (different zymovars strains. Conversely the same zymovar may contain more than one serogroup. It is confirmed that the South American epidemic strain differs from the 7th pandemic El Tor strain in locus LAP (leucyl leucyl aminopeptidase. Here it is shown that this rare allele is present in 1 V. mimicus and 4 non-O1 V. cholerae. Non toxigenic O1 strains from South India epidemic share zymovar 14A with the epidemic El Tor from the 7th pandemic, while another group have diverse zymovars. The sucrose negative epidemic strains isolated in French Guiana and Brazil have the same zymovar of the current American epidemic V. cholerae.

  11. John Snow and cholera--the bicentenary of birth.

    Science.gov (United States)

    Gańczak, Maria

    2014-01-01

    The bicentenary of John Snow's birth, a legend in his field, for his research on epidemiology and the prevention ofcholera, constitutes a unique opportunity to commemorate this iconic figure. In the article, his spectacular achievements in this discipline are presented, including his epidemiological investigation during cholera epidemic and the well-known Broad Street intervention in Soho, in 1854, as well as his methodologically elegant experiment "on the grandest scale" in which he compared the cholera fatality rates in households served by two different water supply companies. Having referred to Snow's research, the cholera outbreak in Haiti in 2010 is also discussed.

  12. Vibrio cholerae O1 from superficial water of the Tucunduba Stream, Brazilian Amazon

    Science.gov (United States)

    Sá, L.L.C.; Vale, E.R.V.; Garza, D.R.; Vicente, A.C.P.

    2012-01-01

    Isolation and genetic characterization of an environmental Vibrio cholerae O1 from the Amazon is reported. This strain lacks two major virulence factors - CTX and TCP - but carries other genes related to virulence. Genetic similarity with epidemic strains is evaluated and the importance of V. cholerae surveillance in the Amazon is emphasized. PMID:24031874

  13. Cholera in Thomas Mann's Death in Venice.

    Science.gov (United States)

    Rütten, Thomas

    2009-01-01

    The article sets the cholera motif in Thomas Mann's famous novella Death in Venice against the historical context from which it partially originates. It is shown that this motif, while undoubtedly appropriated to serve Mann's own poetic ends, has a solid grounding in historical and autobiographical fact, thus blurring the boundaries between fact and fiction. The article illustrates the verifiable events of the outbreak of the Venetian cholera epidemic in May 1911, which Mann partly witnessed himself, during a holiday trip to Brioni and Venice, and partly heard and read about. It is established that Thomas Mann's account of the cholera in Venice in his novella is characterised by a rare and almost preternatural insightfulness into an otherwise murky affair that was marked by rumours, speculations and denials.

  14. Cholera in coastal Africa: a systematic review of its heterogeneous environmental determinants.

    Science.gov (United States)

    Rebaudet, Stanislas; Sudre, Bertrand; Faucher, Benoît; Piarroux, Renaud

    2013-11-01

    According to the "cholera paradigm," epidemiology of this prototypical waterborne disease is considered to be driven directly by climate-induced variations in coastal aquatic reservoirs of Vibrio cholerae. This systematic review on environmental determinants of cholera in coastal Africa shows that instead coastal epidemics constitute a minor part of the continental cholera burden. Most of coastal cholera foci are located near estuaries, lagoons, mangrove forests, and on islands. Yet outbreaks often originate in coastal cities, where cholera is more likely to be imported from distant areas. Cholera outbreaks also may intensify in densely populated slum quarters before spreading to adjacent regions. Frequent seasonality of cholera incidence appears driven by the rainfall-induced contamination of unprotected water sources through latrine overflow and sewage, as well as by the periodicity of human activities like fishing or traveling. Lulls in transmission periods of several years are repeatedly recorded even in high-risk coastal areas. To date, environmental studies have failed to demonstrate a perennial aquatic reservoir of toxigenic V. cholerae around the continent. Finally, applicability of the cholera paradigm therefore appears questionable in Africa, although available data remain limited. Thorough surveys with microbiological analyses of water samples and prospective genotyping of environmental and clinical strains of V. cholerae are needed to understand determinants of cholera in coastal Africa and better target prevention and control measures.

  15. Formation of Medical Units in Response to Epidemics in the Australian Imperial Force in Palestine 1918

    Directory of Open Access Journals (Sweden)

    Prof. G Dennis Shanks MD

    2014-06-01

    Full Text Available In the closing days of the First World War, British cavalry operations defeated the Turkish Armies in Palestine. Australian Light Horse Regiments as part of the Australian Imperial Forces (AIF were prominent in the capture of Amman, Beirut and Damascus. Epidemic infectious diseases were part of the severe desert environment faced by soldiers in the Middle East. Cholera and dysentery epidemics required reformation of medical units to emphasize mobility in an austere environment. A large epidemic of falciparum malaria coinciding with pandemic influenza shut down military operations and caused many deaths in late 1918. Three separate military medical units were formed in Egypt to address epidemic infectious diseases during mobile operations in the desert: ANZAC Field Laboratory, 5th Malaria Diagnosis Station and 7th Mobile Sanitary Section. Laboratory and preventive medicine units were critical to the military’s ability to conduct operations in the Middle East in 1918 and are likely to become vital for future missions in developing countries. As was the case in 1918, military medical units may have to be acutely restructured to control infectious disease outbreaks

  16. Cholera Prevention and Control

    Science.gov (United States)

    ... name="commit" type="submit" value="Submit" /> Prevention & Control Recommend on Facebook Tweet Share Compartir Prevention of ... of cholera and other diarrheal disease prevention. Prevention Control Topics Six Basic Cholera Prevention Messages I nfection ...

  17. What is cholera?

    DEFF Research Database (Denmark)

    Tamason, Charlotte Crim; Tulsiani, Suhella; Siddique, A.;

    2016-01-01

    Background: Cholera has afflicted the Indian sub-continent for centuries, predominantly in West Bengal and modern-day Bangladesh. This preliminary study aims to understand the current level of knowledge of cholera in female Bangladeshi caretakers, which is important in the outcome of the disease...... and its spread. A pilot study was conducted among 85 women in Bangladesh using qualitative questionnaires to explore the ability of female caretakers in identifying cholera and its transmission. Findings: The survey revealed that though all the female caretakers were aware of the term “cholera,” nearly...... a third ofthe respondents did not associate diarrhea with cholera or mentioned symptoms that could not be caused by cholera (29%). Approximately half of the respondents associated water with the cause of cholera (56%) and only 8% associated cholera with sanitation or hygiene. Shame and stigma (54%) were...

  18. Understanding the Hydrology of Cholera in South Asia

    Science.gov (United States)

    Akanda, A. S.; Jutla, A. S.; Islam, S.

    2007-12-01

    Cholera is an acute waterborne illness caused by the bacterium Vibrio cholerae. The disease remains a major public health issue in several regions of the developing world, mainly in coastal areas around the tropics. Cholera incidences have been historically linked to climate variables and more recently with El Nino-Southern Oscillation. The occurrence of cholera shows bi-annual seasonal peaks and strong inter-annual variability in the Ganges basin region of South Asia. However, the role of hydrologic variables in the seasonal patterns of cholera epidemics is less understood. Preliminary results suggest that a unique combination of increasing water temperature and higher salinity in the coastal zone during the low flow season provide the situation amenable to the first outbreak of cholera in the spring season. Other major factors contributing to the subsequent spread of the disease are sea surface height, monsoon precipitation, and coastal phytoplankton concentration. We will further examine the lag periods between the dominant environmental variables and cholera incidences to understand the seasonal dynamics of cholera in South Asia.

  19. Cholera in Zimbabwe

    NARCIS (Netherlands)

    Pruyt, E.

    2009-01-01

    By the end of December 2008, alarming reports and articles concerning the cholera outbreak in Zimbabwe received plenty of international media coverage. By that time nearly 30000 cases of cholera infections and 1600 cholera deaths had been reported. In the first week of January 2009, a System Dynamic

  20. Molecular Epidemiology and Antibiotic Susceptibility of Vibrio cholerae Associated with a Large Cholera Outbreak in Ghana in 2014.

    Directory of Open Access Journals (Sweden)

    Daniel Eibach

    2016-05-01

    Full Text Available Ghana is affected by regular cholera epidemics and an annual average of 3,066 cases since 2000. In 2014, Ghana experienced one of its largest cholera outbreaks within a decade with more than 20,000 notified infections. In order to attribute this rise in cases to a newly emerging strain or to multiple simultaneous outbreaks involving multi-clonal strains, outbreak isolates were characterized, subtyped and compared to previous epidemics in 2011 and 2012.Serotypes, biotypes, antibiotic susceptibilities were determined for 92 Vibrio cholerae isolates collected in 2011, 2012 and 2014 from Southern Ghana. For a subgroup of 45 isolates pulsed-field gel electrophoresis, multilocus sequence typing and multilocus-variable tandem repeat analysis (MLVA were performed. Eighty-nine isolates (97% were identified as ctxB (classical type positive V. cholerae O1 biotype El Tor and three (3% isolates were cholera toxin negative non-O1/non-O139 V. cholerae. Among the selected isolates only sulfamethoxazole/trimethoprim resistance was detectable in 2011, while 95% of all 2014 isolates showed resistance towards sulfamethoxazole/trimethoprim, ampicillin and reduced susceptibility to ciprofloxacin. MLVA achieved the highest subtype discrimination, revealing 22 genotypes with one major outbreak cluster in each of the three outbreak years. Apart from those clusters genetically distant genotypes circulate during each annual epidemic.This analysis suggests different endemic reservoirs of V. cholerae in Ghana with distinct annual outbreak clusters accompanied by the occurrence of genetically distant genotypes. Preventive measures for cholera transmission should focus on aquatic reservoirs. Rapidly emerging multidrug resistance must be monitored closely.

  1. Detection of Vibrio cholerae O1 and O139 in environmental waters of rural Bangladesh: a flow-cytometry-based field trial.

    Science.gov (United States)

    Righetto, L; Zaman, R U; Mahmud, Z H; Bertuzzo, E; Mari, L; Casagrandi, R; Gatto, M; Islam, S; Rinaldo, A

    2015-08-01

    Presence of Vibrio cholerae serogroups O1 and O139 in the waters of the rural area of Matlab, Bangladesh, was investigated with quantitative measurements performed with a portable flow cytometer. The relevance of this work relates to the testing of a field-adapted measurement protocol that might prove useful for cholera epidemic surveillance and for validation of mathematical models. Water samples were collected from different water bodies that constitute the hydrological system of the region, a well-known endemic area for cholera. Water was retrieved from ponds, river waters, and irrigation canals during an inter-epidemic time period. Each sample was filtered and analysed with a flow cytometer for a fast determination of V. cholerae cells contained in those environments. More specifically, samples were treated with O1- and O139-specific antibodies, which allowed precise flow-cytometry-based concentration measurements. Both serogroups were present in the environmental waters with a consistent dominance of V. cholerae O1. These results extend earlier studies where V. cholerae O1 and O139 were mostly detected during times of cholera epidemics using standard culturing techniques. Furthermore, our results confirm that an important fraction of the ponds' host populations of V. cholerae are able to self-sustain even when cholera cases are scarce. Those contaminated ponds may constitute a natural reservoir for cholera endemicity in the Matlab region. Correlations of V. cholerae concentrations with environmental factors and the spatial distribution of V. cholerae populations are also discussed.

  2. Phenotypic and Genetic Heterogeneity in Vibrio cholerae O139 Isolated from Cholera Cases in Delhi, India during 2001-2006.

    Science.gov (United States)

    Ghosh, Raikamal; Sharma, Naresh C; Halder, Kalpataru; Bhadra, Rupak K; Chowdhury, Goutam; Pazhani, Gururaja P; Shinoda, Sumio; Mukhopadhyay, Asish K; Nair, G Balakrish; Ramamurthy, Thadavarayan

    2016-01-01

    Incidence of epidemic Vibrio cholerae serogroup O139 has declined in cholera endemic countries. However, sporadic cholera caused by V. cholerae O139 with notable genetic changes is still reported from many regions. In the present study, 42 V. cholerae O139 strains isolated from 2001 to 2006 in Delhi, India, were retrospectively analyzed to understand their phenotype and molecular characteristics. The majority of isolates were resistant to ampicillin, furazolidone and nalidixic acid. Though the integrative conjugative element was detected in all the O139 isolates, the 2004-2006 isolates remained susceptible to co-trimoxazole, chloramphenicol, and streptomycin. Cholera toxin genotype 1 was present in the majority of the O139 isolates while few had type 3 or a novel type 4. In the cholera toxin encoding gene (ctx) restriction fragment length polymorphism, the majority of the isolates harbored three copies of CTX element, of which one was truncated. In this study, the ctx was detected for the first time in the small chromosome of V. cholerae O139 and one isolate harbored 5 copies of CTX element, of which 3 were truncated. The ribotype BII pattern was found in most of the O139 isolates. Three V. cholerae O139 isolated in 2001 had a new ribotype BVIII. Pulsed-field gel electrophoresis analysis revealed clonal variation in 2001 isolates compared to the 2004-2006 isolates. Molecular changes in V. cholerae O139 have to be closely monitored as this information may help in understanding the changing genetic features of this pathogen in relation to the epidemiology of cholera.

  3. Phenotypic and Genetic Heterogeneity in Vibrio cholerae O139 Isolated from Cholera Cases in Delhi, India during 2001-2006

    Directory of Open Access Journals (Sweden)

    Raikamal Ghosh

    2016-08-01

    Full Text Available Incidence of epidemic Vibrio cholerae serogroup O139 has declined in cholera endemic countries. However, sporadic cholera caused by V. cholerae O139 with notable genetic changes is still reported from many regions. In the present study, 42 V. cholerae O139 strains isolated from 2001 to 2006 in Delhi, India, were retrospectively analyzed to understand their phenotype and molecular characteristics. The majority of isolates were resistant to ampicillin, furazolidone and nalidixic acid. Though the integrative conjugative element was detected in all the O139 isolates, the 2004-2006 isolates remained susceptible to co-trimoxazole, chloramphenicol, and streptomycin. Cholera toxin genotype 1 was present in the majority of the O139 isolates while few had type 3 or a novel type 4. In the cholera toxin encoding gene (ctx restriction fragment length polymorphism, the majority of the isolates harbored three copies of CTX element, of which one was truncated. In this study, the ctx was detected for the first time in the small chromosome of V. cholerae O139 and one isolate harbored 5 copies of CTX element, of which 3 were truncated. The ribotype BII pattern was found in most of the O139 isolates. Three V. cholerae O139 isolated in 2001 had a new ribotype BVIII. Pulsed-field gel electrophoresis analysis revealed clonal variation in 2001 isolates compared to the 2004-2006 isolates. Molecular changes in V. cholerae O139 have to be closely monitored as this information may help in understanding the changing genetic features of this pathogen in relation to the epidemiology of cholera.

  4. A large cholera outbreak due to a new cholera toxin variant of the Vibrio cholerae O1 El Tor biotype in Orissa, Eastern India.

    Science.gov (United States)

    Kumar, P; Jain, M; Goel, A K; Bhadauria, S; Sharma, S K; Kamboj, D V; Singh, L; Ramamurthy, T; Nair, G B

    2009-02-01

    A total of 32 Vibrio cholerae isolates were collected during a recent large cholera outbreak in Eastern India. Biochemical and serological studies revealed that all of the isolates belonged to serogroup O1, biotype El Tor, serotype Ogawa. Two multiplex PCR assays confirmed the presence of various toxigenic and pathogenic genes - ace, ctxAB, hlyA, ompU, ompW, rfbO1, rtx, tcp, toxR and zot - in all of the isolates. Sequencing of the ctxB gene from the isolates revealed a novel mutation in the gene. Sequencing also confirmed the presence of altered cholera toxin B of the classical biotype in all of the El Tor isolates, suggesting infection of isolates by classical CTXPhi. The molecular diversity of V. cholerae isolates studied by enterobacterial repetitive intergenic consensus sequence PCR, BOX-PCR and randomly amplified polymorphic DNA analysis uniformly showed the clonal relationship among the outbreak V. cholerae O1 isolates. The results of this study suggest that cholera-causing V. cholerae strains are constantly evolving in epidemic areas, highlighting the potential of the emergence of more virulent strains.

  5. Satellite Based Assessment of Hydroclimatic Conditions Related to Cholera in Zimbabwe.

    Directory of Open Access Journals (Sweden)

    Antarpreet Jutla

    Full Text Available Cholera, an infectious diarrheal disease, has been shown to be associated with large scale hydroclimatic processes. The sudden and sporadic occurrence of epidemic cholera is linked with high mortality rates, in part, due to uncertainty in timing and location of outbreaks. Improved understanding of the relationship between pathogenic abundance and climatic processes allows prediction of disease outbreak to be an achievable goal. In this study, we show association of large scale hydroclimatic processes with the cholera epidemic in Zimbabwe reported to have begun in Chitungwiza, a city in Mashonaland East province, in August, 2008.Climatic factors in the region were found to be associated with triggering cholera outbreak and are shown to be related to anomalies of temperature and precipitation, validating the hypothesis that poor conditions of sanitation, coupled with elevated temperatures, and followed by heavy rainfall can initiate outbreaks of cholera. Spatial estimation by satellite of precipitation and global gridded air temperature captured sensitivities in hydroclimatic conditions that permitted identification of the location in the region where the disease outbreak began.Satellite derived hydroclimatic processes can be used to capture environmental conditions related to epidemic cholera, as occurred in Zimbabwe, thereby providing an early warning system. Since cholera cannot be eradicated because the causative agent, Vibrio cholerae, is autochthonous to the aquatic environment, prediction of conditions favorable for its growth and estimation of risks of triggering the disease in a given population can be used to alert responders, potentially decreasing infection and saving lives.

  6. 广州海珠地区非O1/非O139群霍乱弧菌流行状况调查及生物学特征研究%Epidemic condition and biological characteristics of non-O1/non-O139 vibrio cholerae in Haizhu District of Guangzhou

    Institute of Scientific and Technical Information of China (English)

    许少洪; 李映霞; 李少彤; 吴琪; 孙凤琪; 黄芳; 曾爱芳

    2010-01-01

    Objective To understand the epidemic condition, distribution and biological characteristics of non-O1/non-O139 vibrio cholerae from 2001 to 2009 in Haizhu District, to provide a scientific basis for the prevention and control of acute diarrhea. Methods Referring to the detecting method written in "Cholera control handbook"in the fifth edition,764 specimens from outside environment (including the water in the Pearl River, drinking water, water for breeding fish, aquatic products and delicatessen foods), 189 specimens of healthy population and 3398 intestinal samples of patients with diarrhea, summing up to 4351 specimens for non-O1/non-O139 vibrio cholerae test. Results 4351 speciments were detected of 101 strains of non O1/non O139 vibrio cholerae, the total detection rate was 2. 32%;66 strains were identified by serotyping and grouped into 26 different serotypes, the typing rate was 65.3%. The strains VBO9,VBO38 and VBO76 were the dominant bacteria. Nine strains of the same type of non-O1/non-O139 vibrio cholerae were found from external environments also from patients with diarrhea, suggesting that there might be a correlation between the two. Conclusion Non-O1/non-O139 vibrio cholerae have diversified serotypes, causing certain infection rate among the population in this region. These bacteria exist extensively in external environment and they are the potential hazard to the citizens.%目的 了解广州海珠地区2001-2009年非O1/非O139群霍乱弧菌的流行、分布状况及生物学特征,为防控该类病原菌引起的急性腹泻病提供科学依据.方法 参照(第5版)中的检测方法,对本区珠江河水、饮用水、养殖水、各种海(水)产品、市售熟食等外环境标本764份、健康人群标本189份及肠道门诊腹泻患者标本3398份,共计4351份标本进行非O1/非O139群霍乱弧菌的检定.结果 4351份标本共检出非O1/非O139群霍乱弧菌101株,总检出率为2.32%;其中有66株可分型,分属于26

  7. [The Austrian Red Cross and Austrian bacteriologists in the Balkan wars 1912/13 - Centenary of the first application of the bacteriology in theatres of war].

    Science.gov (United States)

    Flamm, Heinz

    2012-04-01

    When Austria joined the Geneva Convention the "Patriotischer Hilfsverein" (Patriotic Aid Society) which was founded for the concerns of wounded soldiers, was named "Austrian Society of the Red Cross". It had to stand its first big test in 1912 in the first Balkan war; military surgeons and bacteriologists were deployed to all warring states. The cholera dominated under the infectious diseases among the various forces and the civilian populations. Upon request of the Bulgarian king renowned bacteriologists of the University of Vienna were dispatched. Their work presented the first action of bacteriology for disease control on theatres of war. The great success of the surgical and hygienic measures initiated in 1912 a reform of the Austrian Red Cross. In 1913 Austria made a detailed application to the International Committee of the Red Cross in order to extend the Geneva Convention to war epidemics. The Committee forwarded and recommended this application to all member states, however, the outbreak of the First World War then prevented its resolution.

  8. [Design and implementation of Geographical Information System on prevention and control of cholera].

    Science.gov (United States)

    Li, Xiu-jun; Fang, Li-qun; Wang, Duo-chun; Wang, Lu-xi; Li, Ya-pin; Li, Yan-li; Yang, Hong; Kan, Biao; Cao, Wu-chun

    2012-04-01

    To build the Geographical Information System (GIS) database for prevention and control of cholera programs as well as using management analysis and function demonstration to show the spatial attribute of cholera. Data from case reporting system regarding diarrhoea, vibrio cholerae, serotypes of vibrio cholerae at the surveillance spots and seafoods, as well as surveillance data on ambient environment and climate were collected. All the data were imported to system database to show the incidence of vibrio cholerae in different provinces, regions and counties to support the spatial analysis through the spatial analysis of GIS. The epidemic trends of cholera, seasonal characteristics of the cholera and the variation of the vibrio cholerae with times were better understood. Information on hotspots, regions and time of epidemics was collected, and helpful in providing risk prediction on the incidence of vibrio cholerae. The exploitation of the software can predict and simulate the spatio-temporal risks, so as to provide guidance for the prevention and control of the disease.

  9. Cholera in Haiti: Reproductive numbers and vaccination coverage estimates

    Science.gov (United States)

    Mukandavire, Zindoga; Smith, David L.; Morris, J. Glenn, Jr.

    2013-01-01

    Cholera reappeared in Haiti in October, 2010 after decades of absence. Cases were first detected in Artibonite region and in the ensuing months the disease spread to every department in the country. The rate of increase in the number of cases at the start of epidemics provides valuable information about the basic reproductive number (). Quantitative analysis of such data gives useful information for planning and evaluating disease control interventions, including vaccination. Using a mathematical model, we fitted data on the cumulative number of reported hospitalized cholera cases in Haiti. varied by department, ranging from 1.06 to 2.63. At a national level, 46% vaccination coverage would result in an () debate on the use of cholera vaccines in endemic and non-endemic regions, our results suggest that moderate cholera vaccine coverage would be an important element of disease control in Haiti.

  10. Vibrio cholerae Biofilms and Cholera Pathogenesis.

    Directory of Open Access Journals (Sweden)

    Anisia J Silva

    2016-02-01

    Full Text Available Vibrio cholerae can switch between motile and biofilm lifestyles. The last decades have been marked by a remarkable increase in our knowledge of the structure, regulation, and function of biofilms formed under laboratory conditions. Evidence has grown suggesting that V. cholerae can form biofilm-like aggregates during infection that could play a critical role in pathogenesis and disease transmission. However, the structure and regulation of biofilms formed during infection, as well as their role in intestinal colonization and virulence, remains poorly understood. Here, we review (i the evidence for biofilm formation during infection, (ii the coordinate regulation of biofilm and virulence gene expression, and (iii the host signals that favor V. cholerae transitions between alternative lifestyles during intestinal colonization, and (iv we discuss a model for the role of V. cholerae biofilms in pathogenicity.

  11. Investigating the role of water in the Diffusion of Cholera using Agent-Based simulation

    Science.gov (United States)

    Augustijn, Ellen-Wien; Doldersum, Tom; Augustijn, Denie

    2014-05-01

    Traditionally, cholera was considered to be a waterborne disease. Currently we know that many other factors can contribute to the spread of this disease including human mobility and human behavior. However, the hydrological component in cholera diffusion is significant. The interplay between cholera and water includes bacteria (V. cholera) that survive in the aquatic environment, the possibility that run-off water from dumpsites carries the bacteria to surface water (rivers and lakes), and when the bacteria reach streams they can be carried downstream to infect new locations. Modelling is a very important tool to build theory on the interplay between different types of transmission mechanisms that together are responsible for the spread of Cholera. Agent-based simulation models are very suitable to incorporate behavior at individual level and to reproduce emergence. However, it is more difficult to incorporate the hydrological components in this type of model. In this research we present the hydrological component of an Agent-Based Cholera model developed to study a Cholera epidemic in Kumasi (Ghana) in 2005. The model was calibrated on the relative contribution of each community to the distributed pattern of cholera rather than the absolute number of incidences. Analysis of the results shows that water plays an important role in the diffusion of cholera: 75% of the cholera cases were infected via river water that was contaminated by runoff from the dumpsites. To initiate infections upstream, the probability of environment-to-human transmission seemed to be overestimated compared to what may be expected from literature. Scenario analyses show that there is a strong relation between the epidemic curve and the rainfall. Removing dumpsites that are situated close to the river resulted in a strong decrease in the number of cholera cases. Results are sensitive to the scheduling of the daily activities and the survival time of the cholera bacteria.

  12. Environmental determinants of cholera outbreaks in inland Africa: a systematic review of main transmission foci and propagation routes.

    Science.gov (United States)

    Rebaudet, Stanislas; Sudre, Bertrand; Faucher, Benoît; Piarroux, Renaud

    2013-11-01

    Cholera is generally regarded as the prototypical waterborne and environmental disease. In Africa, available studies are scarce, and the relevance of this disease paradigm is questionable. Cholera outbreaks have been repeatedly reported far from the coasts: from 2009 through 2011, three-quarters of all cholera cases in Africa occurred in inland regions. Such outbreaks are either influenced by rainfall and subsequent floods or by drought- and water-induced stress. Their concurrence with global climatic events has also been observed. In lakes and rivers, aquatic reservoirs of Vibrio cholerae have been evocated. However, the role of these reservoirs in cholera epidemiology has not been established. Starting from inland cholera-endemic areas, epidemics burst and spread to various environments, including crowded slums and refugee camps. Human displacements constitute a major determinant of this spread. Further studies are urgently needed to better understand these complex dynamics, improve water and sanitation efforts, and eliminate cholera from Africa.

  13. Modeling cholera outbreaks

    OpenAIRE

    Dennis L Chao; Longini, Ira M.; Morris, J. Glenn

    2014-01-01

    Mathematical modeling can be a valuable tool for studying infectious disease outbreak dynamics and simulating the effects of possible interventions. Here, we describe approaches to modeling cholera outbreaks and how models have been applied to explore intervention strategies, particularly in Haiti. Mathematical models can play an important role in formulating and evaluating complex cholera outbreak response options. Major challenges to cholera modeling are insufficient data for calibrating mo...

  14. The role of socioeconomic status in longitudinal trends of cholera in Matlab, Bangladesh, 1993-2007.

    Science.gov (United States)

    Root, Elisabeth Dowling; Rodd, Joshua; Yunus, Mohammad; Emch, Michael

    2013-01-01

    There has been little evidence of a decline in the global burden of cholera in recent years as the number of cholera cases reported to WHO continues to rise. Cholera remains a global threat to public health and a key indicator of lack of socioeconomic development. Overall socioeconomic development is the ultimate solution for control of cholera as evidenced in developed countries. However, most research has focused on cross-county comparisons so that the role of individual- or small area-level socioeconomic status (SES) in cholera dynamics has not been carefully studied. Reported cases of cholera in Matlab, Bangladesh have fluctuated greatly over time and epidemic outbreaks of cholera continue, most recently with the introduction of a new serotype into the region. The wealth of longitudinal data on the population of Matlab provides a unique opportunity to explore the impact of socioeconomic status and other demographic characteristics on the long-term temporal dynamics of cholera in the region. In this population-based study we examine which factors impact the initial number of cholera cases in a bari at the beginning of the 0139 epidemic and the factors impacting the number of cases over time. Cholera data were derived from the ICDDR,B health records and linked to socioeconomic and geographic data collected as part of the Matlab Health and Demographic Surveillance System. Longitudinal zero-inflated Poisson (ZIP) multilevel regression models are used to examine the impact of environmental and socio-demographic factors on cholera counts across baris. Results indicate that baris with a high socioeconomic status had lower initial rates of cholera at the beginning of the 0139 epidemic (γ(01) = -0.147, p = 0.041) and a higher probability of reporting no cholera cases (α(01) = 0.156, p = 0.061). Populations in baris characterized by low SES are more likely to experience higher cholera morbidity at the beginning of an epidemic than populations in high

  15. Hydroclimatic Extremes and Cholera Dynamics in the 21st Century

    Science.gov (United States)

    Akanda, A. S.; Jutla, A. S.; Islam, S.

    2012-12-01

    Cholera, an acute water-borne diarrheal illness, has reemerged as a significant health threat across much of the developing world. Despite major advances in the ecological and the microbiological understanding of the causative agent, V. cholerae, the role of the underlying climatic and environmental processes in propagating transmission is not adequately understood. Recent findings suggest a more prominent role of hydroclimatic extremes - droughts and floods - on the unique dual cholera peaks in the Bengal Delta region of South Asia, the native homeland of cholera. Increasing water scarcity and abundance, and coastal sea-level rise, influenced by changing climate patterns and large-scale climatic phenomena, is likely to adversely impact cholera transmission in South Asia. We focus on understanding how associated changes in macro-scale conditions in this region will impact micro-scale processes related to cholera in coming decades. We use the PRECIS Regional Climate Model over the Ganges-Brahmaputra-Meghna (GBM) basin region to simulate detailed high resolution projections of climate patterns for the 21st century. Precipitation outputs are analyzed for the 1980-2040 period to identify the trends and changes in hydroclimatic extremes and potential impacts on cholera dynamics over the next three decades (2010-2040), in relation to the cholera surveillance operations over the past three decades (1980-2010). We find that an increased number of extreme precipitation events with prolonged dry periods in the Ganges basin region will likely adversely affect dry season cholera outbreaks. Increased monsoon precipitation volumes in the Brahmaputra basin catchments are likely to cause record floods and subsequently trigger large epidemics in downstream areas. Our results provide new insight by identifying the changes in the two distinctly different, pre and post monsoon, cholera transmission mechanisms related to large-scale climatic controls that prevail in the region. A

  16. Model of Cholera Forecasting Using Artificial Neural Network in Chabahar City, Iran

    Directory of Open Access Journals (Sweden)

    Pezeshki

    2016-02-01

    Full Text Available Background Cholera as an endemic disease remains a health issue in Iran despite decrease in incidence. Since forecasting epidemic diseases provides appropriate preventive actions in disease spread, different forecasting methods including artificial neural networks have been developed to study parameters involved in incidence and spread of epidemic diseases such as cholera. Objectives In this study, cholera in rural area of Chabahar, Iran was investigated to achieve a proper forecasting model. Materials and Methods Data of cholera was gathered from 465 villages, of which 104 reported cholera during ten years period of study. Logistic regression modeling and correlate bivariate were used to determine risk factors and achieve possible predictive model one-hidden-layer perception neural network with backpropagation training algorithm and the sigmoid activation function was trained and tested between the two groups of infected and non-infected villages after preprocessing. For determining validity of prediction, the ROC diagram was used. The study variables included climate conditions and geographical parameters. Results After determining significant variables of cholera incidence, the described artificial neural network model was capable of forecasting cholera event among villages of test group with accuracy up to 80%. The highest accuracy was achieved when model was trained with variables that were significant in statistical analysis describing that the two methods confirm the result of each other. Conclusions Application of artificial neural networking assists forecasting cholera for adopting protective measures. For a more accurate prediction, comprehensive information is required including data on hygienic, social and demographic parameters.

  17. Adapting to the global shortage of cholera vaccines: targeted single dose cholera vaccine in response to an outbreak in South Sudan.

    Science.gov (United States)

    Parker, Lucy A; Rumunu, John; Jamet, Christine; Kenyi, Yona; Lino, Richard Laku; Wamala, Joseph F; Mpairwe, Allan M; Ciglenecki, Iza; Luquero, Francisco J; Azman, Andrew S; Cabrol, Jean-Clement

    2017-01-18

    Shortages of vaccines for epidemic diseases, such as cholera, meningitis, and yellow fever, have become common over the past decade, hampering efforts to control outbreaks through mass reactive vaccination campaigns. Additionally, various epidemiological, political, and logistical challenges, which are poorly documented in the literature, often lead to delays in reactive campaigns, ultimately reducing the effect of vaccination. In June 2015, a cholera outbreak occurred in Juba, South Sudan, and because of the global shortage of oral cholera vaccine, authorities were unable to secure sufficient doses to vaccinate the entire at-risk population-approximately 1 million people. In this Personal View, we document the first public health use of a reduced, single-dose regimen of oral cholera vaccine, and show the details of the decision-making process and timeline. We also make recommendations to help improve reactive vaccination campaigns against cholera, and discuss the importance of new and flexible context-specific dose regimens and vaccination strategies.

  18. Hydrology and Human Health: Predicting Cholera Outbreaks using Remote Sensing Data

    Science.gov (United States)

    Jutla, A. S.; Akanda, A. S.; Islam, S.

    2010-12-01

    Cholera bacteria survive and thrive in two distinctively different environments: the micro- and the macro-environmental processes that vary over a range of spatial and temporal scales. While micro-environmental conditions are necessary for maintaining epidemic conditions, macro-environmental conditions set the stage for initial outbreak and endemicity of the disease. As macro-environmental processes provide natural ecological niche for V. cholerae and there is powerful evidence of new biotypes emerging, it is unlikely that cholera will be fully eradicated, a condition which necessitates exploration of alternate means to develop prediction mechanism for cholera outbreaks. Satellite remote sensing data provides reliable estimates of plankton abundance through chlorophyll content which then can be used to understand cholera - chlorophyll relationships. However, the functional nature of association of cholera incidence with chlorophyll and its predictive capabilities are not well understood. Here we show that cholera outbreaks in Bengal Delta can be predicted two to three months in advance with an overall prediction accuracy of greater than 80% using combination of satellite derived chlorophyll and air temperature. Such high prediction accuracy is achievable because the two seasonal peaks of cholera in Bengal Delta are controlled by two distinctive macro-environmental processes. We have found that interannual variability of pre- monsoonal cholera outbreaks is intricately linked with coastal plankton through a cascade of hydro-coastal processes. Post- monsoonal cholera outbreaks, on the other hand, are related with wide spreading flooding and subsequent breakdown of the sanitary conditions. Our results demonstrate that satellite data, with a careful choice of space and time scales, can be very effective to develop a cholera prediction model for the Bengal delta with several months lead time. We anticipate that our modeling framework will provide essential lead time for

  19. The Sanitary and Anti- Epidemic Affair in North China Base in the Period of Anti -Japanese War%抗战时期华北根据地的卫生防疫工作述论

    Institute of Scientific and Technical Information of China (English)

    李洪河; 程舒伟

    2012-01-01

    抗战时期华北根据地疾疫流行广泛,疟疾、痢疾、伤寒、麻疹和流行性感冒等尤为严重。边区政府和军队从“一切为了战争胜利”的目的出发,积极建立各级卫生组织,颁布卫生防疫法规,开展积极的卫生防疫宣传和广泛的群众性卫生运动,切实实施包括组建各种医疗组和卫生防疫队、帮助各级政权训练卫生防疫人员、协助地方卫生工作、充分发挥中医中药的作用等各种卫生防疫办法,不仅有效地预防和控制了各种疾疫的流行,巩固了根据地的社会稳定,而且转变了根据地民众的卫生观念,破除了根据地民众落后的封建迷信思想,增进了广大民众对边区政府和军队普遍的政治认同,为其后的卫生防疫工作尤其是新中国的疾疫救治和卫生防疫体系的建立提供了丰富的经验。%The epidemic diseases spread widely in North China Base in the period of anti -Japanese war, most of them were serious, such as malaria, dysentery, typhoid fever, measles, flu and so on. The government and army of the Base established health group at all levels actively, promulgated sanitary & anti - epidemic laws and regulations, and carried out sanitary and epidemic prevention propaganda and mass health movements. The government of the border area set up medical groups and sanitary & anti - epidemic team, helped to train sanitary personnel, and promoted applying Chinese medicine, all of which were helpful for preventing and controlling the prevalence of diseases effectively, consolidating the social stability of the base, and transforming the health concept of the populace.

  20. [Cholera in 1831. Challenges for science and the federal government].

    Science.gov (United States)

    Stamm-Kuhlmann, T

    1989-01-01

    The peak of the first great cholera pandemic in 1831 fomented the controversy among contagionists and non-contagionists. In the following year the public debate centered around the correct interpretation of the recent experiences with cholera. The central government of the bureaucratic-absolutist monarchy in Prussia adhered to a firmly contagionist interpretation of the disease and reacted accordingly. Local authorities in Königsberg and Berlin and the bourgeoisie in the merchant city of Danzig, however, stressed the destructive consequences of the cordon system. They considered the results of an interruption in trade and industry to be worse than the damage inflicted by the epidemic. The summer of 1831 demonstrated that cholera could not be stopped by the cordons, but the King's medical advisors nevertheless remained contagionists. Non-contagionists put forward several hypotheses to explain the origin and the spreading of cholera, mainly "miasma" theory and the Hippocratic paradigm of "epidemic constitution". The correlation between poverty and disease, however, was widely noticed. Physicians in the city of Bremen pointed to the necessity of sanitary precautions to be taken in cholera-free periods. On the other hand, many "honest" citizens believed that individuals with a "dissolute" conduct of life were more at risk to contract cholera than others. Instead of costly sanitary policies, the well-to-do classes preferred to identify the defense against cholera with the segregation of unwelcome elements of society. The article is based on hitherto unpublished sources from the former Prussian State Archives at Merseburg, GDR, and the State Archive of the Hanseatic City of Bremen.

  1. Sanitation in the time of cholera.

    Science.gov (United States)

    Misch, A

    1991-01-01

    Cholera, identified by violent diarrhea, cramps, vomiting, and dehydration, is spreading through Peru into Colombia, Ecuador, Child, and Brazil. Water contaminated with Vibrio cholerae is used for washing food and/or drinking thereby transmitting the disease. PAHO estimates 6 million people in South America may get cholera within the next 3 years. This cholera epidemic is the result of unsanitary conditions in which the urban poor in South America live. In fact, in Lima, Peru, 40% of the people do not have potable, piped water available. These individuals fetch their water from far away taps and private vendors both of which are not necessarily safe. In addition, 40% do not have access to a sewage system. Further, 80% of sick people in developing countries have a water related illness, be it transmitted by contaminated water or by insects and snails that reproduce in the water. Diarrhea is the most deadly of these conditions. Indeed every year 10-20 million children die from the effects of diarrhea which include malnutrition, dehydration, and shock. Yet 940 million people in developing countries have no access to safe water and 1.7 billion do not have a sanitary means of disposing of human wastes, despite the fact that the UN decreed the 1980s the International Drinking Water Supply and Sanitation Decade. Nevertheless UNICEF efforts did bring communal taps, odorless latrines, and/or pour flush toilets to 1.2 billion people. These types of sanitation costs $20-25/person whereas conventional sewers cost $350/person. Low technology supplied water averages $30/person compared to $200/person for piped water. Peru has spent $43 million on emergency medical care for cholera victims which could have provided low cost clean water and sanitation for almost 800,000 poor.

  2. Considerations around the introduction of a cholera vaccine in Bangladesh.

    Science.gov (United States)

    Nelson, Christopher B; Mogasale, Vittal; Bari, Tajul Islam A; Clemens, John D

    2014-12-12

    Cholera is an endemic and epidemic disease in Bangladesh. On 3 March 2013, a meeting on cholera and cholera vaccination in Bangladesh was convened by the Foundation Mérieux jointly with the International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR, B). The purpose of the meeting was to discuss the investment case for cholera vaccination as a complimentary control and prevention strategy. The performance of a new low cost oral cholera vaccine, Shanchol™, used in recent trials in Bangladesh, was also reviewed in the context of a potential large-scale public-sector vaccination program. Findings showed the oral vaccine to be highly cost-effective when targeting ages 1-14 y, and cost-effective when targeting ages 1+y, in high-burden/high-risk districts. Other vaccination strategies targeting urban slums and rural areas without improved water were found to be cost-effective. Regardless of cost-effectiveness (value), the budget impact (affordability) will be an important determinant of which target population and vaccination strategy is selected. Most importantly, adequate vaccine supply for the proposed vaccination programs must be addressed in the context of global efforts to establish a cholera vaccine stockpile and supply other control and prevention efforts.

  3. Sustained Local Diversity of Vibrio cholerae O1 Biotypes in a Previously Cholera-Free Country

    Directory of Open Access Journals (Sweden)

    Yan Boucher

    2016-07-01

    Full Text Available Although the current cholera pandemic can trace its origin to a specific time and place, many variants of Vibrio cholerae have caused this disease over the last 50 years. The relative clinical importance and geographical distribution of these variants have changed with time, but most remain in circulation. Some countries, such as Mexico and Haiti, had escaped the current pandemic, until large epidemics struck them in 1991 and 2010, respectively. Cholera has been endemic in these countries ever since. A recent retrospective study in mBio presents the results of more than 3 decades of V. cholerae monitoring from environmental and clinical sources in Mexico (S. Y. Choi et al., mBio 7:e02160-15, 2016, http://dx.doi.org/10.1128/mBio.02160-15. It reveals that multiple V. cholerae variants, including classical strains from the previous pandemic, as well as completely novel biotypes, have been circulating in Mexico. This discovery has important implications for the epidemiology and evolution of V. cholerae.

  4. Linking Satellite Derived Land Surface Temperature with Cholera: A Case Study for South Sudan

    Science.gov (United States)

    Aldaach, H. S. V.; Jutla, A.; Akanda, A. S.; Colwell, R. R.

    2014-12-01

    A sudden onset of cholera in South Sudan, in April 2014 in Northern Bari in Juba town resulted in more than 400 cholera cases after four weeks of initial outbreak with a case of fatality rate of CFR 5.4%. The total number of reported cholera cases for the period of April to July, 2014 were 5,141 including 114 deaths. With the limited efficacy of cholera vaccines, it is necessary to develop mechanisms to predict cholera occurrence and thereafter devise intervention strategies for mitigating impacts of the disease. Hydroclimatic processes, primarily precipitation and air temperature are related to epidemic and episodic outbreak of cholera. However, due to coarse resolution of both datasets, it is not possible to precisely locate the geographical location of disease. Here, using Land Surface Temperature (LST) from MODIS sensors, we have developed an algorithm to identify regions susceptible for cholera. Conditions for occurrence of cholera were detectable at least one month in advance in South Sudan and were statistically sensitive to hydroclimatic anomalies of land surface and air temperature, and precipitation. Our results indicate significant spatial and temporal averaging required to infer usable information from LST over South Sudan. Preliminary results that geographically location of cholera outbreak was identifiable within 1km resolution of the LST data.

  5. Vibrio cholerae in an Historically Cholera-Free Country.

    Science.gov (United States)

    Haley, Bradd J; Chen, Arlene; Grim, Christopher J; Clark, Philip; Diaz, Celia Municio; Taviani, Elisa; Hasan, Nur A; Sancomb, Elizabeth; Elnemr, Wessam Mahmoud; Islam, Muhammad A; Huq, Anwar; Colwell, Rita R; Benediktsdóttir, Eva

    2012-08-01

    We report the autochthonous existence of Vibrio cholerae in coastal waters of Iceland, a geothermally active country where cholera is absent and has never been reported. Seawater, mussel, and macroalgae samples were collected close to and distant from sites where geothermal activity causes a significant increase in water temperature during low tides. V. cholerae was detected only at geothermal-influenced sites during low-tides. None of the V. cholerae isolates encoded cholera toxin (ctxAB) and all were non-O1/non-O139 serogroups. However, all isolates encoded other virulence factors that are associated with cholera as well as extra-intestinal V. cholerae infections. The virulence factors were functional at temperatures of coastal waters of Iceland, suggesting an ecological role. It is noteworthy that V. cholerae was isolated from samples collected at sites distant from anthropogenic influence, supporting the conclusion that V. cholerae is autochthonous to the aquatic environment of Iceland.

  6. Radiolabelling of cholera toxin

    Energy Technology Data Exchange (ETDEWEB)

    Santos, R.G.; Neves, Nicoli M.J. [Centro de Desenvolvimento da Tecnologia Nuclear (CDTN), Belo Horizonte, MG (Brazil); Abdalla, L.F.; Brandao, R.L.; Etchehebehere, L. [Ouro Preto Univ., MG (Brazil). Escola de Farmacia. Lab. de Fisiologia e Bioquimica de Microorganismos; Lima, M.E. de [Minas Gerais Univ., Belo Horizonte, MG (Brazil). Inst. de Ciencias Biologicas. Dept. de Bioquimica e Imunologia; Nicoli, J.R. [Minas Gerais Univ., Belo Horizonte, MG (Brazil). Inst. de Ciencias Biologicas. Dept. de Microbiologia

    1999-11-01

    Binding of cholera toxin to ganglioside receptors of enterocyte microvilli catalyzes the activation of adenylate cyclase causing a rise in cAMP which final result is a copious diarrhea. Saccharomyces boulardii, a nonpathogenic yeast has been used to prevent diarrhea. Although the antidiarrheic properties of S. boulardii are widely recognized, this yeast has been used on empirical basis, and the mechanism of this protective effect is unknown. The addition of cholera toxin to S. boulardii induces the raising of cAMP that triggers the activation of neutral trehalase. This suggests that toxin specifically binding to cells, is internalized and active the protein phosphorylation cascade. Our objective is labeling the cholera toxin to verify the presence of binding sites on yeast cell surfaces for the cholera toxin. Cholera toxin was radiolabelled with Na {sup 125} I by a chloramine-T method modified from Cuatrecasas and Griffiths et alii. The {sup 125} I-Cholera toxin showed a specific radioactivity at about 1000 cpm/fmol toxin. Biological activity of labeled cholera toxin measured by trehalase activation was similar to the native toxin. (author) 5 refs., 3 figs.; e-mail: nevesmj at urano.cdtn.br

  7. Cholera in Zimbabwe: Developing an Educational Response to a Health Crisis

    Science.gov (United States)

    Mandikonza, Caleb; Musindo, Beatrice; Taylor, Jim

    2011-01-01

    In February 2009, the World Health Organization (WHO) reported that the cholera epidemic in Zimbabwe had claimed 3,300 lives and infected 66,000 people--greater than the toll of that disease in the whole of Africa in most years. How is it possible that a disease such as cholera can have such a devastating effect in modern times? How should one…

  8. Malaria epidemics in Europe after the First World War: the early stages of an international approach to the control of the disease.

    Science.gov (United States)

    Gachelin, Gabriel; Opinel, Annick

    2011-06-01

    The severity and endemicity of malaria declined gradually in Europe until WWI. During and after the war, the number of malaria cases increased substantially and peaked in 1922-1924. This prompted the Hygiene Commission of the League of Nations to establish a Malaria Commission in 1923 to define the most efficient anti-malaria procedures. Additionally, between 1924 and 1930 there were several international meetings and collaborations concerning malaria, which involved the main institutes of parasitology and the Rockefeller Foundation. The Commission reports, the guidelines for anti-malaria campaigns and the scientific programs which came out of these meetings and collaborations are analyzed in the present paper.

  9. Improved laboratory capacity is required to respond better to future cholera outbreaks in Papua New Guinea

    Directory of Open Access Journals (Sweden)

    Paul Horwood

    2012-05-01

    Full Text Available Cholera was first detected in Papua New Guinea in July 2009, caused by Vibrio cholerae O1 El Tor serotype Ogawa. By late 2011, 15 500 cases had been reported throughout lowland Papua New Guinea with a case fatality rate of 3.2%. The epidemic has since slowed, with only sporadic cases reported in Western Province and the Autonomous Region of Bougainville (ARB. Accurate and timely diagnosis is a critical element of the public health response to cholera, yet in low-income countries where the burden of cholera is the greatest, diagnostic services are often limited. Here we report on the diagnostic challenges and the logistical factors that impacted on diagnosis during the first reported outbreak of cholera in Papua New Guinea.

  10. Molecular Analysis and Toxigenic Potential of Vibrio cholerae Isolated from Hilsha fish (Tenualosa ilisha), Bangladesh

    DEFF Research Database (Denmark)

    Hossain, Zenat Zebin; Farhana, Israt; Tulsiani, Suhella

    Exposure to contaminated fish may upsurge the virulent strains of Vibrio cholerae, the deadly human pathogen in the households of rural and urban Bangladesh. Since V. cholerae spreading was reported from the Bay of Bengal, this study hypothesized that Hilsha (Tenualosa ilisha), a marine and fresh...... water fish may serve as a transmission vehicle of potential emerging epidemic causing strains. For this, we studied 9 toxigenic V. cholerae strains isolated from Hilsha fish including 6 V. cholerae O1 and 3 non O1/O139 serogroups for virulence associated genotype and their pathogenic potential on animal...... model and human cancer cell line . The V. cholerae O1 and non- O1/O139 strains possessed diverse virulence genes but lacked some major toxin genes like ctxA, tcp etc. Eight of the nine strains showed survivability up to 1% sodium chloride in broth culture which indicates their coastal origin. All nine...

  11. Predictors of disease severity in patients admitted to a cholera treatment center in urban Haiti.

    Science.gov (United States)

    Valcin, Claude-Lyne; Severe, Karine; Riche, Claudia T; Anglade, Benedict S; Moise, Colette Guiteau; Woodworth, Michael; Charles, Macarthur; Li, Zhongze; Joseph, Patrice; Pape, Jean W; Wright, Peter F

    2013-10-01

    Cholera, previously unrecognized in Haiti, spread through the country in the fall of 2010. An analysis was performed to understand the epidemiological characteristics, clinical management, and risk factors for disease severity in a population seen at the GHESKIO Cholera Treatment Center in Port-au-Prince. A comprehensive review of the medical records of patients admitted during the period of October 28, 2010-July 10, 2011 was conducted. Disease severity on admission was directly correlated with older age, more prolonged length of stay, and presentation during the two epidemic waves seen in the observation period. Although there was a high seroprevalence of human immunodeficiency virus (HIV), severity of cholera was not greater with HIV infection. This study documents the correlation of cholera waves with rainfall and its reduction in settings with improved sanitary conditions and potable water when newly introduced cholera affects all ages equally so that interventions must be directed throughout the population.

  12. Cholera in Azov area

    OpenAIRE

    O. N. Domashenko; T. A. Belomerya; N. V. Martynova; G. N. Daragan; Demkovich, O.O.; U. V. Malakhova; G. I. Zemlyanskaya; Popova, D.M.

    2015-01-01

    The purpose of research is analysis of clinical course and treatment results of patients with cholera in the Azov area. Materials and methods. During the period from 29.05.2011 to 19.08.2011 33 cases of cholera (32 adults and 1 child) and 25 vibrio carriers (22 adults and 3 children), which were caused by toxigenic strains of Vibrio cholera El Tor serogroup O1 Ogawa. Results. Likely factors of disease transmission in Mariupol are sea and river water, and the fish that were caught in the water...

  13. Virulence factors in environmental and clinical Vibrio cholerae from endemic areas in Kenya

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    Racheal W. Kimani

    2014-04-01

    Full Text Available Background: Since 1971, Kenya has had repeated cholera outbreaks. However, the cause of seasonal epidemics of cholera is not fully understood and neither are the factors that drive epidemics, both in Kenya and globally.Objectives: The objectives of the study were to determine the environmental reservoirs of V. cholerae during an interepidemic period in Kenya and to characterise their virulence factors.Methods: One hundred (50 clinical, 50 environmental samples were tested for V. cholerae isolates using both simplex and multiplex polymerase chain reaction.Results: Both sediments and algae from fishing and landing bays yielded isolates of V. cholerae. Clinical strains were characterised along with the environmental strains for comparison. All clinical strains harboured ctxA, tcpA (El Tor, ompU, zot, ace, toxR, hylA (El Tor and tcpI genes. Prevalence for virulence genes in environmental strains was hylA (El Tor (10%, toxR (24%, zot (22%, ctxA (12%,tcpI (8%, hylA (26% and tcpA (12%.Conclusion: The study sites, including landing bays and beaches, contained environmental V. cholerae, suggesting that these may be reservoirs for frequent epidemics. Improved hygiene and fish-handling techniques will be important in reducing the persistence of reservoirs.

  14. Historical epidemiology of the second cholera pandemic: relevance to present day disease dynamics.

    Science.gov (United States)

    Chan, Christina H; Tuite, Ashleigh R; Fisman, David N

    2013-01-01

    Despite nearly two centuries of study, the fundamental transmission dynamic properties of cholera remain incompletely characterized. We used historical time-series data on the spread of cholera in twelve European and North American cities during the second cholera pandemic, as reported in Amariah Brigham's 1832 A Treatise on Epidemic Cholera, to parameterize simple mathematical models of cholera transmission. Richards growth models were used to derive estimates of the basic reproductive number (R0) (median: 16.0, range: 1.9 to 550.9) and the proportion of unrecognized cases (mean: 96.3%, SD: 0.04%). Heterogeneity in model-generated R0 estimates was consistent with variability in cholera dynamics described by contemporary investigators and may represent differences in the nature of cholera spread. While subject to limitations associated with measurement and the absence of microbiological diagnosis, historical epidemic data are a potentially rich source for understanding pathogen dynamics in the absence of control measures, particularly when used in conjunction with simple and readily interpretable mathematical models.

  15. Historical epidemiology of the second cholera pandemic: relevance to present day disease dynamics.

    Directory of Open Access Journals (Sweden)

    Christina H Chan

    Full Text Available Despite nearly two centuries of study, the fundamental transmission dynamic properties of cholera remain incompletely characterized. We used historical time-series data on the spread of cholera in twelve European and North American cities during the second cholera pandemic, as reported in Amariah Brigham's 1832 A Treatise on Epidemic Cholera, to parameterize simple mathematical models of cholera transmission. Richards growth models were used to derive estimates of the basic reproductive number (R0 (median: 16.0, range: 1.9 to 550.9 and the proportion of unrecognized cases (mean: 96.3%, SD: 0.04%. Heterogeneity in model-generated R0 estimates was consistent with variability in cholera dynamics described by contemporary investigators and may represent differences in the nature of cholera spread. While subject to limitations associated with measurement and the absence of microbiological diagnosis, historical epidemic data are a potentially rich source for understanding pathogen dynamics in the absence of control measures, particularly when used in conjunction with simple and readily interpretable mathematical models.

  16. Factors Associated with Fatal Outcomes Following Cholera-Like Syndrome in Far North Region of Cameroon: A Community-Based Survey.

    Science.gov (United States)

    Djouma, Fabrice N; Ateudjieu, Jerome; Ram, Malathi; Debes, Amanda K; Sack, David A

    2016-12-07

    This study demonstrates that most cholera deaths in this region of Cameroon occur out of hospital. This is a region which is prone to cholera, and interventions are needed to improve access to emergency medical care, especially during cholera outbreaks. Cameroon has experienced 14 cholera epidemics during the last 20 years, and these have had high case fatality rates. This study attempted to assess the effect of delays in seeking care and the locations of care as possible risk factors for cholera mortality. The study used data from a community-based survey regarding the circumstances of 97 fatal cases and 197 control (nonfatal) cases following a cholera-like syndrome in villages with cholera-like diseases during cholera outbreaks in Cameroon during 2009-2011. Deaths occurred in one of four environments: the community, in a temporary community treatment center (TCTC), in transit to a treatment center, or in a hospital (39%, 32%, 5%, and 24%, respectively). Using a case-control analysis, factors associated with deaths included the nonuse of a cholera treatment center, receiving health care in a TCTC instead of a hospital, and greater than 4 hours delay between the onset of symptoms and the decision to go to a treatment center (odds ratios of 17.1 [confidence interval (CI): 7.0-41.8], 2.5 [CI: 1.2-5.0], and 2.2 [CI: 1.0-4.6], respectively). During cholera epidemics, a higher proportion of deaths are still occurring in communities. The nonuse and delays in deciding to go a treatment center, and treatment at TCTC rather than a hospital were risk factors for death among patients with cholera-like syndrome in Cameroon. Informing people on community management of cholera-like syndrome and improving care in all health facilities are needed to reduce deaths during cholera epidemics.

  17. Cholera Fact Sheet

    Science.gov (United States)

    ... facilities (chlorination) interventions at the household level (water filtration, chemical or solar disinfection of water, safe water ... spread of cholera and contributes to increasing antimicrobial resistance. Rapid access to treatment is essential during a ...

  18. CHOLERA EL-TOR EN IRAN

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    M. Ghodssi

    1969-01-01

    Full Text Available The bacteriological analysis shows that we have been confronted with the ELTor type, and only that type, until the end of the epidemic.The clinical study presents the symptoms of the real cholera with all its grievous consequences.The epidemiological supertnisicn stales that the El..Tor cholera is not agressiveat all in town areas whereas it presents its usual aspect in country areas, because of a lack of hygiene. there.That disease can be completely cured if the balance between the electrolytesis quickly restored.The disease was all the more dreadful since it came as a surprise and spread from one province to the other.L'examen bacteriologique montrc qu'il s'agit du type EI_ Tor et uniquement du meme type jusqu'a la fin de l'epldemie.La surveillance epidemiologique constate que Ie cholera EI_Tor n'cst nullement agressif dans Ie milieu urbain; mais qu'H revet l'aspect classique dans les milieuxruraux, depourvus d'hyglene.La maludic est totalement guerissablc a condition que l'equilibre des electrolytes so it rapidement retabli. L'evenement a tHe maladie se repandit d'une12

  19. Evaluation of a field appropriate membrane filtration method for the detection of Vibrio cholerae for the measurement of biosand filter performance in the Artibonite Valley, Haiti.

    Science.gov (United States)

    Thomson, Ashley A; Gunsch, Claudia K

    2015-08-01

    Biosand filters in the Artibonite Valley of Haiti, the epicenter of the cholera epidemic that began in October 2010, were tested for total coliform and Vibrio cholerae removal efficiencies. While coliform are often used as an indicator organism for pathogenic bacteria, a correlation has never been established linking the concentration of coliform and V. cholerae, the causative agent for cholera. Hence, a method for field enumeration of V. cholerae was developed and tested. To this end, a plate count test utilizing membrane filtration technique was developed to measure viable V. cholerae cell concentration in the field. Method accuracy was confirmed by comparing plate count concentrations to microscopic counts. Additionally, biosand filters were sampled and removal efficiencies of V. cholerae and coliform bacteria compared. The correlation between removal efficiency and time in operation, biofilm ("schmutzdecke") composition, and idle time was also investigated. The plate count method for V. cholerae was found to accurately reflect microscope counts and was shown to be effective in the field. Overall, coliform concentration was not an appropriate indicator of V. cholerae concentration. In 90% of the influent samples from the study, coliform underestimated V. cholerae concentration (n = 26). Furthermore, coliform removal efficiency was higher than for V. cholerae hence providing a conservative measurement. Finally, time in operation and idle time were found to be important parameters controlling performance. Overall, this method shows promise for field applications and should be expanded to additional studies to confirm its efficacy to test for V. cholerae in various source waters.

  20. Vibrio cholerae O1 strains are facultative intracellular bacteria, able to survive and multiply symbiotically inside the aquatic free-living amoeba Acanthamoeba castellanii.

    Science.gov (United States)

    Abd, Hadi; Saeed, Amir; Weintraub, Andrej; Nair, G Balakrish; Sandström, Gunnar

    2007-04-01

    Vibrio cholerae species are extracellular, waterborne, gram-negative bacteria that are overwhelmed by predators in aquatic environments. The unencapsulated serogroup V. cholerae O1 and encapsulated V. cholerae O139 cause epidemic and pandemic outbreaks of cholera. It has recently been shown that the aquatic and free-living amoeba Acanthamoeba castellanii is not a predator to V. cholerae O139; rather, V. cholerae O139 has shown an intracellular compatibility with this host. The aim of this study was to examine the ability of V. cholerae O1 classical and El Tor strains to grow and survive in A. castellanii. The interaction between A. castellanii and V. cholerae O1 strains was studied by means of amoeba cell counts and viable counts of the bacteria in the absence or presence of amoebae. The viable count of intracellularly growing bacteria was estimated by utilizing gentamicin assay. Confocal microscopy and electron microscopy were used to determine the intracellular localization of V. cholerae in A. castellanii. The results showed that V. cholerae O1 classical and El Tor strains grew and survived intracellularly in the cytoplasm of trophozoites, and that the bacteria were also found in the cysts of A. castellanii. The interaction showed a facultative intracellular behaviour of V. cholerae O1 classical and El Tor strains and a possible role of A. castellanii as an environmental host of V. cholerae species.

  1. Vibrio cholerae Infection of Drosophilamelanogaster Mimics the Human Disease Cholera.

    Directory of Open Access Journals (Sweden)

    2005-09-01

    Full Text Available Cholera, the pandemic diarrheal disease caused by the gram-negative bacterium Vibrio cholerae, continues to be a major public health challenge in the developing world. Cholera toxin, which is responsible for the voluminous stools of cholera, causes constitutive activation of adenylyl cyclase, resulting in the export of ions into the intestinal lumen. Environmental studies have demonstrated a close association between V. cholerae and many species of arthropods including insects. Here we report the susceptibility of the fruit fly, Drosophila melanogaster, to oral V. cholerae infection through a process that exhibits many of the hallmarks of human disease: (i death of the fly is dependent on the presence of cholera toxin and is preceded by rapid weight loss; (ii flies harboring mutant alleles of either adenylyl cyclase, Gsalpha, or the Gardos K channel homolog SK are resistant to V. cholerae infection; and (iii ingestion of a K channel blocker along with V. cholerae protects wild-type flies against death. In mammals, ingestion of as little as 25 mug of cholera toxin results in massive diarrhea. In contrast, we found that ingestion of cholera toxin was not lethal to the fly. However, when cholera toxin was co-administered with a pathogenic strain of V. cholerae carrying a chromosomal deletion of the genes encoding cholera toxin, death of the fly ensued. These findings suggest that additional virulence factors are required for intoxication of the fly that may not be essential for intoxication of mammals. Furthermore, we demonstrate for the first time the mechanism of action of cholera toxin in a whole organism and the utility of D. melanogaster as an accurate, inexpensive model for elucidation of host susceptibility to cholera.

  2. Toxigenic Vibrio cholerae identified in estuaries of Tanzania using PCR techniques.

    Science.gov (United States)

    Dalusi, Lucy; Lyimo, Thomas J; Lugomela, Charles; Hosea, Ken M M; Sjöling, Sara

    2015-03-01

    The current study assessed the occurrence of the Vibrio cholerae serogroups O1 and O139 in environmental samples along salinity gradients in three selected estuaries of Tanzania both through culture independent methods and by cultured bacteria. Occurrence of V. cholerae was determined by PCR targeting the V. cholerae outer membrane protein gene ompW. Furthermore, the presence of toxigenic strains and serogroups O1 and O139 was determined using multiplex PCR with specific primers targeting the cholera toxin gene subunit A, ctxA, and serotype specific primers, O1-rfb and O139-rfb, respectively. Results showed that V. cholerae occurred in approximately 10% (n = 185) of both the environmental samples and isolated bacteria. Eight of the bacteria isolates (n = 43) were confirmed as serogroup O1 while one belonged to serogroup O139, the first reported identification of this epidemic strain in East African coastal waters. All samples identified as serogroup O1 or O139 and a number of non-O1/O139 strains were ctxA positive. This study provides in situ evidence of the presence of pathogenic V. cholerae O1 and O139 and a number of V. cholerae non-O1/O139 that carry the cholera toxin gene in estuaries along the coast of Tanzania.

  3. The complete genomic analysis of an imported Vibrio cholerae from Myanmar in southwest China.

    Science.gov (United States)

    Liao, Feng; Pang, Bo; Fu, Xiaoqing; Xu, Wen; Kan, Biao; Jing, Huaiqi; Gu, Wenpeng

    2016-10-01

    We sequenced and analyzed an imported Vibrio cholerae from Mynamar in 2011 by using whole genome sequencing method in Yunnan Province, southwest China. Other 3 isolates of V. cholerae in Yunnan were also sequenced for comparing purpose. Illumina Hiseq2500 was used and the sequencing results were assembled and annotated. The comparative genomic analysis was also performed with 101 reference strains from China and abroad. The results showed the imported V. cholerae (YN2011004) had two chromosomes and one plasmid; chr1 contained 2727 predicted genes, and 958 genes for chr2. Phylogenomic tree results showed YN2011004 belonged to the seventh pandemic strain, clustered into wave 3 and clade 3B. The strain had the highly homology with SN083 and 4remapscaff isolated in 2010 from other parts of China, and clustered with SN117, VC50 remapscaff, VC57 remapscaff and SN034. These references V. cholerae mostly isolated from coastal areas of China in 2008. For the other 3 strains' comparison, it suggested that V. cholerae in 1990s in Yunnan had the close relationship with the prevalence of cholera in Southeast Asia. Therefore, we thought that the cholera in Yunnan was consistent with the epidemic trend of China, being the "sink" for external source and also acted as a "source" for spread. Moreover, we considered that the imported V. cholerae from Myanmar in 2011 actually was the exported strain from China, and it provided us a new sight for the bacterial change and evolution.

  4. Whole-Genome Enrichment Provides Deep Insights into Vibrio cholerae Metagenome from an African River.

    Science.gov (United States)

    Vezzulli, L; Grande, C; Tassistro, G; Brettar, I; Höfle, M G; Pereira, R P A; Mushi, D; Pallavicini, A; Vassallo, P; Pruzzo, C

    2016-11-25

    The detection and typing of Vibrio cholerae in natural aquatic environments encounter major methodological challenges related to the fact that the bacterium is often present in environmental matrices at very low abundance in nonculturable state. This study applied, for the first time to our knowledge, a whole-genome enrichment (WGE) and next-generation sequencing (NGS) approach for direct genotyping and metagenomic analysis of low abundant V. cholerae DNA (V. cholerae metagenomic DNA via hybridization. An enriched V. cholerae metagenome library was generated and sequenced on an Illumina MiSeq platform. Up to 1.8 × 10(7) bp (4.5× mean read depth) were found to map against V. cholerae reference genome sequences representing an increase of about 2500 times in target DNA coverage compared to theoretical calculations of performance for shotgun metagenomics. Analysis of metagenomic data revealed the presence of several V. cholerae virulence and virulence associated genes in river water including major virulence regions (e.g. CTX prophage and Vibrio pathogenicity island-1) and genetic markers of epidemic strains (e.g. O1-antigen biosynthesis gene cluster) that were not detectable by standard culture and molecular techniques. Overall, besides providing a powerful tool for direct genotyping of V. cholerae in complex environmental matrices, this study provides a 'proof of concept' on the methodological gap that might currently preclude a more comprehensive understanding of toxigenic V. cholerae emergence from natural aquatic environments.

  5. Survival of Vibrio cholerae in nutrient-poor environments is associated with a novel "persister" phenotype.

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    Mohamma Jubair

    Full Text Available In response to antibiotic and/or environmental stress, some species of bacteria shift to a "persister" phenotype. Although toxigenic Vibrio cholerae, responsible for the disease cholera, can be found in nutrient-poor aquatic environments in endemic areas, the underlying mechanism(s by which culturable cells persist in these environmental reservoirs is largely unknown. Here we report that introduction of V. cholerae into a nutrient-poor filter sterilized lake water (FSLW microcosm promoted a shift to what we have defined as a "persister" phenotype (PP which was culturable for >700 days. Direct transfer of PP of V. cholerae from original microcosms to freshly prepared FSLW resulted in the same pattern of persistence seen in the original microcosms. Scanning electron microscopy of cells persisting for over 700 days demonstrated cell morphologies that were very small in size, with a high degree of aggregation associated with flagella emanating from all aspects of the cell. V. cholerae PP cells reverted to a typical V. cholerae morphology when transferred to nutrient-rich L- broth. Cell-free supernatants obtained from microcosms at 24 hours, 180 days, and 700 days all showed >2-fold increase in CAI-1 signaling molecules, consistent with quorum sensing activity, as has been described for Pseudomonas aeruginosa persister cells. Chitin and phosphate promoted cell growth. Our data suggest that nutrient stress can select a V. cholerae persister phenotype in environmental reservoirs, with these strains then seeding subsequent cholera epidemics in response to chitin and phosphate availability.

  6. Characterization of environmental Vibrio cholerae serogroups O1 and O139 in the Pearl River Estuary, China.

    Science.gov (United States)

    Li, Xiujun; Wang, Duochun; Li, Baisheng; Zhou, Haijian; Liang, Song; Ke, Changwen; Deng, Xiaoling; Kan, Biao; Morris, J Glenn; Cao, Wuchun

    2016-02-01

    Toxigenic isolates of Vibrio cholerae serogroups O1 and O139 from aquatic reservoirs are a key source for recurrent epidemics of cholera in human populations. However, we do not have an optimal understanding of the microbiology of the strains within these reservoirs, particularly outside of the time periods when there are active cholera cases in the surrounding community. The main objective of the present study was to identify and characterize V. cholerae O1 and O139 in the Pearl River Estuary at a time when active disease was not being identified, despite prior occurrence of epidemic cholera in the region. Water samples were collected at 24 sites in the research area at monthly intervals between 2007 and 2010, and screened for the presence of V. cholerae O1 and O139. All isolates were screened for the presence of ctxAB, ompW, toxR, and tcpA genes. Multilocus variable number tandem repeat analysis (MLVA) was used to assess possible relationships among strains. The results show that Vibrio cholerae O1 or O139 was isolated, on average, from 6.7% of the sites screened at each time point. All V. cholerae O1 and O139 isolates were ctxAB negative, and 37% were positive for tcpA. Isolation was most common in the oldest, most urbanized district compared with other districts, and was associated with lower pH. Despite year-to-year variability in isolation rates, there was no evidence of seasonality. MLVA of 27 selected isolates showed evidence of high genetic diversity, with no evidence of clustering by year or geographic location. In this region where cholera has been epidemic in the past, there is evidence of environmental persistence of V. cholerae O1 and O139 strains. However, environmental strains were consistently nontoxigenic, with a high level of genetic diversity; their role as current or future agents of human disease remains uncertain.

  7. Multiple antibiotic resistance of Vibrio cholerae serogroup O139 in China from 1993 to 2009.

    Science.gov (United States)

    Yu, Li; Zhou, Yanyan; Wang, Ruibai; Lou, Jing; Zhang, Lijuan; Li, Jie; Bi, Zhenqiang; Kan, Biao

    2012-01-01

    Regarded as an emerging diarrheal micropathogen, Vibrio cholerae serogroup O139 was first identified in 1992 and has become an important cause of cholera epidemics over the last two decades. O139 strains have been continually isolated since O139 cholera appeared in China in 1993, from sporadic cases and dispersed foodborne outbreaks, which are the common epidemic types of O139 cholera in China. Antibiotic resistance profiles of these epidemic strains are required for development of clinical treatments, epidemiological studies and disease control. In this study, a comprehensive investigation of the antibiotic resistance of V. cholerae O139 strains isolated in China from 1993 to 2009 was conducted. The initial O139 isolates were resistant to streptomycin, trimethoprim-sulfamethoxazole and polymyxin B only, while multidrug resistance increased suddenly and became common in strains isolated after 1998. Different resistance profiles were observed in the isolates from different years. In contrast, most V. cholerae O1 strains isolated in the same period were much less resistant to these antibiotics and no obvious multidrug resistance patterns were detected. Most of the non-toxigenic strains isolated from the environment and seafood were resistant to four antibiotics or fewer, although a few multidrug resistant strains were also identified. These toxigenic O139 strains exhibited a high prevalence of the class I integron and the SXT element, which were rare in the non-toxigenic strains. Molecular subtyping of O139 strains showed highly diverse pulsed-field gel electrophoresis patterns, which may correspond to the epidemic state of sporadic cases and small-scale outbreaks and complex resistance patterns. Severe multidrug resistance, even resistance transfers based on mobile antibiotic resistance elements, increases the probability of O139 cholera as a threat to public health. Therefore, continual epidemiological and antibiotic sensitivity surveillance should focus on the

  8. Multiple antibiotic resistance of Vibrio cholerae serogroup O139 in China from 1993 to 2009.

    Directory of Open Access Journals (Sweden)

    Li Yu

    Full Text Available Regarded as an emerging diarrheal micropathogen, Vibrio cholerae serogroup O139 was first identified in 1992 and has become an important cause of cholera epidemics over the last two decades. O139 strains have been continually isolated since O139 cholera appeared in China in 1993, from sporadic cases and dispersed foodborne outbreaks, which are the common epidemic types of O139 cholera in China. Antibiotic resistance profiles of these epidemic strains are required for development of clinical treatments, epidemiological studies and disease control. In this study, a comprehensive investigation of the antibiotic resistance of V. cholerae O139 strains isolated in China from 1993 to 2009 was conducted. The initial O139 isolates were resistant to streptomycin, trimethoprim-sulfamethoxazole and polymyxin B only, while multidrug resistance increased suddenly and became common in strains isolated after 1998. Different resistance profiles were observed in the isolates from different years. In contrast, most V. cholerae O1 strains isolated in the same period were much less resistant to these antibiotics and no obvious multidrug resistance patterns were detected. Most of the non-toxigenic strains isolated from the environment and seafood were resistant to four antibiotics or fewer, although a few multidrug resistant strains were also identified. These toxigenic O139 strains exhibited a high prevalence of the class I integron and the SXT element, which were rare in the non-toxigenic strains. Molecular subtyping of O139 strains showed highly diverse pulsed-field gel electrophoresis patterns, which may correspond to the epidemic state of sporadic cases and small-scale outbreaks and complex resistance patterns. Severe multidrug resistance, even resistance transfers based on mobile antibiotic resistance elements, increases the probability of O139 cholera as a threat to public health. Therefore, continual epidemiological and antibiotic sensitivity surveillance

  9. Biochemical and full genome sequence analyses of clinical Vibrio cholerae isolates in Mexico reveals the presence of novel V. cholerae strains.

    Science.gov (United States)

    Díaz-Quiñonez, José Alberto; Hernández-Monroy, Irma; Montes-Colima, Norma Angélica; Moreno-Pérez, María Asunción; Galicia-Nicolás, Adriana Guadalupe; López-Martínez, Irma; Ruiz-Matus, Cuitláhuac; Kuri-Morales, Pablo; Ortíz-Alcántara, Joanna María; Garcés-Ayala, Fabiola; Ramírez-González, José Ernesto

    2016-05-01

    The first week of September 2013, the National Epidemiological Surveillance System identified two cases of cholera in Mexico City. The cultures of both samples were confirmed as Vibrio cholerae serogroup O1, serotype Ogawa, biotype El Tor. Initial analyses by PFGE and by PCR-amplification of the virulence genes, suggested that both strains were similar, but different from those previously reported in Mexico. The following week, four more cases were identified in a community in the state of Hidalgo, located 121 km northeast of Mexico City. Thereafter a cholera outbreak started in the region of La Huasteca. Genomic analyses of the four strains obtained in this study confirmed the presence of Pathogenicity Islands VPI-1 and -2, VSP-1 and -2, and of the integrative element SXT. The genomic structure of the 4 isolates was similar to that of V. cholerae strain 2010 EL-1786, identified during the epidemic in Haiti in 2010.

  10. Examining rainfall and cholera dynamics in Haiti using statistical and dynamic modeling approaches.

    Science.gov (United States)

    Eisenberg, Marisa C; Kujbida, Gregory; Tuite, Ashleigh R; Fisman, David N; Tien, Joseph H

    2013-12-01

    Haiti has been in the midst of a cholera epidemic since October 2010. Rainfall is thought to be associated with cholera here, but this relationship has only begun to be quantitatively examined. In this paper, we quantitatively examine the link between rainfall and cholera in Haiti for several different settings (including urban, rural, and displaced person camps) and spatial scales, using a combination of statistical and dynamic models. Statistical analysis of the lagged relationship between rainfall and cholera incidence was conducted using case crossover analysis and distributed lag nonlinear models. Dynamic models consisted of compartmental differential equation models including direct (fast) and indirect (delayed) disease transmission, where indirect transmission was forced by empirical rainfall data. Data sources include cholera case and hospitalization time series from the Haitian Ministry of Public Health, the United Nations Water, Sanitation and Health Cluster, International Organization for Migration, and Hôpital Albert Schweitzer. Rainfall data was obtained from rain gauges from the U.S. Geological Survey and Haiti Regeneration Initiative, and remote sensing rainfall data from the National Aeronautics and Space Administration Tropical Rainfall Measuring Mission. A strong relationship between rainfall and cholera was found for all spatial scales and locations examined. Increased rainfall was significantly correlated with increased cholera incidence 4-7 days later. Forcing the dynamic models with rainfall data resulted in good fits to the cholera case data, and rainfall-based predictions from the dynamic models closely matched observed cholera cases. These models provide a tool for planning and managing the epidemic as it continues.

  11. Occurrence in Mexico, 1998-2008, of Vibrio cholerae CTX+ El Tor carrying an additional truncated CTX prophage.

    Science.gov (United States)

    Alam, Munirul; Rashed, Shah Manzur; Mannan, Shahnewaj Bin; Islam, Tarequl; Lizarraga-Partida, Marcial Leonardo; Delgado, Gabriela; Morales-Espinosa, Rosario; Mendez, Jose Luis; Navarro, Armando; Watanabe, Haruo; Ohnishi, Makoto; Hasan, Nur A; Huq, Anwar; Sack, R Bradley; Colwell, Rita R; Cravioto, Alejandro

    2014-07-08

    The seventh cholera pandemic caused by Vibrio cholerae O1 El Tor (ET) has been superseded in Asia and Africa by altered ET possessing the cholera toxin (CTX) gene of classical (CL) biotype. The CL biotype of V. cholerae was isolated, along with prototypic and altered ET, during the 1991 cholera epidemic in Mexico and subsequently remained endemic until 1997. Microbiological, molecular, and phylogenetic analyses of clinical and environmental V. cholerae isolated in Mexico between 1998 and 2008 revealed important genetic events favoring predominance of ET over CL and altered ET. V. cholerae altered ET was predominant after 1991 but not after 2000. V. cholerae strains isolated between 2001 and 2003 and a majority isolated in 2004 lacked CTX prophage (Φ) genes encoding CTX subunits A and B and repeat sequence transcriptional regulators of ET and CL biotypes: i.e., CTXΦ(-). Most CTXΦ(-) V. cholerae isolated in Mexico between 2001 and 2003 also lacked toxin coregulated pili tcpA whereas some carried either tcpA(ET) or a variant tcpA with noticeable sequence dissimilarity from tcpA(CL). The tcpA variants were not detected in 2005 after CTXΦ(+) ET became dominant. All clinical and environmental V. cholerae O1 strains isolated during 2005-2008 in Mexico were CTXΦ(+) ET, carrying an additional truncated CTXΦ instead of RS1 satellite phage. Despite V. cholerae CTXΦ(-) ET exhibiting heterogeneity in pulsed-field gel electrophoresis patterns, CTXΦ(+) ET isolated during 2004-2008 displayed homogeneity and clonal relationship with V. cholerae ET N16961 and V. cholerae ET isolated in Peru.

  12. Strategies to Prevent Cholera Introduction during International Personnel Deployments: A Computational Modeling Analysis Based on the 2010 Haiti Outbreak.

    Directory of Open Access Journals (Sweden)

    Joseph A Lewnard

    2016-01-01

    Full Text Available Introduction of Vibrio cholerae to Haiti during the deployment of United Nations (UN peacekeepers in 2010 resulted in one of the largest cholera epidemics of the modern era. Following the outbreak, a UN-commissioned independent panel recommended three pre-deployment intervention strategies to minimize the risk of cholera introduction in future peacekeeping operations: screening for V. cholerae carriage, administering prophylactic antimicrobial chemotherapies, or immunizing with oral cholera vaccines. However, uncertainty regarding the effectiveness of these approaches has forestalled their implementation by the UN. We assessed how the interventions would have impacted the likelihood of the Haiti cholera epidemic.We developed a stochastic model for cholera importation and transmission, fitted to reported cases during the first weeks of the 2010 outbreak in Haiti. Using this model, we estimated that diagnostic screening reduces the probability of cases occurring by 82% (95% credible interval: 75%, 85%; however, false-positive test outcomes may hamper this approach. Antimicrobial chemoprophylaxis at time of departure and oral cholera vaccination reduce the probability of cases by 50% (41%, 57% and by up to 61% (58%, 63%, respectively. Chemoprophylaxis beginning 1 wk before departure confers a 91% (78%, 96% reduction independently, and up to a 98% reduction (94%, 99% if coupled with vaccination. These results are not sensitive to assumptions about the background cholera incidence rate in the endemic troop-sending country. Further research is needed to (1 validate the sensitivity and specificity of rapid test approaches for detecting asymptomatic carriage, (2 compare prophylactic efficacy across antimicrobial regimens, and (3 quantify the impact of oral cholera vaccine on transmission from asymptomatic carriers.Screening, chemoprophylaxis, and vaccination are all effective strategies to prevent cholera introduction during large-scale personnel

  13. Strategies to Prevent Cholera Introduction during International Personnel Deployments: A Computational Modeling Analysis Based on the 2010 Haiti Outbreak

    Science.gov (United States)

    Lewnard, Joseph A.; Antillón, Marina; Gonsalves, Gregg; Miller, Alice M.; Ko, Albert I.; Pitzer, Virginia E.

    2016-01-01

    Background Introduction of Vibrio cholerae to Haiti during the deployment of United Nations (UN) peacekeepers in 2010 resulted in one of the largest cholera epidemics of the modern era. Following the outbreak, a UN-commissioned independent panel recommended three pre-deployment intervention strategies to minimize the risk of cholera introduction in future peacekeeping operations: screening for V. cholerae carriage, administering prophylactic antimicrobial chemotherapies, or immunizing with oral cholera vaccines. However, uncertainty regarding the effectiveness of these approaches has forestalled their implementation by the UN. We assessed how the interventions would have impacted the likelihood of the Haiti cholera epidemic. Methods and Findings We developed a stochastic model for cholera importation and transmission, fitted to reported cases during the first weeks of the 2010 outbreak in Haiti. Using this model, we estimated that diagnostic screening reduces the probability of cases occurring by 82% (95% credible interval: 75%, 85%); however, false-positive test outcomes may hamper this approach. Antimicrobial chemoprophylaxis at time of departure and oral cholera vaccination reduce the probability of cases by 50% (41%, 57%) and by up to 61% (58%, 63%), respectively. Chemoprophylaxis beginning 1 wk before departure confers a 91% (78%, 96%) reduction independently, and up to a 98% reduction (94%, 99%) if coupled with vaccination. These results are not sensitive to assumptions about the background cholera incidence rate in the endemic troop-sending country. Further research is needed to (1) validate the sensitivity and specificity of rapid test approaches for detecting asymptomatic carriage, (2) compare prophylactic efficacy across antimicrobial regimens, and (3) quantify the impact of oral cholera vaccine on transmission from asymptomatic carriers. Conclusions Screening, chemoprophylaxis, and vaccination are all effective strategies to prevent cholera introduction

  14. Clinical Features of Human Immunodeficiency Virus-Infected Patients Presenting with Cholera in Port-au-Prince, Haiti.

    Science.gov (United States)

    Sévère, Karine; Anglade, Stravinsky B; Bertil, Claudin; Duncan, Aynsley; Joseph, Patrice; Deroncenay, Alexandra; Mabou, Marie M; Ocheretina, Oksana; Reif, Lindsey; Seo, Grace; Pape, Jean W; Fitzgerald, Daniel W

    2016-11-02

    Human immunodeficiency virus (HIV) infection has been postulated to alter the natural history of cholera, including increased susceptibility to infection, severity of illness, and chronic carriage of Vibrio cholerae Haiti has a generalized HIV epidemic with an adult HIV prevalence of 1.9% and recently suffered a cholera epidemic. We conducted a prospective study at the cholera treatment center (CTC) of GHESKIO in Haiti to characterize the coinfection. Adults admitted at the CTC for acute diarrhea were invited to participate in the study. Vital signs, frequency, and volume of stools and/or vomiting were monitored, and single-dose doxycycline was administered. After counseling, participants were screened for HIV by enzyme-linked immunosorbent assay and for cholera by culture. Of 729 adults admitted to the CTC, 99 (13.6%) had HIV infection, and 457 (63%) had culture-confirmed cholera. HIV prevalence was three times higher in patients without cholera (23%, 63/272) than in those with culture-confirmed cholera (7.9%, 36/457). HIV prevalence in patients with culture-confirmed cholera (7.9%) was four times higher than the adult prevalence in Port-au-Prince (1.9%). Of the 36 HIV-infected patients with cholera, 25 (69%) had moderate/severe dehydration versus 302/421 (72%) in the HIV negative. Of 30 HIV-infected patients with weekly stool cultures performed after discharge, 29 (97%) were negative at week 1. Of 50 HIV-negative patients with weekly stool cultures, 49 (98%) were negative at week 1. In countries with endemic HIV infection, clinicians should consider screening patients presenting with suspected cholera for HIV coinfection.

  15. Modeling the Epidemiology of Cholera to Prevent Disease Transmission in Developing Countries

    Science.gov (United States)

    MUKANDAVIRE, ZINDOGA; MORRIS, J. GLENN

    2015-01-01

    Cholera remains an important global cause of morbidity and mortality, which is capable of causing periodic epidemic disease. A number of mathematical models have been developed to help in understanding the dynamics of cholera outbreaks and for use as a tool in planning interventions, including vaccination campaigns. We have explored the utility of models in assessing the spread of cholera in the recent epidemics in Zimbabwe and Haiti. In both instances, a mathematical model was formulated and fitted to cumulative cholera cases to estimate the basic reproductive number ℜ0, and the partial reproductive numbers reflecting potential differences in environmental-to-human versus human-to-human transmission were quantified. In Zimbabwe, estimated ℜ0 for the epidemic using aggregated data at the national level was 1.15; in Haiti, it was 1.55. However, when calculated at a provincial/departmental level, estimated basic reproductive numbers were highly heterogeneous, with a range of 1.11 to 2.72 in Zimbabwe and 1.06 to 2.63 in Haiti. Our models suggest that the underlying patterns of cholera transmission varied widely from region to region, with a corresponding variation in the amenability of outbreaks to control measures such as immunization. These data underscore the heterogeneity of transmission dynamics, potentially linked to differences in environment, socio-economic conditions, and cultural practices. They also highlight the potential utility of these types of models in guiding development of public health intervention strategies. PMID:26185087

  16. Avian cholera, a threat to the viability of an Arctic seabird colony?

    Directory of Open Access Journals (Sweden)

    Sébastien Descamps

    Full Text Available Evidence that infectious diseases cause wildlife population extirpation or extinction remains anecdotal and it is unclear whether the impacts of a pathogen at the individual level can scale up to population level so drastically. Here, we quantify the response of a Common eider colony to emerging epidemics of avian cholera, one of the most important infectious diseases affecting wild waterfowl. We show that avian cholera has the potential to drive colony extinction, even over a very short period. Extinction depends on disease severity (the impact of the disease on adult female survival and disease frequency (the number of annual epidemics per decade. In case of epidemics of high severity (i.e., causing >30% mortality of breeding females, more than one outbreak per decade will be unsustainable for the colony and will likely lead to extinction within the next century; more than four outbreaks per decade will drive extinction to within 20 years. Such severity and frequency of avian cholera are already observed, and avian cholera might thus represent a significant threat to viability of breeding populations. However, this will depend on the mechanisms underlying avian cholera transmission, maintenance, and spread, which are currently only poorly known.

  17. Modeling the Epidemiology of Cholera to Prevent Disease Transmission in Developing Countries.

    Science.gov (United States)

    Mukandavire, Zindoga; Morris, J Glenn

    2015-06-01

    Cholera remains an important global cause of morbidity and mortality, which is capable of causing periodic epidemic disease. A number of mathematical models have been developed to help in understanding the dynamics of cholera outbreaks and for use as a tool in planning interventions, including vaccination campaigns. We have explored the utility of models in assessing the spread of cholera in the recent epidemics in Zimbabwe and Haiti. In both instances, a mathematical model was formulated and fitted to cumulative cholera cases to estimate the basic reproductive number ℛ0, and the partial reproductive numbers reflecting potential differences in environmental-to-human versus human-to-human transmission were quantified. In Zimbabwe, estimated ℛ0 for the epidemic using aggregated data at the national level was 1.15; in Haiti, it was 1.55. However, when calculated at a provincial/departmental level, estimated basic reproductive numbers were highly heterogeneous, with a range of 1.11 to 2.72 in Zimbabwe and 1.06 to 2.63 in Haiti. Our models suggest that the underlying patterns of cholera transmission varied widely from region to region, with a corresponding variation in the amenability of outbreaks to control measures such as immunization. These data underscore the heterogeneity of transmission dynamics, potentially linked to differences in environment, socio-economic conditions, and cultural practices. They also highlight the potential utility of these types of models in guiding development of public health intervention strategies.

  18. High-frequency rugose exopolysaccharide production by Vibrio cholerae strains isolated in Haiti.

    Science.gov (United States)

    Rahman, Mustafizur; Jubair, Mohammad; Alam, Meer T; Weppelmann, Thomas A; Azarian, Taj; Salemi, Marco; Sakharuk, Ilya A; Rashid, Mohammed H; Johnson, Judith A; Yasmin, Mahmuda; Morris, J Glenn; Ali, Afsar

    2014-01-01

    In October, 2010, epidemic cholera was reported for the first time in Haiti in over 100 years. Establishment of cholera endemicity in Haiti will be dependent in large part on the continued presence of toxigenic V. cholerae O1 in aquatic reservoirs. The rugose phenotype of V. cholerae, characterized by exopolysaccharide production that confers resistance to environmental stress, is a potential contributor to environmental persistence. Using a microbiologic medium promoting high-frequency conversion of smooth to rugose (S-R) phenotype, 80 (46.5%) of 172 V. cholerae strains isolated from clinical and environmental sources in Haiti were able to convert to a rugose phenotype. Toxigenic V. cholerae O1 strains isolated at the beginning of the epidemic (2010) were significantly less likely to shift to a rugose phenotype than clinical strains isolated in 2012/2013, or environmental strains. Frequency of rugose conversion was influenced by incubation temperature and time. Appearance of the biofilm produced by a Haitian clinical rugose strain (altered biotype El Tor HC16R) differed from that of a typical El Tor rugose strain (N16961R) by confocal microscopy. On whole-genome SNP analysis, there was no phylogenetic clustering of strains showing an ability to shift to a rugose phenotype. Our data confirm the ability of Haitian clinical (and environmental) strains to shift to a protective rugose phenotype, and suggest that factors such as temperature influence the frequency of transition to this phenotype.

  19. High-frequency rugose exopolysaccharide production by Vibrio cholerae strains isolated in Haiti.

    Directory of Open Access Journals (Sweden)

    Mustafizur Rahman

    Full Text Available In October, 2010, epidemic cholera was reported for the first time in Haiti in over 100 years. Establishment of cholera endemicity in Haiti will be dependent in large part on the continued presence of toxigenic V. cholerae O1 in aquatic reservoirs. The rugose phenotype of V. cholerae, characterized by exopolysaccharide production that confers resistance to environmental stress, is a potential contributor to environmental persistence. Using a microbiologic medium promoting high-frequency conversion of smooth to rugose (S-R phenotype, 80 (46.5% of 172 V. cholerae strains isolated from clinical and environmental sources in Haiti were able to convert to a rugose phenotype. Toxigenic V. cholerae O1 strains isolated at the beginning of the epidemic (2010 were significantly less likely to shift to a rugose phenotype than clinical strains isolated in 2012/2013, or environmental strains. Frequency of rugose conversion was influenced by incubation temperature and time. Appearance of the biofilm produced by a Haitian clinical rugose strain (altered biotype El Tor HC16R differed from that of a typical El Tor rugose strain (N16961R by confocal microscopy. On whole-genome SNP analysis, there was no phylogenetic clustering of strains showing an ability to shift to a rugose phenotype. Our data confirm the ability of Haitian clinical (and environmental strains to shift to a protective rugose phenotype, and suggest that factors such as temperature influence the frequency of transition to this phenotype.

  20. [ACTUAL PROBLEMS OF EPIDEMIOLOGIC CONTROL, LABORATORY DIAGNOSTICS AND PROPHYLAXIS OF CHOLERA IN RUSSIAN FEDERATION].

    Science.gov (United States)

    Onischenko, G G; Popova, A Yu; Kutyrev, V V; Smirnova, N I; Scherbakova, S A; Moskvitina, E A; Titova, S V

    2016-01-01

    Main problems of system of epidemiologic control for cholera active in Russian Federation, as well as laboratory diagnostics and vaccine prophylaxis of this especially dangerous infection, that had emerged in the contemporary period of the ongoing 7th pandemic of cholera, are discussed. Features of the genome of natural strains of Vibrio cholerae of El Tor biovar, that possess a poten- tial epidemic threat, as well as problems, that have emerged during isolation of these strains from samples of water of surface water bodies during their monitoring, are also examined. The main direction of enhancement of the system of epidemiologic control for cholera consist in develop- ment of a new algorithm of differentiation of administrative territories of Russian Federation by types of epidemic manifestations, as well as optimization of monitoring of environment objects. Integration of modern highly informative technologies into practice, as well as development of new generation diagnostic preparations based on DNA-chips and immunechips is necessary to increase effectiveness of the conducted operative and retrospective diagnostics in the contemporary period. Creation of national cholera vaccine, ensuring simultaneous protection from cholera causative agents of both O1 and O139 serogroups, is also required.

  1. Understanding impacts of climatic extremes on diarrheal disease epidemics: Insights from mechanistic disease propagation models

    Science.gov (United States)

    Jutla, A.; Akanda, A. S.; Colwell, R. R.

    2013-12-01

    An epidemic outbreak of diarrheal diseases (primarily cholera) in Haiti in 2010 is a reminder that our understanding on disease triggers, transmission and spreading mechanisms is incomplete. Cholera can occur in two forms - epidemic (defined as sudden outbreak in a historically disease free region) and endemic (recurrence and persistence of the disease for several consecutive years). Examples of countries with epidemic cholera include Pakistan (2008), Congo (2008), and most recently Haiti (2010). A significant difference between endemic and epidemic regions is the mortality rate, i.e., 1% or lower in an endemic regions versus 3-7% during recent epidemic outbreaks. A fundamentally transformational approach - a warning system with several months prediction lead time - is needed to prevent disease outbreak and minimize its impact on population. Lack of information on spatial and temporal variability of disease incidence as well as transmission in human population continues to be significant challenge in the development of early-warning systems for cholera. Using satellite data on regional hydroclimatic processes, water and sanitation infrastructure indices, and biological pathogen growth information, here we present a Simple, Mechanistic, Adaptive, Remote sensing based Regional Transmission or SMART model to (i) identify regions of potential cholera outbreaks and (ii) quantify mechanism of spread of the disease in previously disease free region. Our results indicate that epidemic regions are located near regional rivers and are characterized by sporadic outbreaks, which are likely to be initiated during episodes of prevailing warm air temperature with low river flows, creating favorable environmental conditions for the growth of cholera bacteria. Heavy rainfall, through inundation or breakdown of sanitary infrastructure, accelerates interaction between contaminated water and human activities, resulting in an epidemic. We discuss the above findings in light of

  2. [Environmental drivers of emergence and spreading of Vibrio epidemics in South America].

    Science.gov (United States)

    Gavilán, Ronnie G; Martínez-Urtaza, Jaime

    2011-03-01

    Vibrio cholerae and V. parahaemolyticus are the two Vibrio species with a major impact on human health. Diseases caused by both pathogens are acquiring increasing relevance due to their expansion at global scale. In this paper, we resume the ecological aspects associated with the arrival and spreading of infections caused by V. parahaemolyticus and V. cholerae in Peru from a South American perspective. Moreover, we discuss the similarities in the emergence in Peru of cholera cases in 1991 and V. parahaemolyticus infections in 1997. These constituted exceptional experiments to evaluate the relationships between the Vibrio epidemics and changes in the environment. The epidemic radiations of V. cholerae and V. parahaemolyticus constitute to clear examples supporting the oceanic dispersion of pathogenic vibrios and have enabled the identification of El Niño events as a potential mechanism for the spreading of diseases through the ocean.

  3. 陕甘回民战争和捻军起义中的传染病类型考辨%On the Types of the Infectious Diseases in Huis′War in Shangxi-Gansu Area and Nian Uprising

    Institute of Scientific and Technical Information of China (English)

    李玉尚

    2015-01-01

    陕甘军队中常感染腹泻、皮肤病和瘴气等疾病,造成大量疾病减员,但对战争影响最大的传染病却是霍乱。捻军起义期间皖北地区流行病以咸丰七年和八年(1857年和1858年)最为严重,其病种很可能为霍乱;山东咸丰十一年(1861年)和同治五年至七年(1866年至1868年)的流行病都与捻军有关系,主要病种包括黄胆性肝炎、霍乱和痢疾等。与同时期的长江中下游战场相同,对西北回民战争和捻军起义军队和战区民众影响最大的疾病也是霍乱。%Diseases such as diarrhea,skin diseases,and miasma were commonly prevalent in soldiers of Shanxi-Gansu Area,and led to many casualties,of which influenced mostly was cholera.And,during the period of Nian Uprising,epidemic,which was probably chol-era as well,was very serious in 1857 and 1858.Also,epidemics,including icterohepatitis,cholera,dysentery,etc in Shandong prov-ince during 1866 -1868 were relevant to Nian Uprising.In a nut shell,cholera was the most highly affected disease in Huis′War in Shangxi-Gansu Area and Nian Uprising.

  4. Climate and infectious disease: use of remote sensing for detection of Vibrio cholerae by indirect measurement

    Science.gov (United States)

    Lobitz, B.; Beck, L.; Huq, A.; Wood, B.; Fuchs, G.; Faruque, A. S.; Colwell, R.

    2000-01-01

    It has long been known that cholera outbreaks can be initiated when Vibrio cholerae, the bacterium that causes cholera, is present in drinking water in sufficient numbers to constitute an infective dose, if ingested by humans. Outbreaks associated with drinking or bathing in unpurified river or brackish water may directly or indirectly depend on such conditions as water temperature, nutrient concentration, and plankton production that may be favorable for growth and reproduction of the bacterium. Although these environmental parameters have routinely been measured by using water samples collected aboard research ships, the available data sets are sparse and infrequent. Furthermore, shipboard data acquisition is both expensive and time-consuming. Interpolation to regional scales can also be problematic. Although the bacterium, V. cholerae, cannot be sensed directly, remotely sensed data can be used to infer its presence. In the study reported here, satellite data were used to monitor the timing and spread of cholera. Public domain remote sensing data for the Bay of Bengal were compared directly with cholera case data collected in Bangladesh from 1992-1995. The remote sensing data included sea surface temperature and sea surface height. It was discovered that sea surface temperature shows an annual cycle similar to the cholera case data. Sea surface height may be an indicator of incursion of plankton-laden water inland, e.g., tidal rivers, because it was also found to be correlated with cholera outbreaks. The extensive studies accomplished during the past 25 years, confirming the hypothesis that V. cholerae is autochthonous to the aquatic environment and is a commensal of zooplankton, i.e., copepods, when combined with the findings of the satellite data analyses, provide strong evidence that cholera epidemics are climate-linked.

  5. Antimicrobial Drug Resistance of Vibrio cholerae, Democratic Republic of the Congo.

    Science.gov (United States)

    Miwanda, Berthe; Moore, Sandra; Muyembe, Jean-Jacques; Nguefack-Tsague, Georges; Kabangwa, Ickel Kakongo; Ndjakani, Daniel Yassa; Mutreja, Ankur; Thomson, Nicholas; Thefenne, Helene; Garnotel, Eric; Tshapenda, Gaston; Kakongo, Denis Kandolo; Kalambayi, Guy; Piarroux, Renaud

    2015-05-01

    We analyzed 1,093 Vibrio cholerae isolates from the Democratic Republic of the Congo during 1997-2012 and found increasing antimicrobial drug resistance over time. Our study also demonstrated that the 2011-2012 epidemic was caused by an El Tor variant clonal complex with a single antimicrobial drug susceptibility profile.

  6. Disease dynamics in a coupled cholera model linking within-host and between-host interactions.

    Science.gov (United States)

    Wang, Xueying; Wang, Jin

    2016-09-19

    A new modelling framework is proposed to study the within-host and between-host dynamics of cholera, a severe intestinal infection caused by the bacterium Vibrio cholerae. The within-host dynamics are characterized by the growth of highly infectious vibrios inside the human body. These vibrios shed from humans contribute to the environmental bacterial growth and the transmission of the disease among humans, providing a link from the within-host dynamics at the individual level to the between-host dynamics at the population and environmental level. A fast-slow analysis is conducted based on the two different time scales in our model. In particular, a bifurcation study is performed, and sufficient and necessary conditions are derived that lead to a backward bifurcation in cholera epidemics. Our result regarding the backward bifurcation highlights the challenges in the prevention and control of cholera.

  7. Cholera Illness and Symptoms

    Science.gov (United States)

    ... are typically no long term consequences. Persons with cholera do not become carriers of the disease after they recover, but can be reinfected if ... Diseases (NCEZID) Division of Foodborne, Waterborne, and Environmental Diseases (DFWED) ... of Health & Human Services HHS/Open USA.gov Top

  8. 1998至2001年四川省霍乱流行中6b型菌株的分子特征%Molecular characterization of vibrio cholerae phage-type 6b epidemic isolates from 1998 to 2001 in Sichuan province

    Institute of Scientific and Technical Information of China (English)

    徐冬蕾; 王洪霞; 刁保卫; 刘红露; 熊理凤; 高守一; 阚飙

    2009-01-01

    目的 分析1998-2001年四川省霍乱流行中噬菌体-生物分型为6b的特殊菌型霍乱弧菌的分子特征.方法 选择1998-2001年四川省01群霍乱弧菌流行菌株以及同时期其他省份的流行菌株共45株,进行噬菌体-生物分型、脉冲场凝胶电泳(PFGE)分析以及突变基因的序列测定比较.结果 四川在1998-2001年期间流行的菌株存在1b型和6b型菌株,这些菌株均为产毒株;PFGE分析结果显示菌株呈现24种带型,其中13株菌表现为相同带型;来自四川的部分1b和6b型菌株以及部分其他省份的1b型菌株具有相同的PFGE带型;与1b型菌株相比,6b型菌株(共22株)的ompW基因ORF内存在11 bp缺失,而其余23株菌非6b型菌株的ompW基因ORF是完整的.结论 1998-2001年四川流行的O1群霍乱弧菌6b菌株是一类具有特殊遗传背景的菌型,可能与同期流行的1b型菌株有进化上的关联.%Objective To investigate the molecular characteristics of phage-type 6b isolates emerging in 1998-2001 cholera epidemics in Sichuan province. Methods Isolates were analyzed by phage-typing, pulsed field gel electrophoresis (PFGE) and ompW gene sequencing. Results All phage-type 1b and 6b isolates in Sichuan province from 1998 to 2001 were toxigenic. A total of 24 patterns were identified after PFGE analysis, and one predominant pattern consisted of 13 isolates. Several 1b and 6b isolates from Sichuan and isolates of the 1b from other provinces showed the same PFGE pattern. Mutation in ompW gene was found in 6b isolates. Conclusion V. cholerae O1 6b isolates in Sichuan province from 1998 to 2001 have special genetic markers,and might genetically correlate with contemporaneous 1b isolates.

  9. High-resolution spatial analysis of cholera patients reported in Artibonite department, Haiti in 2010–2011

    Directory of Open Access Journals (Sweden)

    Maya Allan

    2016-03-01

    Conclusion/significance: These findings demonstrate the value of high-resolution mapping for pinpointing locations most affected by cholera, and in the future could help prioritize the places in need of interventions such as improvement of sanitation and vaccination. The findings also describe spatio-temporal transmission patterns of the epidemic in a cholera-naïve country such as Haiti. By identifying transmission hubs, it is possible to target prevention strategies that, over time, could reduce transmission of the disease and eventually eliminate cholera in Haiti.

  10. Hydroclimatological Controls of Endemic and Non-endemic Cholera of the 20th Century

    Science.gov (United States)

    Jutla, A. S.; Whitcombe, E.; Colwell, R.

    2012-12-01

    Cholera remains a major public health threat for the developing countries. Since the causative agent, Vibrio cholerae, is autochthonous to aquatic environment, it is not possible to eradicate the agent of the disease. Hydroclimatology based prediction and prevention strategies can be implemented in disease susceptible regions for reducing incidence rates. However, the precise role of hydrological and climatological processes, which will further aid in development of suitable prediction models, in creating spatial and temporal environmental conditions favorable for disease outbreak has not been adequately quantified. Here, we show distinction between seasonality and occurrence of cholera in epidemic and non-endemic regions. Using historical cholera mortality data, from the late 1800s for 27 locations in the Indian subcontinent, we show that non-endemic regions are generally located close to regional river systems but away from the coasts and are characterized by single sporadic outbreak in a given year. Increase in air temperature during the low river flow season increases evaporation, leading to an optimal salinity and pH required for bacterial growth. Thereafter, monsoonal rainfall, leads to interactions of contaminated river waters via human activity resulting in cholera epidemics. Endemic regions are located close to coasts where cholera outbreak occurs twice (spring and fall) in a year. Spring outbreak is generally associated with intrusion of bacterial seawater to inland whereas the fall peak is correlated with widespread flooding and cross-contamination of water resources via increased precipitation. This may be one of the first studies to hydroclimatologically quantitatively the seasonality of cholera in both endemic and non-endemic regions. Our results prompt the need of region and cause-specific prediction models for cholera, employing appropriate environmental determinants.

  11. Cholera toxin expression by El Tor Vibrio cholerae in shallow culture growth conditions.

    Science.gov (United States)

    Cobaxin, Mayra; Martínez, Haydee; Ayala, Guadalupe; Holmgren, Jan; Sjöling, Asa; Sánchez, Joaquín

    2014-01-01

    Vibrio cholerae O1 classical, El Tor and O139 are the primary biotypes that cause epidemic cholera, and they also express cholera toxin (CT). Although classical V. cholerae produces CT in various settings, the El Tor and O139 strains require specific growth conditions for CT induction, such as the so-called AKI conditions, which consist of growth in static conditions followed by growth under aerobic shaking conditions. However, our group has demonstrated that CT production may also take place in shallow static cultures. How these type of cultures induce CT production has been unclear, but we now report that in shallow culture growth conditions, there is virtual depletion of dissolved oxygen after 2.5 h of growth. Concurrently, during the first three to 4 h, endogenous CO2 accumulates in the media and the pH decreases. These findings may explain CT expression at the molecular level because CT production relies on a regulatory cascade, in which the key regulator AphB may be activated by anaerobiosis and by low pH. AphB activation stimulates TcpP synthesis, which induces ToxT production, and ToxT directly stimulates ctxAB expression, which encodes CT. Importantly, ToxT activity is enhanced by bicarbonate. Therefore, we suggest that in shallow cultures, AphB is activated by initial decreases in oxygen and pH, and subsequently, ToxT is activated by intracellular bicarbonate that has been generated from endogenous CO2. This working model would explain CT production in shallow cultures and, possibly, also in other growth conditions.

  12. Cholera in the United States, 2001-2011: a reflection of patterns of global epidemiology and travel.

    Science.gov (United States)

    Loharikar, A; Newton, A E; Stroika, S; Freeman, M; Greene, K D; Parsons, M B; Bopp, C; Talkington, D; Mintz, E D; Mahon, B E

    2015-03-01

    US cholera surveillance offers insight into global and domestic trends. Between 2001 and 2011, 111 cases were reported to the Centers for Disease Control and Prevention. Cholera was associated with international travel in 90 (81%) patients and was domestically acquired in 20 (18%) patients; for one patient, information was not available. From January 2001 to October 2010, the 42 (47%) travel-associated cases were associated with travel to Asia. In October 2010, a cholera epidemic started in Haiti, soon spreading to the Dominican Republic (Hispaniola). From then to December 2011, 40 (83%) of the 48 travel-associated cases were associated with travel to Hispaniola. Of 20 patients who acquired cholera domestically, 17 (85%) reported seafood consumption; 10 (59%) ate seafood from the US Gulf Coast. In summary, an increase in travel-associated US cholera cases was associated with epidemic cholera in Hispaniola in 2010-2011. Travel to Asia and consumption of Gulf Coast seafood remained important sources of US cholera cases.

  13. Social epidemics in the aftermath of disasters.

    NARCIS (Netherlands)

    IJzermans, C.J.

    2002-01-01

    Issue/problem: After disasters, terrorist attacks and wars social epidemics of medically unexplained physical symptoms/syndromes (ups) are often seen. In modern times people feel more vulnerable and especially under pressure of those incidents, everyday symptoms are interpreted as disease and causal

  14. Evidence of a dominant lineage of Vibrio cholerae-specific lytic bacteriophages shed by cholera patients over a 10-year period in Dhaka, Bangladesh.

    Science.gov (United States)

    Seed, Kimberley D; Bodi, Kip L; Kropinski, Andrew M; Ackermann, Hans-Wolfgang; Calderwood, Stephen B; Qadri, Firdausi; Camilli, Andrew

    2011-01-01

    Lytic bacteriophages are hypothesized to contribute to the seasonality and duration of cholera epidemics in Bangladesh. However, the bacteriophages contributing to this phenomenon have yet to be characterized at a molecular genetic level. In this study, we isolated and sequenced the genomes of 15 bacteriophages from stool samples from cholera patients spanning a 10-year surveillance period in Dhaka, Bangladesh. Our results indicate that a single novel bacteriophage type, designated ICP1 (for the International Centre for Diarrhoeal Disease Research, Bangladesh cholera phage 1) is present in all stool samples from cholera patients, while two other bacteriophage types, one novel (ICP2) and one T7-like (ICP3), are transient. ICP1 is a member of the Myoviridae family and has a 126-kilobase genome comprising 230 open reading frames. Comparative sequence analysis of ICP1 and related isolates from this time period indicates a high level of genetic conservation. The ubiquitous presence of ICP1 in cholera patients and the finding that the O1 antigen of lipopolysaccharide (LPS) serves as the ICP1 receptor suggest that ICP1 is extremely well adapted to predation of human-pathogenic V. cholerae O1.

  15. Epidemic suicide among Micronesian adolescents.

    Science.gov (United States)

    Rubinstein, D H

    1983-01-01

    Suicide rates since 1960 in Micronesia (the U.S. Trust Territory of the Pacific Islands) have undergone an epidemic-like increase. This phenomenon is focused narrowly within the 15--24-year male age-group. Extremely high rates and culturally patterned motives and methods are now characteristic of this group. Survey research throughout Micronesia suggests that the epidemic increase in adolescent male suicide is a cohort effect among the first post-war generation. Traditional adolescent socialization in pre-war Micronesia largely involved village-level subsistence activities organized around communal lineage-houses. This extra-familial level of socialization served as a cultural solution to the residential and psychological distance post-pubertal males maintained from their domestic families. With the post-war social change in Micronesia, the communal village-level of organization has largely disintegrated, causing adolescent socialization functions to be absorbed by the nuclear family. The resulting situations of intergenerational domestic discord appear the primary social triggers for adolescent suicide. At the same time, suicides have acquired subcultural significance among male youth, giving rise to fad-like and imitative acts. A 3-year research project is now being undertaken to conduct an ethnographic study of factors contributing to adolescent stress and suicide in one Micronesian community.

  16. Reduced Susceptibility to Extended-Spectrum β-Lactams in Vibrio cholerae Isolated in Bangladesh

    Science.gov (United States)

    Ceccarelli, Daniela; Alam, Munirul; Huq, Anwar; Colwell, Rita R.

    2016-01-01

    β-lactams are antibiotic molecules able to inhibit cell wall biosynthesis. Among other mechanisms, resistance in Gram-negative bacteria is mostly associated with production of β-lactamase enzymes able to bind and hydrolyze the β-lactam ring. Extended-spectrum β-lactamases extend this ability also to third- and fourth-generation cephalosporins, as well as to carbapenems and monobactams. Vibrio cholerae is the causative agent of epidemic cholera and a public health burden for developing countries like Bangladesh. Although appropriate oral or intravenous rehydration is the therapy of choice for cholera, severe infections and V. cholerae-associated septicemia are treated with antimicrobial drugs, including doxycycline, erythromycin, azithromycin, ciprofloxacin, and/or third-generation cephalosporins. In the years after the introduction of antibiotics in clinical practice, V. cholerae developed resistance to commonly used drugs worldwide mostly through gene acquisition via horizontal gene transfer. Reduced susceptibility of V. cholerae to third-generation cephalosporins has been occasionally documented. However, carbapenemase-producing V. cholerae has been reported at higher rates than resistance to extended-spectrum β-lactams, mainly associated with blaNDM-1 emergence and successful plasmid dissemination. Recent findings suggest limited β-lactam resistance is present in V. cholerae O1 isolates collected during ecological and epidemiological surveillance in Bangladesh. However, a trend to intermediate-susceptibility insurgence was observed. Horizontal gene transfer of β-lactam resistance from enteric pathogens to environmental microorganisms should not be underrated, given the ability of V. cholerae to acquire new genetic information.

  17. Reduced Susceptibility to Extended-Spectrum β-Lactams in Vibrio cholerae Isolated in Bangladesh.

    Science.gov (United States)

    Ceccarelli, Daniela; Alam, Munirul; Huq, Anwar; Colwell, Rita R

    2016-01-01

    β-lactams are antibiotic molecules able to inhibit cell wall biosynthesis. Among other mechanisms, resistance in Gram-negative bacteria is mostly associated with production of β-lactamase enzymes able to bind and hydrolyze the β-lactam ring. Extended-spectrum β-lactamases extend this ability also to third- and fourth-generation cephalosporins, as well as to carbapenems and monobactams. Vibrio cholerae is the causative agent of epidemic cholera and a public health burden for developing countries like Bangladesh. Although appropriate oral or intravenous rehydration is the therapy of choice for cholera, severe infections and V. cholerae-associated septicemia are treated with antimicrobial drugs, including doxycycline, erythromycin, azithromycin, ciprofloxacin, and/or third-generation cephalosporins. In the years after the introduction of antibiotics in clinical practice, V. cholerae developed resistance to commonly used drugs worldwide mostly through gene acquisition via horizontal gene transfer. Reduced susceptibility of V. cholerae to third-generation cephalosporins has been occasionally documented. However, carbapenemase-producing V. cholerae has been reported at higher rates than resistance to extended-spectrum β-lactams, mainly associated with blaNDM-1 emergence and successful plasmid dissemination. Recent findings suggest limited β-lactam resistance is present in V. cholerae O1 isolates collected during ecological and epidemiological surveillance in Bangladesh. However, a trend to intermediate-susceptibility insurgence was observed. Horizontal gene transfer of β-lactam resistance from enteric pathogens to environmental microorganisms should not be underrated, given the ability of V. cholerae to acquire new genetic information.

  18. Reduced susceptibility to extended-spectrum β-lactams in V. cholerae isolated in Bangladesh

    Directory of Open Access Journals (Sweden)

    Daniela Ceccarelli

    2016-10-01

    Full Text Available β-lactams are antibiotic molecules able to inhibit cell wall biosynthesis. Among other mechanisms, resistance in Gram-negative bacteria is mostly associated with production of β-lactamase enzymes able to bind and hydrolyze the β-lactam ring. Extended-spectrum β-lactamases extend this ability also to 3rd- and 4th generation cephalosporins as well as to carbapenems and monobactams. V. cholerae is the causative agent of epidemic cholera and a public health burden for developing countries like Bangladesh. Although appropriate oral or intravenous rehydration is the therapy of choice for cholera, severe infections and V. cholerae associated septicemia are treated with antimicrobial drugs including doxycycline, erythromycin, azithromycin, ciprofloxacin and/or third-generation cephalosporins. In the years after introduction of antibiotics in clinical practice, V. cholerae developed resistance to commonly used drugs worldwide mostly through gene acquisition via horizontal gene transfer. Reduced susceptibility of V. cholerae to third-generation cephalosporins has been occasionally documented. However, carbapenemase-producing V. cholerae has been reported at higher rates than resistance to extended spectrum β-lactams, mainly associated with blaNDM-1 emergence and successful plasmid dissemination. Recent findings suggest limited β-lactam resistance is present in V. cholerae O1 isolates collected during ecological and epidemiological surveillance in Bangladesh. However a trend to intermediate-susceptibility insurgence was observed. Horizontal gene transfer of β-lactam resistance from enteric pathogens to environmental microorganisms should not be underrated, given the ability of V. cholerae to acquire new genetic information.

  19. Active surveillance of the aquatic environment for potential prediction, prevention and spread of water borne disease: the cholera paradigm

    Science.gov (United States)

    Huq, A.; Colwell, R.

    2011-12-01

    Based on results of ecological and epidemiological studies, occurrence and spread of certain diseases are more fully understood. Cholera is a major waterborne disease, that is relatively easily treatable and clearly preventable, yet tens of thousands die each year worldwide. A dose dependent disease, the infectious dose can vary from 103-106, depending on health status of the victim. Historically, cholera has been shown to spread from person to person. Furthermore, the disease is caused predominantly via ingestion of contaminated water and most of the outbreaks that have been recorded worldwide originated in a coastal region. Using appropriate detection methods, Vibrio cholerae can be isolated from samples collected from ponds, rivers, estuaries, and coastal waters globally. The populations of V. cholerae may vary in numbers during different seasons of the year. It is important to have a clear understanding of the distribution of the causative agent in the environment as such information can assist public health officials in taking action to prevent outbreaks of cholera. Thus an effective monitoring program is critical, particularly in light of climate change with temperature extremes more likely to be occurring. Based on a predictive model and results of ground truth data, temperature has been found to be a factor in the increase of V. cholerae in the environment. Correlation was observed with occurrence of cholera and both temperature and salinity. More recent research indicates additional factors need to be considered in predicting cholera epidemics, including the hydrology and disease dynamics.

  20. [Epidemiological situation of infectious diseases in Lvov and Cracow during and after World War I (until the year 1922)].

    Science.gov (United States)

    Berner, Włodzimierz

    2009-01-01

    In Lvov and Cracow at the times of World War I, the infectious diseases such as tuberculosis followed by typhus fever, typhoid fever, dysentery, as well as scarlet fever, diphtheria, measles, whooping cough, smallpox, cholera and venereal diseases (particularly syphilis) posed one of the most significant and dangerous problems for inhabitants. Their increased prevalence was the result of deteriorating sanitary and living conditions of the city population. The spread of epidemic infectious diseases was enhanced by marching troops, migration of civilians and war prisoners, return of large groups of displaced people and demobilized soldiers after regaining independence in November 1918. Additionally, unfavorable epidemiological situation in Lvov deteriorated at the time of the war with Ukrainians (November 1918-April 1919) and Bolsheviks (July-August 1920). The control of infectious diseases was in the hands of regional local physicians who referred patients to hospitals, isolated homes, bath and disinfection institutions, and conducted vaccinations against smallpox. A decrease in infectious diseases prevalence and deaths to the prewar levels occurred in 1922.

  1. El Niño, Climate, and Cholera Associations in Piura, Peru, 1991-2001: A Wavelet Analysis.

    Science.gov (United States)

    Ramírez, Iván J; Grady, Sue C

    2016-03-01

    In Peru, it was hypothesized that epidemic cholera in 1991 was linked to El Niño, the warm phase of El Niño-Southern Oscillation. While previous studies demonstrated an association in 1997-1998, using cross-sectional data, they did not assess the consistency of this relationship across the decade. Thus, how strong or variable an El Niño-cholera relationship was in Peru or whether El Niño triggered epidemic cholera early in the decade remains unknown. In this study, wavelet and mediation analyses were used to characterize temporal patterns among El Niño, local climate variables (rainfall, river discharge, and air temperature), and cholera incidence in Piura, Peru from 1991 to 2001 and to estimate the mediating effects of local climate on El Niño-cholera relationships. The study hypothesis is that El Niño-related connections with cholera in Piura were transient and interconnected via local climate pathways. Overall, our findings provide evidence that a strong El Niño-cholera link, mediated by local hydrology, existed in the latter part of the 1990s but found no evidence of an El Niño association in the earlier part of the decade, suggesting that El Niño may not have precipitated cholera emergence in Piura. Further examinations of cholera epicenters in Peru are recommended to support these results in Piura. For public health planning, the results may improve existing efforts that utilize El Niño monitoring for preparedness during future climate-related extremes in the region.

  2. High depth, whole-genome sequencing of cholera isolates from Haiti and the Dominican Republic

    Directory of Open Access Journals (Sweden)

    Sealfon Rachel

    2012-09-01

    Full Text Available Abstract Background Whole-genome sequencing is an important tool for understanding microbial evolution and identifying the emergence of functionally important variants over the course of epidemics. In October 2010, a severe cholera epidemic began in Haiti, with additional cases identified in the neighboring Dominican Republic. We used whole-genome approaches to sequence four Vibrio cholerae isolates from Haiti and the Dominican Republic and three additional V. cholerae isolates to a high depth of coverage (>2000x; four of the seven isolates were previously sequenced. Results Using these sequence data, we examined the effect of depth of coverage and sequencing platform on genome assembly and identification of sequence variants. We found that 50x coverage is sufficient to construct a whole-genome assembly and to accurately call most variants from 100 base pair paired-end sequencing reads. Phylogenetic analysis between the newly sequenced and thirty-three previously sequenced V. cholerae isolates indicates that the Haitian and Dominican Republic isolates are closest to strains from South Asia. The Haitian and Dominican Republic isolates form a tight cluster, with only four variants unique to individual isolates. These variants are located in the CTX region, the SXT region, and the core genome. Of the 126 mutations identified that separate the Haiti-Dominican Republic cluster from the V. cholerae reference strain (N16961, 73 are non-synonymous changes, and a number of these changes cluster in specific genes and pathways. Conclusions Sequence variant analyses of V. cholerae isolates, including multiple isolates from the Haitian outbreak, identify coverage-specific and technology-specific effects on variant detection, and provide insight into genomic change and functional evolution during an epidemic.

  3. Genome engineering in Vibrio cholerae

    DEFF Research Database (Denmark)

    Val, Marie-Eve; Skovgaard, Ole; Ducos-Galand, Magaly

    2012-01-01

    importance in public health, Vibrio cholerae, the causative agent of cholera, has become a preferred model to study bacteria with multipartite genomes. However, most in vivo studies in V. cholerae have been hampered by its genome architecture, as it is difficult to give phenotypes to a specific chromosome....... This difficulty was surmounted using a unique and powerful strategy based on massive rearrangement of prokaryotic genomes. We developed a site-specific recombination-based engineering tool, which allows targeted, oriented, and reciprocal DNA exchanges. Using this genetic tool, we obtained a panel of V. cholerae...... in V. cholerae and the general question concerning bacteria carrying circular chromosomes--by looking at the effect of chromosome size on topological issues. In this article, we show that Dam, RctB, and ParA2/ParB2 are strictly essential for chrII origin maintenance, and we formally demonstrate...

  4. Predicting the evolution of large cholera outbreaks: lessons learnt from the Haiti case study

    Science.gov (United States)

    Bertuzzo, Enrico; Mari, Lorenzo; Righetto, Lorenzo; Knox, Allyn; Finger, Flavio; Casagrandi, Renato; Gatto, Marino; Rodriguez-Iturbe, Ignacio; Rinaldo, Andrea

    2013-04-01

    Mathematical models can provide key insights into the course of an ongoing epidemic, potentially aiding real-time emergency management in allocating health care resources and possibly anticipating the impact of alternative interventions. Spatially explicit models of waterborne disease are made routinely possible by widespread data mapping of hydrology, road network, population distribution, and sanitation. Here, we study the ex-post reliability of predictions of the ongoing Haiti cholera outbreak. Our model consists of a set of dynamical equations (SIR-like, i.e. subdivided into the compartments of Susceptible, Infected and Recovered individuals) describing a connected network of human communities where the infection results from the exposure to excess concentrations of pathogens in the water, which are, in turn, driven by hydrologic transport through waterways and by mobility of susceptible and infected individuals. Following the evidence of a clear correlation between rainfall events and cholera resurgence, we test a new mechanism explicitly accounting for rainfall as a driver of enhanced disease transmission by washout of open-air defecation sites or cesspool overflows. A general model for Haitian epidemic cholera and the related uncertainty is thus proposed and applied to the dataset of reported cases now available. The model allows us to draw predictions on longer-term epidemic cholera in Haiti from multi-season Monte Carlo runs, carried out up to January 2014 by using a multivariate Poisson rainfall generator, with parameters varying in space and time. Lessons learned and open issues are discussed and placed in perspective. We conclude that, despite differences in methods that can be tested through model-guided field validation, mathematical modeling of large-scale outbreaks emerges as an essential component of future cholera epidemic control.

  5. The complete genome sequence of Vibrio cholerae: a tale of two chromosomes and of two lifestyles.

    Science.gov (United States)

    Schoolnik, G K; Yildiz, F H

    2000-01-01

    Vibrio cholerae O1 has figured prominently in the history of infectious diseases as a cause of periodic global epidemics, an affliction of refugees in areas of social strife and as the disease first subjected to modern epidemiological analysis during the classic investigations of John Snow in mid-19th century London [1]. Thus, publication of the entire genome sequence of V. cholerae O1 (biotype El Tor) in Nature [2] by a consortium of investigators from The Institute for Genomic Research, the University of Maryland and Harvard Medical School is properly regarded as an historic event that will trigger a paradigm shift in the study of this organism.

  6. Connecting Environmental Observations with Cholera Outbreaks in Bangladesh

    Science.gov (United States)

    Stack, D.; Sandborn, A.; Widmeyer, P. A.; Escobar, V. M.

    2011-12-01

    Research has demonstrated that cholera epidemics in Bangladesh occur seasonally. This bimodal outbreak pattern closely follows times when large monsoon events are most frequent (spring and fall). While these patterns are presented in regional data, this knowledge alone cannot forecast the severity and location of cholera outbreaks until a monsoon event occurs, or an outbreak is reported. Therefore, there can only be reactive responses to cholera outbreaks. A heightened understanding of the link between environmental factors and outbreak occurrence will greatly enhance disease management capabilities. A predictive tool capable of giving an advanced warning of the environmental hazards that lead to location specific outbreaks allows for proactive and preventative responses, minimizing negative effects. A specific goal of this research was to relate latitude-longitude data with existing points associated with V. cholerae human case data collected from four cities in Bangladesh. Remotely sensed products were used to better understand the correlation between human outbreak occurrences, chlorophyll-a estimates, sea surface temperature (SST), and rainfall. Using MODIS, SeaWiFS, and TRMM satellite data, a gridded regional image was developed. Correlation analyses of the data were studied within the context of geographically diverse locations for the four cities of interest. Seasonal relationships were found between the cholera case data and all three of the chosen remotely sensed parameters. The strongest correlation found was between chlorophyll-a concentrations and reported human cases. The primary deliverable of this project was the production of an interactive Google Earth base map for use in a pilot design study that will lead to the development of applications to connect earth science products with water and health studies. The base map, with its inherent value of merging remotely sensed data with in situ observation points, can be used as a basis for constructing

  7. Review of two decades of cholera diagnostics--how far have we really come?

    Directory of Open Access Journals (Sweden)

    Michal H Dick

    Full Text Available BACKGROUND: Cholera, an ancient scourge, continues to inflict high rates of mortality today. The rising incidence of epidemics in areas of poor sanitation and crowding highlight the need for better epidemic prevention and early response. Such interventions require the availability of rapid and accurate diagnostic techniques to trigger timely response and mitigate the scale of the outbreak. The current gold standard of bacterial culture is inadequate for rapid diagnosis, highlighting the overarching neglect of field diagnostic needs. This paper was written to support the World Health Organisation's Global Task Force on Cholera Control mandated Cholera and diarrhoeal disease laboratory Network (CholdiNet in devising a protocol for the validation of Rapid Diagnostic Tests (RDTs for Vibrio cholerae. The status of diagnostic tools for Vibrio cholerae is assessed, describing products that have been commercialised over the last two decades and discussing their peer-reviewed evaluation. METHOD: Review of post-1990 peer-reviewed and grey literature on rapid diagnostic tests for Vibrio cholerae. RESULTS: Since 1990, twenty four diagnostic tests have been developed for the detection of Vibrio cholerae in human faecal samples. Fourteen of these have also been described in the literature, with rapid chromatographic-immuno assays (CIA featuring strongly. Polymerase chain reaction (PCR assays maintain the ability to detect the lowest amount of bacteria; however CIAs achieve both low detection thresholds and high sensitivity and specificity, making them possible candidates for use in field conditions. Field and laboratory studies were performed in a wide range of settings demonstrating variability in performance, however only a few of these studies were sufficiently stringent, highlighting five RDTs that showed promise in field conditions; COAT, IP cholera dipstick, SMART, IP dipstick and Medicos. In light of non-independent reporting, the authors would like to

  8. Increased isolation frequency of toxigenic Vibrio cholerae O1 from environmental monitoring sites in Haiti.

    Science.gov (United States)

    Alam, Meer T; Weppelmann, Thomas A; Longini, Ira; De Rochars, Valery Madsen Beau; Morris, John Glenn; Ali, Afsar

    2015-01-01

    Since the identification of the first cholera case in 2010, the disease has spread in epidemic form throughout the island nation of Haiti; as of 2014, about 700,000 cholera cases have been reported, with over 8,000 deaths. While case numbers have declined, the more fundamental question of whether the causative bacterium, Vibrio cholerae has established an environmental reservoir in the surface waters of Haiti remains to be elucidated. In a previous study conducted between April 2012 and March 2013, we reported the isolation of toxigenic V. cholerae O1 from surface waters in the Ouest Department. After a second year of surveillance (April 2013 to March 2014) using identical methodology, we observed a more than five-fold increase in the number of water samples containing culturable V. cholerae O1 compared to the previous year (1.7% vs 8.6%), with double the number of sites having at least one positive sample (58% vs 20%). Both seasonal water temperatures and precipitation were significantly related to the frequency of isolation. Our data suggest that toxigenic V. cholerae O1 are becoming more common in surface waters in Haiti; while the basis for this increase is uncertain, our findings raise concerns that environmental reservoirs are being established.

  9. Genetic Profile of IS1004 among Environmental Vibrio cholerae Isolated from Surface Water Sources in Iran

    Directory of Open Access Journals (Sweden)

    Bita Bakhshi B

    2013-03-01

    Full Text Available AbstractBackground and objective: Vibrio cholerae includes toxigenic and non-toxigenic serotypes. Non O1-non O139 serotypes are non toxigenic and do not have any role in cholera epidemics or pandemics all over the world. Different typing methods are widely used for molecular epidemiological investigations of clinical and environmental V. cholerae. The aim of this study is to investigate the genetic relatedness of environmental isolates of this bacterium using IS1004 profiling as an epidemiological marker. Materials and methods: Environmental samples collected from surface water sources in Tehran and cultured of TCBS agar after filtration. One single colony on TCBS was selected and cultured on BHI agar after which the cultures were used for biochemical diagnostic tests and serogroupings. DNA was isolated and used for PCR confirmation of V. cholerae isolates and wbeT gene. Genetic relatedness of isolates was determined using southern blot analysis. Results: From total 20 environmental V. cholerae identified in this study no wbeT gene was detected for the isolates. A total of 7 different banding patterns were obtained for the isolates while other 13 isolates identified as non-typeable by this method. Comparison with our previous studies indicated no identical pattern with clinical V. cholerae isolates. Conclusion: Differences in the banding pattern of IS1004 revealed a high heterogeneity among the isolates from surface water sources in Iran while these heterogenic isolates do not have any genetic relatedness with clinical isolates.

  10. IncA/C plasmids harboured in serious multidrug-resistant Vibrio cholerae serogroup O139 strains in China.

    Science.gov (United States)

    Wang, Ruibai; Yu, Dong; Zhu, Lianhui; Li, Jie; Yue, Junjie; Kan, Biao

    2015-03-01

    Vibrio cholerae serogroup O139 emerged in 1992 and is one of two major serogroups to have caused cholera epidemics. After 1998, serious multidrug-resistant (MDR) O139 strains quickly became common in China, showing a multidrug resistance profile to eight antibiotics. It is a great threat to public health, and elucidation of its mechanisms of resistance will provide a helpful guide for the clinical treatment and prevention of cholera. In this study, mega-plasmids from MDR V. cholerae O139 strains were identified by pulsed-field gel electrophoresis (PFGE) without enzyme digestion. One plasmid was isolated and sequenced, belonging to the IncA/C family. Ten antibiotic resistance genes were found in the MDR regions, including a blaTEM-20 gene, and these genes endowed the host with resistance to seven antibiotics. This kind of plasmid was positive in 71.2% (198/278) of toxigenic O139 strains, and the rate of plasmid positivity was consistent with the yearly change in MDR rates of these strains. This study reveals an important role of the IncA/C family plasmid in the spread of multiple antibiotic resistance of epidemic V. cholerae serogroup O139 strains, which has recombined with plasmids from different bacterial species and transferred among V. cholerae strains.

  11. Rapid detection by multiplex PCR of Genomic Islands, prophages and Integrative Conjugative Elements in V. cholerae 7th pandemic variants.

    Science.gov (United States)

    Spagnoletti, Matteo; Ceccarelli, Daniela; Colombo, Mauro M

    2012-01-01

    Vibrio cholerae poses a threat to human health, and new epidemic variants have been reported so far. Seventh pandemic V. cholerae strains are characterized by highly related genomic sequences but can be discriminated by a large set of Genomic Islands, phages and Integrative Conjugative Elements. Classical serotyping and biotyping methods do not easily discriminate among new variants arising worldwide, therefore the establishment of new methods for their identification is required. We developed a multiplex PCR assay for the rapid detection of the major 7th pandemic variants of V. cholerae O1 and O139. Three specific genomic islands (GI-12, GI-14 and GI-15), two phages (Kappa and TLC), Vibrio Seventh Pandemic Island 2 (VSP-II), and the ICEs of the SXT/R391 family were selected as targets of our multiplex PCR based on a comparative genomic approach. The optimization and specificity of the multiplex PCR was assessed on 5 V. cholerae 7th pandemic reference strains, and other 34 V. cholerae strains from various epidemic events were analyzed to validate the reliability of our method. This assay had sufficient specificity to identify twelve different V. cholerae genetic profiles, and therefore has the potential to be used as a rapid screening method.

  12. Naturally Occurring IgG Antibodies Provide Innate Protection against Vibrio cholerae Bacteremia by Recognition of the Outer Membrane Protein U.

    Science.gov (United States)

    Aung, Kyaw Min; Sjöström, Annika E; von Pawel-Rammingen, Ulrich; Riesbeck, Kristian; Uhlin, Bernt Eric; Wai, Sun Nyunt

    2016-01-01

    Cholera epidemics are caused by Vibrio cholerae serogroups O1 and O139, whereas strains collectively known as non-O1/non-O139 V. cholerae are found in cases of extraintestinal infections and bacteremia. The mechanisms and factors influencing the occurrence of bacteremia and survival of V. cholerae in normal human serum have remained unclear. We found that naturally occurring IgG recognizing V. cholerae outer membrane protein U (OmpU) mediates a serum-killing effect in a complement C1q-dependent manner. Moreover, outer membrane vesicles (OMVs) containing OmpU caused enhanced survival of highly serum-sensitive classical V. cholerae in a dose-dependent manner. OMVs from wild-type and ompU mutant V. cholerae thereby provided a novel means to verify by extracellular transcomplementation the involvement of OmpU. Our data conclusively indicate that loss, or reduced expression, of OmpU imparts resistance to V. cholerae towards serum killing. We propose that the difference in OmpU protein levels is a plausible reason for differences in serum resistance and the ability to cause bacteremia observed among V. cholerae biotypes. Our findings provide a new perspective on how naturally occurring antibodies, perhaps induced by members of the microbiome, may play a role in the recognition of pathogens and the provocation of innate immune defense against bacteremia.

  13. Development of lipopolysaccharide-mimicking peptides and their immunoprotectivity against Vibrio cholerae serogroup O1.

    Science.gov (United States)

    Mohammad Pour Ghazi, Fatemeh; Gargari, Seyed Latif Mousavi

    2016-11-01

    Vibrio cholerae serogroup O1 is the main causative agent of cholera diseases defined by life threatening rice watery diarrhea. Cholera routine vaccination has failed in controlling epidemics in developing countries because of their hard and expensive production. In this study, our aim was to investigate phage displayed mimotopes that could mimic V. cholerae lipopolysaccharide (LPS). Although LPS of Vibrio, as an endotoxin, can stimulate the immune system, thereby making it a suitable candidate for cholera vaccine, its toxicity remains as a main problem. Phage particles displaying 12 amino acid peptides were selected from phage library mimicking the antigenic epitopes of LPS from vibrio. The screening was carried out using single-domain antibody fragment VHH against LPS as target through three rounds of selection. Three clones with highest affinity to VHH were selected. To find out a new and efficient vaccine against cholera, these three phage particles containing high-affinity peptides were administered to mice to investigate the active and passive immunity. Out of 20 particles, three showed the highest affinity toward VHH. ELISA was carried out with immunized mice sera using LPS and three selected phages particles individually. ETEC, Shigella sonnei, and clinical isolates were used as bacterial targets. These three selected phages (individually or in combination) could stimulate mice immune system producing active and passive immunity. The mice immunized with phage particles could protect about 14 LD50 of V. cholerae. In conclusion, these peptides are mimicking LPS and can potentially act as vaccine candidates against V. cholerae. Copyright © 2016 European Peptide Society and John Wiley & Sons, Ltd.

  14. Flexibility of oral cholera vaccine dosing-a randomized controlled trial measuring immune responses following alternative vaccination schedules in a cholera hyper-endemic zone.

    Directory of Open Access Journals (Sweden)

    Suman Kanungo

    2015-03-01

    Full Text Available BACKGROUND: A bivalent killed whole cell oral cholera vaccine has been found to be safe and efficacious for five years in the cholera endemic setting of Kolkata, India, when given in a two dose schedule, two weeks apart. A randomized controlled trial revealed that the immune response was not significantly increased following the second dose compared to that after the first dose. We aimed to evaluate the impact of an extended four week dosing schedule on vibriocidal response. METHODOLOGY/PRINCIPAL FINDINGS: In this double blind randomized controlled non-inferiority trial, 356 Indian, non-pregnant residents aged 1 year or older were randomized to receive two doses of oral cholera vaccine at 14 and 28 day intervals. We compared vibriocidal immune responses between these schedules. Among adults, no significant differences were noted when comparing the rates of seroconversion for V. cholerae O1 Inaba following two dose regimens administered at a 14 day interval (55% vs the 28 day interval (58%. Similarly, no differences in seroconversion were demonstrated in children comparing the 14 (80% and 28 day intervals (77%. Following 14 and 28 day dosing intervals, vibriocidal response rates against V. cholerae O1 Ogawa were 45% and 49% in adults and 73% and 72% in children respectively. Responses were lower for V. cholerae O139, but similar between dosing schedules for adults (20%, 20% and children (28%, 20%. CONCLUSIONS/SIGNIFICANCE: Comparable immune responses and safety profiles between the two dosing schedules support the option for increased flexibility of current OCV dosing. Further operational research using a longer dosing regimen will provide answers to improve implementation and delivery of cholera vaccination in endemic and epidemic outbreak scenarios.

  15. Comparative genome analysis of VSP-II and SNPs reveals heterogenic variation in contemporary strains of Vibrio cholerae O1 isolated from cholera patients in Kolkata, India.

    Science.gov (United States)

    Imamura, Daisuke; Morita, Masatomo; Sekizuka, Tsuyoshi; Mizuno, Tamaki; Takemura, Taichiro; Yamashiro, Tetsu; Chowdhury, Goutam; Pazhani, Gururaja P; Mukhopadhyay, Asish K; Ramamurthy, Thandavarayan; Miyoshi, Shin-Ichi; Kuroda, Makoto; Shinoda, Sumio; Ohnishi, Makoto

    2017-02-13

    Cholera is an acute diarrheal disease and a major public health problem in many developing countries in Asia, Africa, and Latin America. Since the Bay of Bengal is considered the epicenter for the seventh cholera pandemic, it is important to understand the genetic dynamism of Vibrio cholerae from Kolkata, as a representative of the Bengal region. We analyzed whole genome sequence data of V. cholerae O1 isolated from cholera patients in Kolkata, India, from 2007 to 2014 and identified the heterogeneous genomic region in these strains. In addition, we carried out a phylogenetic analysis based on the whole genome single nucleotide polymorphisms to determine the genetic lineage of strains in Kolkata. This analysis revealed the heterogeneity of the Vibrio seventh pandemic island (VSP)-II in Kolkata strains. The ctxB genotype was also heterogeneous and was highly related to VSP-II types. In addition, phylogenetic analysis revealed the shifts in predominant strains in Kolkata. Two distinct lineages, 1 and 2, were found between 2007 and 2010. However, the proportion changed markedly in 2010 and lineage 2 strains were predominant thereafter. Lineage 2 can be divided into four sublineages, I, II, III and IV. The results of this study indicate that lineages 1 and 2-I were concurrently prevalent between 2007 and 2009, and lineage 2-III observed in 2010, followed by the predominance of lineage 2-IV in 2011 and continued until 2014. Our findings demonstrate that the epidemic of cholera in Kolkata was caused by several distinct strains that have been constantly changing within the genetic lineages of V. cholerae O1 in recent years.

  16. Isolation and characterization of protective anti-LPS nanobody against V. cholerae O1 recognizing Inaba and Ogawa serotypes.

    Science.gov (United States)

    Ebrahimizadeh, Walead; Mousavi Gargari, Seyedlatif; Rajabibazl, Masoumeh; Safaee Ardekani, Leila; Zare, Hamed; Bakherad, Hamid

    2013-05-01

    Vibrio cholerae is considered one of the major health threats in developing countries. Lack of efficient vaccine, short incubating time of the disease, and bacterium ability to survive in aquatic environment have made cholera one of the most epidemic diseases yet known. The lipopolysaccharide is one of the bacterium key antigens used to classify V. cholerae into 206 serogroups. V. cholerae serogroup O1 is a causative agent of all cholera pandemics. Research has shown that anti-lipopolysaccharide (LPS) antibodies could provide protective immunity in cholera cases. In this research, we used N-terminal fragments of the camel's heavy-chain antibodies called VHH or nanobodies and produced a phagemid library. The obtained library was panned against V. cholerae O1 LPS, and four monoclonal nanobodies were isolated. Isolated nanobodies were tested in LPS ELISA and bacterial ELISA. The nanobody with the highest affinity toward the bacterium was used in an in vivo challenge and successfully neutralized the bacterium infection. The isolated nanobody showed high thermostability and proteolytic resistance in characterization tests.

  17. Chromosome Segregation in Vibrio cholerae

    OpenAIRE

    Ramachandran, R.; Jha, J.; Chattoraj, DK

    2014-01-01

    The study of chromosome segregation is currently one of the most exciting research frontiers in cell biology. In this review, we discuss our current knowledge of the chromosome segregation process in Vibrio cholerae, based primarily on findings from fluorescence microscopy experiments. This bacterium is of special interest because of its eukaryotic feature of having a divided genome, a feature shared with 10% of known bacteria. We also discuss how the segregation mechanisms of V. cholerae com...

  18. Distribution and molecular characteristics of Vibrio cholerae O1 El Tor isolates recovered in Guangdong Province, China, 1961-2013.

    Science.gov (United States)

    Li, Baisheng; Chen, Rongfeng; Wang, Duochun; Tan, Hailing; Ke, Bixia; He, Dongmei; Ke, Changwen; Zhang, Yonghui

    2016-01-01

    China's Guangdong Province is located along the same latitude as Kolkata, India and Dhaka, Bangladesh, and is also considered a source of epidemic cholera. However, molecular description and the genetic relationships between Vibrio cholerae O1 El Tor isolates in Guangdong remain unclear. In this study, 381 clinical V. cholerae O1 isolates recovered from cholera cases presenting in Guangdong between 1961 and 2013 were investigated by PCR, amplicon sequencing and pulsed-field gel electrophoresis (PFGE). During this time frame, four distinct epidemic periods (1-4) were observed based on the different dominant serotype leading its epidemic, correspond to years; or time periods from/to 1961-1969, 1978-1989, 1990-2000, 2001-2013, respectively. Molecular analysis of representative isolates indicated that a single dominating clone was associated with each epidemic stage. All isolates from periods 1 and 2 carried the typical El Tor ctxB; this allele was displaced by classical ctxB beginning in 1993. However all isolates carried the El Tor-specific toxin-coregulated pili subunit A (tcpA). Isolates were grouped into five clusters on the basis of Not I enzyme digested PFGE, and the first four clusters were associated with specific periods, cluster I (period 1), II (period 3), III (period 2) and IV (period 4), respectively. While cluster V consisted of isolates from all four epidemic periods, but was most heterogeneous in appearance. Our data indicate genetic variations that shape the relationship among emerging isolates of V. cholerae O1 in Guangdong Province contribute to the 7th global pandemic.

  19. The Role Of The Aquatic Reservoir In Long-Term Cholera Dynamics

    Science.gov (United States)

    Righetto, L.; Bertuzzo, E.; Mari, L.; Casagrandi, R.; Gatto, M.; Rodriguez-Iturbe, I.; Rinaldo, A.

    2010-12-01

    A novel class of models for Cholera epidemics is described, where the dynamics of the water volume defining the aquatic reservoir of pathogens accessible to a given local community is explicitly considered. In particular, we study how the hydrologic dynamics affects the fluctuations of Vibrio cholerae concentrations in the local reservoir thus driving the evolution of the epidemics at local scales. The novelty of the approach lies in the coupling of an input-output hydrologic dynamics with an epidemiological model which tracks susceptibles, infected and recovered individuals, jointly with bacterial concentrations. Reservoir volumes fluctuating over time indeed control the concentrations of Vibrio cholerae: one of the most common mechanisms of cholera insurgence in endemic regions is, in fact, spring water drought. Here we consider a spatially implicit framework, in order to distinguish the contribution of local dynamics to cholera insurgence at community scales. Our main goal is to investigate the relation between yearly water volume oscillations and long-term trajectories of cholera infection. To this end we take into account a monsoonal fluctuation, with one summer peak in the water input. This simple addition allows us to derive relationships between hydrologic regimes and the epidemiological behavior of the system. Since most of the numerical values of model parameters can be reliably drawn from the literature on the subject, this method allows us to concentrate on significant but still uncertain quantities and associate different ranges of parameter values to different model behaviors which need to be clearly differentiated . Our analysis provides information on the characteristic value of the model parameters for real case studies, comparing simulations and real time series. The model can be very useful in particular for the inference of the intensity of the disease, expressed in terms of the basic reproductive number.

  20. [Epidemics and colonial medicine in West Africa].

    Science.gov (United States)

    Becker, C; Collignon, R

    1998-01-01

    We studied colonial medical practices and health policies in West Africa, which has faced endemics and epidemics that have affected entire societies. We found that attempts to centralize the organization of colonial medicine, which began in the late 19th Century, were limited until the end of World War I. Research and control programs expanded after 1920, concentrating on epidemics, but largely ignoring many major health problems, such as measles, whooping cough and malnutrition, the importance of which were not recognized until after World War II. This appraisal of colonial medicine highlights the difficulties of introducing modern medicine and its ideas into African societies. There have been various social reactions, resulting in the current duality in which traditional and modern medicine coexist.

  1. Non-O1 Vibrio cholerae in Thailand: homology with cloned cholera toxin genes.

    OpenAIRE

    Hanchalay, S; Seriwatana, J; Echeverria, P.; Holmgren, J.; Tirapat, C.; Moseley, S L; Taylor, D N

    1985-01-01

    We examined 281 non-O1 Vibrio cholerae isolates from Thailand for homology with genes coding for cholera toxin. Five isolates from environmental sources were homologous with the cholera toxin gene probe and produced both the A and B subunits of cholera toxin.

  2. Urban Cholera and Water Sustainability Challenges under Climatic and Anthropogenic Change

    Science.gov (United States)

    Akanda, A. S.; Jutla, A.; Huq, A.; Faruque, A. G.; Colwell, R. R.

    2013-12-01

    The last three decades of surveillance data shows a drastic increase of cholera prevalence in the largest cholera-endemic city of the world - Dhaka, Bangladesh. Emerging megacities in the developing world, especially those located in coastal regions of the tropics remain vulnerable to similar. However, there has not been any systematic study on linking the long-term disease trends with changes in related climatic, environmental, or societal variables. Here, we analyze the 30-year dynamics of urban cholera prevalence in Dhaka with changes in climatic or societal factors: regional hydrology, flooding, water usage, changes in distribution systems, population growth and density in urban settlements, as well as shifting climate patterns. An interesting change is observed in the seasonal trends of cholera incidence; while an endemic upward trend is seen in the dry season, the post-monsoon trend seem to be more epidemic in nature. Evidence points to growing urbanization and rising population in unplanned settlements that have negligible to poor water and sanitation systems compounded by increasing frequency of record flood events. Growing water scarcity in the dry season and lack of sustainable water and sanitation infrastructure for urban settlements have increased endemicity of spring outbreaks, while record flood events and prolonged post-monsoon inundation have contributed to increased epidemic outbreaks in fall. We analyze our findings with the World Health Organization recommended guidelines and investigate water sustainability challenges in the context of climatic and anthropogenic changes in the region.

  3. Toxin-coregulated pilus-loaded microparticles as a vaccine against Vibrio cholerae O139

    Institute of Scientific and Technical Information of China (English)

    杜艳; 贾文祥; 刘莉

    2004-01-01

    @@ The cholera epidemics is an important public health problem in many developing countries. Highly effective and preventive vaccines against cholera are under investigation as alternatives to the one available presently. Much of the vaccine research focuses on colonization factors. Colonization of a human by the Vibrio cholerae (V. cholerae Ol strain is mediated by toxin-coregulated pilus (TCP), 1 which was shown to play a role in the infant mouse cholera model and subsequently in human volunteers. 2 TCP-loaded vaccines could potentially provide cross-protection among experimental strains. Data have indicated that poly (D,L-lactide)-polyethylene glycol copolymer (PELA)microparticles loaded antigens were strongly immunogenic, 3 and that these microparticles served as an effective delivery system for a single dose of vaccine. 4Microparticle formulation could represent the next generation of vaccines, as they are highly effective at delivery of vaccines, thus requiring fewer doses. 5 We prepared PELA microparticles loaded with TCP for testing as a vaccine; their targeting distributions were identified and related immune responses were analyzed.

  4. Why treatment centres failed to prevent cholera deaths among Rwandan refugees in Goma, Zaire.

    Science.gov (United States)

    Siddique, A K; Salam, A; Islam, M S; Akram, K; Majumdar, R N; Zaman, K; Fronczak, N; Laston, S

    1995-02-11

    In July, 1994, in one of the worst cholera outbreaks in recent times, an estimated 12,000 Rwandan refugees died in Goma in eastern Zaire. The Vibrio cholerae strains were resistant to tetracycline and doxycycline, the commonly used drugs for cholera treatment. Despite the efforts of international organisations, which provided medical relief by establishing treatment centres in Goma, mortality from the disease was much higher than expected. In the area of Muganga camp, which had the largest concentration of refugees and where most of the medical aid organisations were active, the highest reported case-fatality ratio for a single day was 48%. The slow rate of rehydration, inadequate use of oral rehydration therapy, use of inappropriate intravenous fluids, and inadequate experience of health workers in management of severe cholera are thought to be some of the factors associated with the failure to prevent so many deaths during the epidemic. In one of the temporary treatment centres with the worst case-fatality record, our team showed that improvement of these factors could increase the odds of survival of cholera patients even in a disaster setting.

  5. Scanning the landscape of genome architecture of non-O1 and non-O139 Vibrio cholerae by whole genome mapping reveals extensive population genetic diversity.

    Science.gov (United States)

    Chapman, Carol; Henry, Matthew; Bishop-Lilly, Kimberly A; Awosika, Joy; Briska, Adam; Ptashkin, Ryan N; Wagner, Trevor; Rajanna, Chythanya; Tsang, Hsinyi; Johnson, Shannon L; Mokashi, Vishwesh P; Chain, Patrick S G; Sozhamannan, Shanmuga

    2015-01-01

    Historically, cholera outbreaks have been linked to V. cholerae O1 serogroup strains or its derivatives of the O37 and O139 serogroups. A genomic study on the 2010 Haiti cholera outbreak strains highlighted the putative role of non O1/non-O139 V. cholerae in causing cholera and the lack of genomic sequences of such strains from around the world. Here we address these gaps by scanning a global collection of V. cholerae strains as a first step towards understanding the population genetic diversity and epidemic potential of non O1/non-O139 strains. Whole Genome Mapping (Optical Mapping) based bar coding produces a high resolution, ordered restriction map, depicting a complete view of the unique chromosomal architecture of an organism. To assess the genomic diversity of non-O1/non-O139 V. cholerae, we applied a Whole Genome Mapping strategy on a well-defined and geographically and temporally diverse strain collection, the Sakazaki serogroup type strains. Whole Genome Map data on 91 of the 206 serogroup type strains support the hypothesis that V. cholerae has an unprecedented genetic and genomic structural diversity. Interestingly, we discovered chromosomal fusions in two unusual strains that possess a single chromosome instead of the two chromosomes usually found in V. cholerae. We also found pervasive chromosomal rearrangements such as duplications and indels in many strains. The majority of Vibrio genome sequences currently in public databases are unfinished draft sequences. The Whole Genome Mapping approach presented here enables rapid screening of large strain collections to capture genomic complexities that would not have been otherwise revealed by unfinished draft genome sequencing and thus aids in assembling and finishing draft sequences of complex genomes. Furthermore, Whole Genome Mapping allows for prediction of novel V. cholerae non-O1/non-O139 strains that may have the potential to cause future cholera outbreaks.

  6. Binding of cholera toxin to Giardia lamblia.

    OpenAIRE

    McCardell, B. A.; Madden, J M; Stanfield, J T; Tall, B D; Stephens, M. J.

    1987-01-01

    Binding of cholera toxin to Giardia lamblia was demonstrated by two slightly different methods: an immunofluorescence technique using antibody to cholera toxin and anti-rabbit immunoglobulin G conjugated to fluorescein isothiocyanate, and a one-step fluorescence method in which G. lamblia was incubated with the B subunit of cholera toxin conjugated to fluorescein isothiocyanate.

  7. Agent-based modelling of cholera diffusion

    NARCIS (Netherlands)

    Augustijn, Ellen-Wien; Doldersum, Tom; Useya, Juliana; Augustijn, Denie

    2016-01-01

    This paper introduces a spatially explicit agent-based simulation model for micro-scale cholera diffusion. The model simulates both an environmental reservoir of naturally occurring V. cholerae bacteria and hyperinfectious V. cholerae. Objective of the research is to test if runoff from open refuse

  8. Agent-based modelling of cholera diffusion

    NARCIS (Netherlands)

    Augustijn, Ellen-Wien; Doldersum, Tom; Useya, Juliana; Augustijn, Denie

    2016-01-01

    This paper introduces a spatially explicit agent-based simulation model for micro-scale cholera diffusion. The model simulates both an environmental reservoir of naturally occurring V.cholerae bacteria and hyperinfectious V. cholerae. Objective of the research is to test if runoff from open refuse d

  9. Revisiting Cholera-Climate Teleconnections in the Native Homeland: ENSO and other Extremes through the Regional Hydroclimatic Drivers

    Science.gov (United States)

    Akanda, A. S.; Jutla, A.; Huq, A.; Colwell, R. R.

    2014-12-01

    Cholera is a global disease, with significantly large outbreaks occurring since the 1990s, notably in Sub-Saharan Africa and South Asia and recently in Haiti, in the Caribbean. Critical knowledge gaps remain in the understanding of the annual recurrence in endemic areas and the nature of epidemic outbreaks, especially those that follow extreme hydroclimatic events. Teleconnections with large-scale climate phenomena affecting regional scale hydroclimatic drivers of cholera dynamics remain largely unexplained. For centuries, the Bengal delta region has been strongly influenced by the asymmetric availability of water in the rivers Ganges and the Brahmaputra. As these two major rivers are known to have strong contrasting affects on local cholera dynamics in the region, we argue that the role of El Nino-Southern Oscillation (ENSO), Indian Ocean Dipole (IOD), or other phenomena needs to be interpreted in the context of the seasonal role of individual rivers and subsequent impact on local environmental processes, not as a teleconnection having a remote and unified effect. We present a modified hypothesis that the influences of large-scale climate phenomena such as ENSO and IOD on Bengal cholera can be explicitly identified and incorporated through regional scale hydroclimatic drivers. Here, we provide an analytical review of the literature addressing cholera and climate linkages and present hypotheses, based on recent evidence, and quantification on the role of regional scale hydroclimatic drivers of cholera. We argue that the seasonal changes in precipitation and temperature, and resulting river discharge in the GBM basin region during ENSO and IOD events have a dominant combined effect on the endemic persistence and the epidemic vulnerability to cholera outbreaks in spring and fall seasons, respectively, that is stronger than the effect of localized hydrological and socio-economic sensitivities in Bangladesh. In addition, systematic identification of underlying seasonal

  10. Molecular epidemiology of Vibrio cholerae associated with flood in Brahamputra River valley, Assam, India.

    Science.gov (United States)

    Bhuyan, Soubhagya K; Vairale, Mohan G; Arya, Neha; Yadav, Priti; Veer, Vijay; Singh, Lokendra; Yadava, Pramod K; Kumar, Pramod

    2016-06-01

    Cholera is often caused when drinking water is contaminated through environmental sources. In recent years, the drastic cholera epidemics in Odisha (2007) and Haiti (2010) were associated with natural disasters (flood and Earthquake). Almost every year the state of Assam India witnesses flood in Brahamputra River valley during reversal of wind system (monsoon). This is often followed by outbreak of diarrheal diseases including cholera. Beside the incidence of cholera outbreaks, there is lack of experimental evidence for prevalence of the bacterium in aquatic environment and its association with cholera during/after flood in the state. A molecular surveillance during 2012-14 was carried out to study prevalence, strain differentiation, and clonality of Vibrio cholerae in inland aquatic reservoirs flooded by Brahamputra River in Assam. Water samples were collected, filtered, enriched in alkaline peptone water followed by selective culturing on thiosulfate bile salt sucrose agar. Environmental isolates were identified as V. cholerae, based on biochemical assays followed by sero-grouping and detailed molecular characterization. The incidence of the presence of the bacterium in potable water sources was higher after flood. Except one O1 isolate, all of the strains were broadly grouped under non-O1/non-O139 whereas some of them did have cholera toxin (CT). Surprisingly, we have noticed Haitian ctxB in two non-O1/non-O139 strains. MLST analyses based on pyrH, recA and rpoA genes revealed clonality in the environmental strains. The isolates showed varying degree of antimicrobial resistance including tetracycline and ciprofloxacin. The strains harbored the genetic elements SXT constins and integrons responsible for multidrug resistance. Genetic characterization is useful as phenotypic characters alone have proven to be unsatisfactory for strain discrimination. An assurance to safe drinking water, sanitation and monitoring of the aquatic reservoirs is of utmost importance for

  11. [German nurses during the First World War].

    Science.gov (United States)

    Wagner, Franz

    2014-06-01

    Nurses from several German organisations participated in the First World War. For the most part, they did not work on the frontline but at the rear, in hospital trains, hospitals or refugee camps. They cared forwounded soldiers and faced epidemics of infectious diseases. The journal of the national association of nurses, which continued to be published during the war, provides a snapshot of their concerns and their questioning regarding the profession and its evolution.

  12. Vibriosis, not cholera: toxigenic Vibrio cholerae non-O1, non-O139 infections in the United States, 1984-2014.

    Science.gov (United States)

    Crowe, S J; Newton, A E; Gould, L H; Parsons, M B; Stroika, S; Bopp, C A; Freeman, M; Greene, K; Mahon, B E

    2016-11-01

    Toxigenic strains of Vibrio cholerae serogroups O1 and O139 have caused cholera epidemics, but other serogroups - such as O75 or O141 - can also produce cholera toxin and cause severe watery diarrhoea similar to cholera. We describe 31 years of surveillance for toxigenic non-O1, non-O139 infections in the United States and map these infections to the state where the exposure probably originated. While serogroups O75 and O141 are closely related pathogens, they differ in how and where they infect people. Oysters were the main vehicle for O75 infection. The vehicles for O141 infection include oysters, clams, and freshwater in lakes and rivers. The patients infected with serogroup O75 who had food traceback information available ate raw oysters from Florida. Patients infected with O141 ate oysters from Florida and clams from New Jersey, and those who only reported being exposed to freshwater were exposed in Arizona, Michigan, Missouri, and Texas. Improving the safety of oysters, specifically, should help prevent future illnesses from these toxigenic strains and similar pathogenic Vibrio species. Post-harvest processing of raw oysters, such as individual quick freezing, heat-cool pasteurization, and high hydrostatic pressurization, should be considered.

  13. Chromosome segregation in Vibrio cholerae.

    Science.gov (United States)

    Ramachandran, Revathy; Jha, Jyoti; Chattoraj, Dhruba K

    2014-01-01

    The study of chromosome segregation is currently one of the most exciting research frontiers in cell biology. In this review, we discuss our current knowledge of the chromosome segregation process in Vibrio cholerae, based primarily on findings from fluorescence microscopy experiments. This bacterium is of special interest because of its eukaryotic feature of having a divided genome, a feature shared with 10% of known bacteria. We also discuss how the segregation mechanisms of V. cholerae compare with those in other bacteria, and highlight some of the remaining questions regarding the process of bacterial chromosome segregation.

  14. Epidemiology of cholera in the Philippines.

    Directory of Open Access Journals (Sweden)

    Anna Lena Lopez

    2015-01-01

    Full Text Available Despite being a cholera-endemic country, data on cholera in the Philippines remain sparse. Knowing the areas where cholera is known to occur and the factors that lead to its occurrence will assist in planning preventive measures and disaster mitigation.Using sentinel surveillance data, PubMed and ProMED searches covering information from 2008-2013 and event-based surveillance reports from 2010-2013, we assessed the epidemiology of cholera in the Philippines. Using spatial log regression, we assessed the role of water, sanitation and population density on the incidence of cholera.We identified 12 articles from ProMED and none from PubMed that reported on cholera in the Philippines from 2008 to 2013. Data from ProMed and surveillance revealed 42,071 suspected and confirmed cholera cases reported from 2008 to 2013, among which only 5,006 were confirmed. 38 (47% of 81 provinces and metropolitan regions reported at least one confirmed case of cholera and 32 (40% reported at least one suspected case. The overall case fatality ratio in sentinel sites was 0.62%, but was 2% in outbreaks. All age groups were affected. Using both confirmed and suspected cholera cases, the average annual incidence in 2010-2013 was 9.1 per 100,000 population. Poor access to improved sanitation was consistently associated with higher cholera incidence. Paradoxically, access to improved water sources was associated with higher cholera incidence using both suspected and confirmed cholera data sources. This finding may have been due to the breakdown in the infrastructure and non-chlorination of water supplies, emphasizing the need to maintain public water systems.Our findings confirm that cholera affects a large proportion of the provinces in the country. Identifying areas most at risk for cholera will support the development and implementation of policies to minimize the morbidity and mortality due to this disease.

  15. [Sanitary and epidemiological supply for the Russian Army during the First World War (1914-1918)].

    Science.gov (United States)

    gorelova, L E; Loktev, A E

    2014-02-01

    At the beginning of the First World War the most typical diseases in the Russian Army were typhoid, typhus, diphtheria, cholera, smallpox and other infectious diseases. At the beginning of the First World War the level of infectious morbidity was significantly low, but further increased and pandemic risk arose. Servicemen were mostly ill with typhus, relapsing fever, flux, cholera, smallpox and typhoid. The highest mortality rate was registered in patients with cholera, typhus and typhoid. According the prewar deployment program of the Russian Army anti-epidemiologic facilities were established. By the end of war were established 110 sanitary-and-hygienic and 90 disinfection units. However, organization of anti-epidemiologic security was unsatisfactory. Due to lack of specialists and equipment anti-epidemiologic facilities of units were under strength. Commanders of sanitary units and sanitary service had not enough resources for operational service in the Forces and facilities of rear area.

  16. Spatial clustering in the spatio-temporal dynamics of endemic cholera

    Directory of Open Access Journals (Sweden)

    Emch Michael

    2010-03-01

    Full Text Available Abstract Background The spatio-temporal patterns of infectious diseases that are environmentally driven reflect the combined effects of transmission dynamics and environmental heterogeneity. They contain important information on different routes of transmission, including the role of environmental reservoirs. Consideration of the spatial component in infectious disease dynamics has led to insights on the propagation of fronts at the level of counties in rabies in the US, and the metapopulation behavior at the level of cities in childhood diseases such as measles in the UK, both at relatively coarse scales. As epidemiological data on individual infections become available, spatio-temporal patterns can be examined at higher resolutions. Methods The extensive spatio-temporal data set for cholera in Matlab, Bangladesh, maps the individual location of cases from 1983 to 2003. This unique record allows us to examine the spatial structure of cholera outbreaks, to address the role of primary transmission, occurring from an aquatic reservoir to the human host, and that of secondary transmission, involving a feedback between current and past levels of infection. We use Ripley's K and L indices and bootstrapping methods to evaluate the occurrence of spatial clustering in the cases during outbreaks using different temporal windows. The spatial location of cases was also confronted against the spatial location of water sources. Results Spatial clustering of cholera cases was detected at different temporal and spatial scales. Cases relative to water sources also exhibit spatial clustering. Conclusions The clustering of cases supports an important role of secondary transmission in the dynamics of cholera epidemics in Matlab, Bangladesh. The spatial clustering of cases relative to water sources, and its timing, suggests an effective role of water reservoirs during the onset of cholera outbreaks. Once primary transmission has initiated an outbreak, secondary

  17. The Curse of Frybread: The Diabetes Epidemic in Indian Country.

    Science.gov (United States)

    Hill, Mary Anne

    1997-01-01

    Diabetes among American Indians has become epidemic since World War II, due to dietary changes and a possible genetic predisposition. Innovative community-based programs teach prevention and management of diabetes through exercise, diet, and blood sugar monitoring. Traditional American Indian lifestyles and diets prevented diabetes. Sidebars…

  18. Maladi Kolera PSA (:60) (Cholera)

    Centers for Disease Control (CDC) Podcasts

    2010-02-18

    This is an important public health announcement about ways you can prevent the spread of cholera. Language: Haitian Creole.  Created: 2/18/2010 by Centers for Disease Control and Prevention (CDC).   Date Released: 2/18/2010.

  19. Cholera in the United States

    Centers for Disease Control (CDC) Podcasts

    2011-11-08

    Anna Newton, Surveillance Epidemiologist at CDC, discusses cholera that was brought to the United States during an outbreak in Haiti and the Dominican Republic (Hispaniola).  Created: 11/8/2011 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).   Date Released: 11/8/2011.

  20. Dynamics in genome evolution of Vibrio cholerae.

    Science.gov (United States)

    Banerjee, Rachana; Das, Bhabatosh; Balakrish Nair, G; Basak, Surajit

    2014-04-01

    Vibrio cholerae, the etiological agent of the acute secretary diarrheal disease cholera, is still a major public health concern in developing countries. In former centuries cholera was a permanent threat even to the highly developed populations of Europe, North America, and the northern part of Asia. Extensive studies on the cholera bug over more than a century have made significant advances in our understanding of the disease and ways of treating patients. V. cholerae has more than 200 serogroups, but only few serogroups have caused disease on a worldwide scale. Until the present, the evolutionary relationship of these pandemic causing serogroups was not clear. In the last decades, we have witnessed a shift involving genetically and phenotypically varied pandemic clones of V. cholerae in Asia and Africa. The exponential knowledge on the genome of several representatives V. cholerae strains has been used to identify and analyze the key determinants for rapid evolution of cholera pathogen. Recent comparative genomic studies have identified the presence of various integrative mobile genetic elements (IMGEs) in V. cholerae genome, which can be used as a marker of differentiation of all seventh pandemic clones with very similar core genome. This review attempts to bring together some of the important researches in recent times that have contributed towards understanding the genetics, epidemiology and evolution of toxigenic V. cholerae strains.

  1. Modeling Epidemic Network Failures

    DEFF Research Database (Denmark)

    Ruepp, Sarah Renée; Fagertun, Anna Manolova

    2013-01-01

    This paper presents the implementation of a failure propagation model for transport networks when multiple failures occur resulting in an epidemic. We model the Susceptible Infected Disabled (SID) epidemic model and validate it by comparing it to analytical solutions. Furthermore, we evaluate...... the SID model’s behavior and impact on the network performance, as well as the severity of the infection spreading. The simulations are carried out in OPNET Modeler. The model provides an important input to epidemic connection recovery mechanisms, and can due to its flexibility and versatility be used...... to evaluate multiple epidemic scenarios in various network types....

  2. Spatial epidemiological techniques in cholera mapping and analysis towards a local scale predictive modelling

    Science.gov (United States)

    Rasam, A. R. A.; Ghazali, R.; Noor, A. M. M.; Mohd, W. M. N. W.; Hamid, J. R. A.; Bazlan, M. J.; Ahmad, N.

    2014-02-01

    Cholera spatial epidemiology is the study of the spread and control of the disease spatial pattern and epidemics. Previous studies have shown that multi-factorial causation such as human behaviour, ecology and other infectious risk factors influence the disease outbreaks. Thus, understanding spatial pattern and possible interrelationship factors of the outbreaks are crucial to be explored an in-depth study. This study focuses on the integration of geographical information system (GIS) and epidemiological techniques in exploratory analyzing the cholera spatial pattern and distribution in the selected district of Sabah. Spatial Statistic and Pattern tools in ArcGIS and Microsoft Excel software were utilized to map and analyze the reported cholera cases and other data used. Meanwhile, cohort study in epidemiological technique was applied to investigate multiple outcomes of the disease exposure. The general spatial pattern of cholera was highly clustered showed the disease spread easily at a place or person to others especially 1500 meters from the infected person and locations. Although the cholera outbreaks in the districts are not critical, it could be endemic at the crowded areas, unhygienic environment, and close to contaminated water. It was also strongly believed that the coastal water of the study areas has possible relationship with the cholera transmission and phytoplankton bloom since the areas recorded higher cases. GIS demonstrates a vital spatial epidemiological technique in determining the distribution pattern and elucidating the hypotheses generating of the disease. The next research would be applying some advanced geo-analysis methods and other disease risk factors for producing a significant a local scale predictive risk model of the disease in Malaysia.

  3. Haiti's progress in achieving its 10-year plan to eliminate cholera: hidden sickness cannot be cured.

    Science.gov (United States)

    Koski-Karell, Victoria; Farmer, Paul E; Isaac, Benito; Campa, Elizabeth M; Viaud, Loune; Namphy, Paul C; Ternier, Ralph; Ivers, Louise C

    2016-01-01

    Since the beginning of the cholera epidemic in Haiti 5 years ago, the prevalence of this deadly water-borne disease has fallen far below the initial rates registered during its explosive outset. However, cholera continues to cause extensive suffering and needless deaths across the country, particularly among the poor. The urgent need to eliminate transmission of cholera persists: compared to the same period in 2014, the first 4 months of 2015 saw three times the number of cholera cases. Drawing upon epidemiology, clinical work (and clinical knowledge), policy, ecology, and political economy, and informed by ethnographic data collected in a rural area of Haiti called Bocozel, this paper evaluates the progress of the nation's 10-year Plan for the Elimination of Cholera. Bocozel is a rice-producing region where most people live in extreme poverty. The irrigation network is decrepit, the land is prone to environmental shocks, fertilizer is not affordable, and the government's capacity to assist farmers is undermined by resource constraints. When peasants do have rice to sell, the price of domestically grown rice is twice that of US-imported rice. Canal water is not only used to irrigate thousands of acres of rice paddies and sustain livestock, but also to bathe, wash, and play, while water from wells, hand pumps, and the river is used for drinking, cooking, and bathing. Only one out of the three government-sponsored water treatment stations in the research area is still functional and utilized by those who can afford it. Latrines are scarce and often shared by up to 30 people; open defecation remains common. Structural vulnerabilities cut across all sectors - not just water, sanitation, health care, and education, but agriculture, environment, (global and local) commerce, transportation, and governance as well. These are among the hidden sicknesses that impede Haiti and its partners' capacity to eliminate cholera.

  4. Bukovina and the “Humdinger Plague” of the 19th Century: Cholera

    Directory of Open Access Journals (Sweden)

    Harieta Mareci-Sabol

    2014-12-01

    Full Text Available The issue of natural disasters and their impact on the population of Bukovina may represent a field of research for biologists and historians, demographers and sociologists. The nineteenth century was less auspicious in the history of the province that has experienced many harmful effects of destructive factors: from hostile weather conditions, to famine and epidemics. Population of Bukovina was not spared by the great waves of epidemics, and the quarantine measures were more or less effective in preventing the spread of diseases. A large number of people, mostly adults, fell victim to cholera. The aim of the article is to illustrate the impact of the epidemic – known as the “Humdinger plague” – on demographic and socio-cultural evolution of the province.

  5. [Service quality assurance by death analysis during the 2004 cholera outbreak in Douala].

    Science.gov (United States)

    Guévart, Edouard; Noeske, Jürgen; Mouangue, Antoine; Ekambi, Armand; Solle, Jérémie; Fouda, André Bita

    2006-01-01

    Morbidity and mortality conferences (MMC) are used today in most medical departments as a tool for quality assurance as well as an educational tool. We introduced MMC with regard to cholera lethality during the 2004 cholera outbreak in Douala. The Delegation of Public Health (DPH) in Douala, coordinating body for the combat against the epidemic, decided to open cholera treatment units (CTU) in fourteen hospitals, equally distributed over the town. The CTUs' personnel was retrained on diagnostic and treatment protocols, procedures to follow and on management tools. To assure the quality of services, a provincial supervision team was constituted for the close follow-up of the CTUs. The supervision team had two main tasks, i.e. on-the-job training of the personnel involved in the care of cholera patients and systematic meetings whenever a cholera death occurred during hospital stay in order to analyse the reasons behind the death. We communicate our experience with these systematic meetings inspired by the MMC and aiming at the analysis of cholera deaths in the CTUs. Immediately after a cholera death in one of the CTUs, a meeting was organised by a member of the supervision team, assisted by the entire CTU team. During the meeting, the patient's file was re-examined as were the decisions token, the actions undertaken by the personnel, and the difficulties met. Alternative decisions and actions were discussed and conclusions based on the lessons learned formulated. Of all meetings minutes were kept. A monthly provincial meeting, joining all CTU teams, was organized for discussion of the minutes, exchange of experiences, and, eventually, adapting of protocols, procedures, and management tools. Five thousand and twenty cholera patients were notified during an 8-months-period (January-August 2004), 69 (1.4%) of the patients died, amongst them 8 before the declaration of the epidemic and 4 before hospital admission. Eleven CTUs out of a total of 14 organised 15 meetings

  6. Actions of cholera toxin and the prevention and treatment of cholera

    Science.gov (United States)

    Holmgren, Jan

    1981-07-01

    The drastic intestinal secretion of fluid and electrolytes that is characteristic of cholera is the result of reasonably well understood cellular and biochemical actions of the toxin secreted by Vibrio cholerae. Based on this understanding it is possible to devise new techniques for the treatment and prophylaxis of cholera to complement those based on fluid replacement therapy and sanitation.

  7. Controlling endemic cholera with oral vaccines.

    Directory of Open Access Journals (Sweden)

    Ira M Longini

    2007-11-01

    Full Text Available BACKGROUND: Although advances in rehydration therapy have made cholera a treatable disease with low case-fatality in settings with appropriate medical care, cholera continues to impose considerable mortality in the world's most impoverished populations. Internationally licensed, killed whole-cell based oral cholera vaccines (OCVs have been available for over a decade, but have not been used for the control of cholera. Recently, these vaccines were shown to confer significant levels of herd protection, suggesting that the protective potential of these vaccines has been underestimated and that these vaccines may be highly effective in cholera control when deployed in mass immunization programs. We used a large-scale stochastic simulation model to investigate the possibility of controlling endemic cholera with OCVs. METHODS AND FINDINGS: We construct a large-scale, stochastic cholera transmission model of Matlab, Bangladesh. We find that cholera transmission could be controlled in endemic areas with 50% coverage with OCVs. At this level of coverage, the model predicts that there would be an 89% (95% confidence interval [CI] 72%-98% reduction in cholera cases among the unvaccinated, and a 93% (95% CI 82%-99% reduction overall in the entire population. Even a more modest coverage of 30% would result in a 76% (95% CI 44%-95% reduction in cholera incidence for the population area covered. For populations that have less natural immunity than the population of Matlab, 70% coverage would probably be necessary for cholera control, i.e., an annual incidence rate of < or = 1 case per 1,000 people in the population. CONCLUSIONS: Endemic cholera could be reduced to an annual incidence rate of < or = 1 case per 1,000 people in endemic areas with biennial vaccination with OCVs if coverage could reach 50%-70% depending on the level of prior immunity in the population. These vaccination efforts could be targeted with careful use of ecological data.

  8. WAR HORSES:

    DEFF Research Database (Denmark)

    War Horses: Helhesten and the Danish Avant-Garde During World War II This exhibition is the first to explore the history and significance of the accomplishments of Danish artists working during the Nazi occupation of their country (1940-45), who called themselves Helhesten, such as Ejler Bille...

  9. Serotype cycles in cholera dynamics

    OpenAIRE

    Koelle, Katia; Pascual, Mercedes; Yunus, Md.

    2006-01-01

    Interest in understanding strain diversity and its impact on disease dynamics has grown over the past decade. Theoretical disease models of several co-circulating strains indicate that incomplete cross-immunity generates conditions for strain-cycling behaviour at the population level. However, there have been no quantitative analyses of disease time-series that are clear examples of theoretically expected strain cycling. Here, we analyse a 40-year (1966–2005) cholera time-series from Banglade...

  10. Presence of CTX gene cluster in environmental non-O1/O139 Vibrio cholerae and its potential clinical significance

    Directory of Open Access Journals (Sweden)

    B Bakhshi

    2012-01-01

    Full Text Available Purpose: The aim of this study was to understand the epidemiological linkage of clinical and environmental isolates of Vibrio cholerae and to determine their genotypes and virulence genes content. Materials and Methods: A total of 60 V. cholerae strains obtained from clinical specimens (n = 40 and surface waters (n = 20 were subjected to genotyping using PFGE and determination of their virulence-associated gene clusters. Result: PCR analysis showed the presence of chromosomally located hly and RTX genetic elements in 100% and 90% of the environmental isolates, respectively. The phage-mediated genetic elements such as CTX, TLC and VPI were detected in 5% of the environmental isolates suggesting that the environmental isolates cannot acquire certain mobile gene clusters. A total of 4 and 18 pulsotypes were obtained among the clinical and environmental V. cholerae isolates, respectively. Non-pathogenic environmentally isolated V. cholerae constituted a distinct cluster with one single non-O1, non-O139 strain (EP6 carrying the virulence genes similar to the epidemic strains. This may suggest the possible potential of conversion of non-pathogenic to a pathogenic environmental strain. Conclusions: The emergence of a single environmental isolate in our study containing the pathogenicity genes amongst the diverse non-pathogenic environmental isolates needs to be further studied in the context of V. cholerae pathogenicity sero-coversion.

  11. The Aquatic Environment as a Reservoir of Vibrio cholerae O1 in Hydrographic Basins of the State of Pernambuco, Brazil

    Directory of Open Access Journals (Sweden)

    Carina Lucena Mendes-Marques

    2013-01-01

    Full Text Available After the worldwide cholera epidemic in 1993, permanent environmental monitoring of hydrographic basins was established in Pernambuco, Brazil, where cholera is endemic. After a quiescent period, 4 rfbN (serogroup O1 positive water samples that were culture negative were detected by multiplex single-tube nested PCR (MSTNPCR; 2 of these were also ctxA (cholera toxin positive. From May to June 2012, 30 V. cholerae O1 isolates were obtained by culturing samples. These isolates were analyzed for the presence of virulence genes by PCR, intergenic spacer region 16S-23S PCR (ISR-PCR, and pulsed field gel electrophoresis (PFGE. The isolates were positive for the rfbN gene and negative for the assessed pathogenic genes and were classified into 2 groups by ISR and the same profile by PFGE. Close genetic similarity was observed between them (2012 and environmental strains from 2004 to 2005, indicating the permanence of endemic V. cholerae O1 in the region.

  12. Tainted commons, public health: the politico-moral significance of cholera in Vietnam.

    Science.gov (United States)

    Lincoln, Martha L

    2014-09-01

    In October 2007, a series of cholera epidemics broke out in Hanoi, interrupting a moment of economic triumphalism in post-transition Vietnam. In seeking the source of a refractory disease associated with poverty and underdevelopment, officials, media, and citizens not only identified scapegoats and proposed solutions, they also endorsed particular visions of moral conduct, social order, and public health. Controversy over cholera, a potent politico-moral symbol, expressed an imaginary of "tainted commons" (i.e., an emergent space of civil society and small-scale entrepreneurship from which the state has partially withdrawn, while still exercising some measure of scrutiny and control). The ambiguities of this situation permitted the state to assume moral postures, evade responsibility, and deflect criticism to convenient targets. Prevalent outbreak narratives thus played on anxieties regarding specifically classed and gendered social groups, whose behavior was imagined to contravene ideals of public health and order.

  13. Vibrio cholerae-induced inflammation in the neonatal mouse cholera model.

    Science.gov (United States)

    Bishop, Anne L; Patimalla, Bharathi; Camilli, Andrew

    2014-06-01

    Vibrio cholerae is the causative agent of the acute diarrheal disease of cholera. Innate immune responses to V. cholerae are not a major cause of cholera pathology, which is characterized by severe, watery diarrhea induced by the action of cholera toxin. Innate responses may, however, contribute to resolution of infection and must be required to initiate adaptive responses after natural infection and oral vaccination. Here we investigated whether a well-established infant mouse model of cholera can be used to observe an innate immune response. We also used a vaccination model in which immunized dams protect their pups from infection through breast milk antibodies to investigate innate immune responses after V. cholerae infection for pups suckled by an immune dam. At the peak of infection, we observed neutrophil recruitment accompanied by induction of KC, macrophage inflammatory protein 2 (MIP-2), NOS-2, interleukin-6 (IL-6), and IL-17a. Pups suckled by an immunized dam did not mount this response. Accessory toxins RtxA and HlyA played no discernible role in neutrophil recruitment in a wild-type background. The innate response to V. cholerae deleted for cholera toxin-encoding phage (CTX) and part of rtxA was significantly reduced, suggesting a role for CTX-carried genes or for RtxA in the absence of cholera toxin (CTX). Two extracellular V. cholerae DNases were not required for neutrophil recruitment, but DNase-deficient V. cholerae caused more clouds of DNA in the intestinal lumen, which appeared to be neutrophil extracellular traps (NETs), suggesting that V. cholerae DNases combat NETs. Thus, the infant mouse model has hitherto unrecognized utility for interrogating innate responses to V. cholerae infection.

  14. Gulf War

    DEFF Research Database (Denmark)

    Dalgaard-Nielsen, Anja

    2003-01-01

    As it became a non‐permanent member of the UN Security Council in January 2003, Germany stepped up its opposition to war with Iraq. The stage was set for a repeat of Germany's uncomfortable position during the 1991 Gulf War. At that time, as most of Germany's allies rallied behind Washington......, Germany made only financial contributions, and hundreds of thousands of Germans took to the streets to protest against the war. Yet, since 1991, Germany had come a long way in its attitudes towards military force. From a policy of complete abstention from military deployments beyond NATO's area (so...

  15. Molecular mechanism of acquisition of the cholera toxin genes.

    Science.gov (United States)

    Das, Bhabatosh; Bischerour, Julien; Barre, Francois-Xavier

    2011-02-01

    One of the major pathogenic determinants of Vibrio cholerae, the cholera toxin, is encoded in the genome of a filamentous phage, CTXφ. CTXφ makes use of the chromosome dimer resolution system of V. cholerae to integrate its single stranded genome into one, the other, or both V. cholerae chromosomes. Here, we review current knowledge about this smart integration process.

  16. Prediction of the spatial evolution and effects of control measures for the unfolding Haiti cholera outbreak

    Science.gov (United States)

    Bertuzzo, E.; Mari, L.; Righetto, L.; Gatto, M.; Casagrandi, R.; Blokesch, M.; Rodriguez-Iturbe, I.; Rinaldo, A.

    2011-03-01

    Here we propose spatially explicit predictions of the residual progression of the current Haiti cholera outbreak accounting for the dynamics of susceptible and infected individuals within different local human communities, and for the redistribution among them of Vibrio cholerae, the causative agent of the disease. Spreading mechanisms include the diffusion of pathogens in the aquatic environment and their dissemination due to the movement of human carriers. The model reproduces the spatiotemporal features of the outbreak to date, thus suggesting the robustness of predicted future developments of the epidemic. We estimate that, under unchanged conditions, the number of new cases in the whole country should start to decrease in January. During this month the epidemic should mainly involve the Ouest department (Port-au-Prince) while fading out in northern regions. Our spatially explicit model allows also the analysis of the effectiveness of alternative intervention strategies. To that end our results show that mass vaccinations would have a negligible impact at this stage of the epidemic. We also show that targeted sanitation strategies, providing clean drinking water supply and/or staging educational campaigns aimed at reducing exposure, may weaken the strength of the residual evolution of the infection.

  17. 9 CFR 311.3 - Hog cholera.

    Science.gov (United States)

    2010-01-01

    ... of hog cholera observed during the ante-mortem inspection of a U.S. suspect shall be duly considered in connection with post-mortem findings and when the carcass of such a suspect shows lesions in the kidneys and the lymph nodes which resemble lesions of hog cholera, they shall be regarded as those of...

  18. Tetra- versus Pentavalent Inhibitors of Cholera Toxin

    NARCIS (Netherlands)

    Fu, Ou; Pukin, Aliaksei V.; Quarles Van Ufford, Linda; Branson, Thomas R.; Thies-Weesie, Dominique M E; Turnbull, W. Bruce; Visser, Gerben M.; Pieters, Roland J.

    2015-01-01

    The five B-subunits (CTB5) of the Vibrio cholerae (cholera) toxin can bind to the intestinal cell surface so the entire AB5 toxin can enter the cell. Simultaneous binding can occur on more than one of the monosialotetrahexosylganglioside (GM1) units present on the cell surface.

  19. Seasonal and Interannual Trends in Largest Cholera Endemic Megacity: Water Sustainability - Climate - Health Challenges in Dhaka, Bangladesh

    Science.gov (United States)

    Akanda, Ali S.; Jutla, Antarpreet; Faruque, Abu S. G.; Huq, Anwar; Colwell, Rita R.

    2014-05-01

    The last three decades of surveillance data shows a drastic increase of cholera prevalence in the largest cholera-endemic city in the world - Dhaka, Bangladesh. Emerging megacities in the region, especially those located in coastal areas also remain vulnerable to large scale drivers of cholera outbreaks. However, there has not been any systematic study on linking long-term disease trends with related changes in natural or societal variables. Here, we analyze the 30-year dynamics of urban cholera prevalence in Dhaka with changes in climatic or anthropogenic forcings: regional hydrology, flooding, water usage, changes in distribution systems, population growth and density in urban settlements, as well as shifting climate patterns and frequency of natural disasters. An interesting change is observed in the seasonal trends of cholera prevalence; while an endemic upward trend is seen in the dry season, the post-monsoon trend is epidemic in nature. In addition, the trend in the pre-monsoon dry season is significantly stronger than the post-monsoon wet season; and thus spring is becoming the dominant cholera season of the year. Evidence points to growing urbanization and rising population in unplanned settlements along the city peripheries. The rapid pressure of growth has led to an unsustainable and potentially disastrous situation with negligible-to-poor water and sanitation systems compounded by changing climatic patterns and increasing number of extreme weather events. Growing water scarcity in the dry season and lack of sustainable water and sanitation infrastructure for urban settlements have increased endemicity of cholera outbreaks in spring, while record flood events and prolonged post-monsoon inundation have contributed to increased epidemic outbreaks in fall. We analyze our findings with the World Health Organization recommended guidelines and investigate large scale water sustainability challenges in the context of climatic and anthropogenic changes in the

  20. Dynamics of beneficial epidemics

    CERN Document Server

    Berdahl, Andrew; De Bacco, Caterina; Dumas, Marion; Ferdinand, Vanessa; Grochow, Joshua A; Hébert-Dufresne, Laurent; Kallus, Yoav; Kempes, Christopher P; Kolchinsky, Artemy; Larremore, Daniel B; Libby, Eric; Power, Eleanor A; Stern, Caitlin A; Tracey, Brendan

    2016-01-01

    Pathogens can spread epidemically through populations. Beneficial contagions, such as viruses that enhance host survival or technological innovations that improve quality of life, also have the potential to spread epidemically. How do the dynamics of beneficial biological and social epidemics differ from those of detrimental epidemics? We investigate this question using three theoretical approaches as well as an empirical analysis of concept propagation. First, in evolutionary models, we show that a beneficial horizontally-transmissible element, such as viral DNA, spreads super-exponentially through a population, substantially more quickly than a beneficial mutation. Second, in an epidemiological social network approach, we show that infections that cause increased connectivity lead to faster-than-exponential fixation in the population. Third, in a sociological model with strategic rewiring, we find that preferences for increased global infection accelerate spread and produce super-exponential fixation rates,...

  1. Using computer algebra and SMT-solvers to analyze a mathematical model of cholera propagation

    Science.gov (United States)

    Trujillo Arredondo, Mariana

    2014-06-01

    We analyze a mathematical model for the transmission of cholera. The model is already defined and involves variables such as the pathogen agent, which in this case is the bacterium Vibrio cholera, and the human population. The human population is divided into three classes: susceptible, infectious and removed. Using Computer Algebra, specifically Maple we obtain two equilibrium states: the disease free state and the endemic state. Using Maple it is possible to prove that the disease free state is locally asymptotically stable if and only if R0 1. Using the package Red-Log of the Computer algebra system Reduce and the SMT-Solver Z3Py it is possible to obtain numerical conditions for the model. The formula for the basic reproductive number makes a synthesis with all epidemic parameters in the model. Also it is possible to make numerical simulations which are very illustrative about the epidemic patters that are expected to be observed in real situations. We claim that these kinds of software are very useful in the analysis of epidemic models given that the symbolic computation provides algebraic formulas for the basic reproductive number and such algebraic formulas are very useful to derive control measures. For other side, computer algebra software is a powerful tool to make the stability analysis for epidemic models given that the all steps in the stability analysis can be made automatically: finding the equilibrium points, computing the jacobian, computing the characteristic polynomial for the jacobian, and applying the Routh-Hurwitz theorem to the characteristic polynomial. Finally, using SMT-Solvers is possible to make automatically checks of satisfiability, validity and quantifiers elimination being these computations very useful to analyse complicated epidemic models.

  2. Modularity promotes epidemic recurrence

    CERN Document Server

    Jesan, T; Sinha, Sitabhra

    2016-01-01

    The long-term evolution of epidemic processes depends crucially on the structure of contact networks. As empirical evidence indicates that human populations exhibit strong community organization, we investigate here how such mesoscopic configurations affect the likelihood of epidemic recurrence. Through numerical simulations on real social networks and theoretical arguments using spectral methods, we demonstrate that highly contagious diseases that would have otherwise died out rapidly can persist indefinitely for an optimal range of modularity in contact networks.

  3. Seasonal dynamics of Vibrio cholerae and its phages in riverine ecosystem of Gangetic West Bengal: cholera paradigm.

    Science.gov (United States)

    Mookerjee, Subham; Jaiswal, Abhishek; Batabyal, Prasenjit; Einsporn, Marc H; Lara, Ruben J; Sarkar, Banwarilal; Neogi, Sucharit Basu; Palit, Anup

    2014-10-01

    The Gangetic delta is a century-old cholera endemic belt where the role of riverine-estuarine ecosystem in cholera transmission has never been elucidated. Seasonality, distribution, and abundance of environmental Vibrio cholerae O1/O139 and vibriophage in Hooghly riverine-estuarine environment and their correlation with cholera incidence pattern in West Bengal, India, have been analyzed for the first time across summer, monsoon, and winter months. A total of 146 water samples collected from two sites of the Hooghly River (Howrah and Diamond Harbour) were analyzed physicochemically along with cultivable Vibrio count (CVC), V. cholerae O1/O139, and vibriophages. V. cholerae O1 was detected in 56 (38.3%) samples, while 66 (45.2%) were positive for V. cholerae O1 phages. Flood tide, water temperature (31 ± 1.6 °C), and turbidity (≥250 nephelometric turbidity unit (NTU)) significantly stimulated V. cholerae and vibriophage abundance in riverine ecosystem. Solitary existence of V. cholerae O1 and phages (p V. cholerae O1 or V. cholerae O1 Φ) on the other. Significant association (p cholera cases and V. cholerae O1 in aquatic environment implies the role of riverine-estuarine ecosystem in cholera transmission. A "biomonitoring tool" of physicochemical stimulants, tidal, and climatic variants has been proposed collating V. cholerae and phage dynamics that can forewarn any impending cholera outbreak.

  4. Spatial dependency of cholera prevalence on potential cholera reservoirs in an urban area, Kumasi, Ghana

    Science.gov (United States)

    Osei, Frank B.; Duker, Alfred A.; Augustijn, Ellen-Wien; Stein, Alfred

    2010-10-01

    Cholera has been a public health burden in Ghana since the early 1970s. Between 1999 and 2005, a total of 25,636 cases and 620 deaths were officially reported to the WHO. In one of the worst affected urban cities, fecal contamination of surface water is extremely high, and the disease is reported to be prevalent among inhabitants living in close proximity to surface water bodies. Surface runoff from dump sites is a major source of fecal and bacterial contamination of rivers and streams in the study area. This study aims to determine (a) the impacts of surface water contamination on cholera infection and (b) detect and map arbitrary shaped clusters of cholera. A Geographic Information System (GIS) based spatial analysis is used to delineate potential reservoirs of the cholera vibrios; possibly contaminated by surface runoff from open space refuse dumps. Statistical modeling using OLS model reveals a significant negative association between (a) cholera prevalence and proximity to all the potential cholera reservoirs ( R2 = 0.18, p cholera prevalence and proximity to upstream potential cholera reservoirs ( R2 = 0.25, p cholera prevalence on the spatial neighbors of the communities. A flexible scan statistic identifies a most likely cluster with a higher relative risk (RR = 2.04, p cholera infection.

  5. Cholera and shigellosis: different epidemiology but similar responses to climate variability.

    Directory of Open Access Journals (Sweden)

    Benjamin A Cash

    Full Text Available Comparative studies of the associations between different infectious diseases and climate variability, such as the El Niño-Southern Oscillation, are lacking. Diarrheal illnesses, particularly cholera and shigellosis, provide an important opportunity to apply a comparative approach. Cholera and shigellosis have significant global mortality and morbidity burden, pronounced differences in transmission pathways and pathogen ecologies, and there is an established climate link with cholera. In particular, the specific ecology of Vibrio cholerae is often invoked to explain the sensitivity of that disease to climate.The extensive surveillance data of the International Center for Diarrheal Disease Research, Bangladesh are used here to revisit the known associations between cholera and climate, and to address their similarity to previously unexplored patterns for shigellosis. Monthly case data for both the city of Dhaka and a rural area known as Matlab are analyzed with respect to their association with El Niño and flooding. Linear correlations are examined between flooding and cumulative cases, as well as for flooding and El Niño. Rank-correlation maps are also computed between disease cases in the post-monsoon epidemic season and sea surface temperatures in the Pacific. Similar climate associations are found for both diseases and both locations. Increased cases follow increased monsoon flooding and increased sea surface temperatures in the preceding winter corresponding to an El Niño event.The similarity in association patterns suggests a systemic breakdown in population health with changing environmental conditions, in which climate variability acts primarily through increasing the exposure risk of the human population. We discuss these results in the context of the on-going debate on the relative importance of the environmental reservoir vs. secondary transmission, as well as the implications for the use of El Niño as an early indicator of

  6. How World War 1 changed global attitudes to war and infectious diseases.

    Science.gov (United States)

    Shanks, G Dennis

    2014-11-08

    World War 1 was a key transition point towards scientific medicine. Medical officers incorporated Louis Pasteur's discoveries into their understanding of microorganisms as the cause of infectious diseases, which were therefore susceptible to rational control and treatment measures even in the pre-antibiotic era. Typhoid vaccination led to the successful evasion of the disastrous epidemics of previous wars. The incidence of tetanus was probably decreased by giving millions of doses of horse antitoxin to wounded soldiers. Quinine treated but could not control malaria; its use required mass compulsion. Tuberculosis was not a great military problem during World War 1, although mortality in civilian populations increased substantially. Treatment of sexually transmitted infections remained a matter of aversive conditioning, with invasive antiseptics used in the absence of antibiotics. Pandemic influenza in 1918-19 killed more people than died during the entire war, showing how much remained beyond the capability of the scientists and doctors who fought infectious diseases during World War 1.

  7. Zinc: Role in the management of diarrhea and cholera

    OpenAIRE

    Qadir, M Imran; Arshad, Arfa; Ahmad, Bashir

    2013-01-01

    Diarrhea and cholera are major health problems. Vibrio cholera, the causative agent of cholera, infects the small intestine, resulting in vomiting, massive watery diarrhea and dehydration. Reduced water and electrolyte absorption is also due to zinc deficiency. Zinc has an important role in recovery from the disease. The combination of zinc with cholera vaccine and oral rehydration solutions has a positive impact on cholera and diarrhea. It has led to a decrease in the mortality and morbidity...

  8. Vibrio cholerae and Changing of Microbial Resistance Patterns in Sistan and Balouchestan Province

    Directory of Open Access Journals (Sweden)

    Alireza Salimi-Khorashad

    2012-08-01

    Full Text Available Background: Cholera is a diarrheal disease in tropical regions that exclusively affects humans. This study conducted to compare changes in antibiotic resistance patterns in 2011with that of the period of 2008-2010 on cholera patients in the area covered by Zahedan University of Medical Sciences.Materials and Methods: In this descriptive study, rectal swab samples within Blair working environment of all suspected patients of each region were sent to the laboratory of each region and diagnostic procedures were performed, and Antimicrobial Susceptibility Testing (AST was performed trough distribution methods on agar disk. Disks were prepared from Iranian Padtan Teb Company and the results were evaluated and reported using NCCLS table and the other experimental antimicrobial susceptibility determination tables.Results: In this study, antimicrobial susceptibility testing was performed on 81 positive samples including Agave or Inaba during 4 years. The samples in 2008, 2009 and 2010 followed a similar susceptibility pattern and all these samples were resistant to co-trimoxazole, nalidixic acid and ampicillin, had intermediate sensitivity to furazolidone, were sensitive to tetracycline, ciprofloxacin, doxycycline, erythromycin and susceptibility pattern of cases in 2011 included sensitivity to erythromycin and ciprofloxacin and have shown no sensitivity to doxycycline and tetracycline and halo of their lack of growth were placed in the intermediate range.Conclusion: Vast border between the province and Afghanistan and Pakistan and inevitability of the occurrence of regional cholera epidemics may cause a serious problem in control of the possible epidemics and recalls the need to perform drug sensitivity tests during epidemics before any remedial action more than ever.

  9. [Epidemics, state and society: the case of Minas Gerais in the second half of the 19th century].

    Science.gov (United States)

    Torres Silveira, Anny Jackeline

    2011-01-01

    One of the characteristics of historical analyses of epidemic diseases is the notion of crisis: epidemics are generally perceived as events that do not fit within the framework of everyday order and practices and go beyond individual experiences (suffering, threat of death), jeopardizing social structures, public order, economic activities and moral values. However, epidemic events also shed light on how societies organize healthcare in times of normality, including the extent and limits of the action of health authorities and the role of populations in meeting their own daily needs. This article discusses the organization of healthcare in Minas Gerais province of Brazil during two epidemic episodes, i.e., smallpox (from 1873 to 1875) and cholera (from 1855 to 1856), with the aim of identifying the problems experienced by the population of Minas and the actions taken by the public health authorities during these epidemics. We suggest that the difficulties caused by the arrival of cholera and/or intensification of the smallpox epidemic contributed to expose and exacerbate the shortcomings characterizing healthcare in that society. We also observe that the social mobilization of patients during these events was nothing new, given the low participation of the state in public health during this period, which counted on initiatives and support from civil society.

  10. Antitoxic immunity to cholera in dogs immunized orally with cholera toxin.

    Science.gov (United States)

    Pierce, N F; Cray, W C; Engel, P F

    1980-02-01

    Colera toxin was evaluated as an oral immunogen against experimental canine cholera. Dogs were immunized orally with 100-microgram doses of purified cholera toxin or comparable doses of crude toxin. Both doses caused moderate diarrhea in most nonimmune dogs. Repeated oral doses (12 doses in 54 days) gave marked protection against the diarrheal effect of oral toxin, provoked a vigorous antitoxic response in jejunal mucosa, and gave nearly complete protection against subsequent oral challenge with living virulent Vibrio cholerae. Protection appeared to be due largely to the antitoxic response in intestinal mucosa. The effectiveness of cholera toxin as an oral vaccine contrasts with the previously described ineffectiveness of toxoid given orally. This study provides an example of mucosal immunity due to a nonreplicating vaccine given orally and suggests that cholera toxin may be useful as a component of an oral vaccine for cholera.

  11. Haiti's progress in achieving its 10-year plan to eliminate cholera: hidden sickness cannot be cured

    Directory of Open Access Journals (Sweden)

    Koski-Karell V

    2016-05-01

    Full Text Available Victoria Koski-Karell,1,2 Paul E Farmer,2–4 Benito Isaac,5 Elizabeth M Campa,5 Loune Viaud,5 Paul C Namphy,6 Ralph Ternier,5 Louise C Ivers2–4 1Department of Anthropology, University of Michigan, and University of Michigan Medical School, Ann Arbor, MI, 2Partners In Health, 3Department of Global Health and Social Medicine, Harvard Medical School, 4Department of Medicine, Division of Global Health Equity, Brigham and Women's Hospital, Boston, MA, USA; 5Zanmi Lasante, Cange, 6Direction Nationale de l'Eau Potable et de l'Assainissement, Port-au-Prince, Haiti Abstract: Since the beginning of the cholera epidemic in Haiti 5 years ago, the prevalence of this deadly water-borne disease has fallen far below the initial rates registered during its explosive outset. However, cholera continues to cause extensive suffering and needless deaths across the country, particularly among the poor. The urgent need to eliminate transmission of cholera persists: compared to the same period in 2014, the first 4 months of 2015 saw three times the number of cholera cases. Drawing upon epidemiology, clinical work (and clinical knowledge, policy, ecology, and political economy, and informed by ethnographic data collected in a rural area of Haiti called Bocozel, this paper evaluates the progress of the nation's 10-year Plan for the Elimination of Cholera. Bocozel is a rice-producing region where most people live in extreme poverty. The irrigation network is decrepit, the land is prone to environmental shocks, fertilizer is not affordable, and the government's capacity to assist farmers is undermined by resource constraints. When peasants do have rice to sell, the price of domestically grown rice is twice that of US-imported rice. Canal water is not only used to irrigate thousands of acres of rice paddies and sustain livestock, but also to bathe, wash, and play, while water from wells, hand pumps, and the river is used for drinking, cooking, and bathing. Only one out of

  12. Swedish isolates of Vibrio cholerae enhance their survival when interacted intracellularly with Acanthamoeba castellanii

    OpenAIRE

    Shanan, Salah; Bayoumi, Magdi; Saeed, Amir; Sandström, Gunnar; Abd, Hadi

    2016-01-01

    Vibrio cholerae is a Gram-negative bacterium that occurs naturally in aquatic environment. Only V. cholerae O1 and V. cholerae O139 produce cholera toxin and cause cholera, other serogroups can cause gastroenteritis, open wounds infection, and septicaemia. V. cholerae O1 and V. cholerae O139 grow and survive inside Acanthamoeba castellanii. The aim of this study is to investigate the interactions of the Swedish clinical isolates V. cholerae O3, V. cholerae O4, V. cholerae O5, V. cholerae O11,...

  13. Epidemiologic and Drug Resistance Pattern of Vibrio cholerae O1 Biotype El Tor, Serotype Ogawa, in the 2011 Cholera Outbreak, in Alborz Province, Iran

    Science.gov (United States)

    Barati, Hojatolah; Moradi, Ghobad; Rasouli, Mohammad Aziz; Mohammadi, Parvin

    2015-01-01

    Background: Although the national guidelines recommend special antibiotics, based on the antibiogram of National Reference Laboratory, it seems that, because of uncontrolled usage of antibiotics in the society and due to the changes in the serotypes causing the disease, it is essential to monitor the status of drug resistance, permanently, and to revise the current prescriptions guidelines. Objectives: This study aimed to assess the epidemiological aspects and drug resistance pattern of Vibrio cholerae O1, biotype El Tor, serotype Ogawa, in cholera outbreak, in Alborz province in Iran, during 2011. Materials and Methods: This is a cross-sectional study, which reviews a cholera epidemic that occurred in Iran. A total of 9844 specimens were taken from suspected cases, among diarrheal patients, via rectal swabs. The specimens were placed in Cary-Blair transport medium and sent to laboratory. Samples were enriched, in alkaline peptone water, and isolated on thiosulphate-citrate-bile salt-sucrose agar. From the 244 confirmed cases, 239 cases underwent antibiogram test, via disk diffusion method and based on national committee for clinical laboratory standards (NCCLS) instructions. The standard Escherichia coli ATCC 25922 was used for antibiogram quality control and, eventually, all results were interpreted and reported using NCCLS standard table. Results: In total, until October 22, 2011, which was announced as the end of outbreak, 9844 samples were taken from diarrheal patients. Regarding the type of V. cholerae, 244 El Tor biotype positive cases were reported. The case fatality rate was 1.3%. The mean age of patients was 37.8 years and the highest incidence rate occurred in the age group 21 - 30 years. After conducting antibiotic susceptibility test in the 244 V. cholerae, biotype El Tor, serotype Ogawa, it was found that ciprofloxacin had the highest level of antibiotic susceptibility (99.6%) and the highest level of antibiotic resistance was observed in co

  14. Biosensing Vibrio cholerae with Genetically Engineered Escherichia coli.

    Science.gov (United States)

    Holowko, Maciej B; Wang, Huijuan; Jayaraman, Premkumar; Poh, Chueh Loo

    2016-11-18

    Cholera is a potentially mortal, infectious disease caused by Vibrio cholerae bacterium. Current treatment methods of cholera still have limitations. Beneficial microbes that could sense and kill the V. cholerae could offer potential alternative to preventing and treating cholera. However, such V. cholerae targeting microbe is still not available. This microbe requires a sensing system to be able to detect the presence of V. cholera bacterium. To this end, we designed and created a synthetic genetic sensing system using nonpathogenic Escherichia coli as the host. To achieve the system, we have moved proteins used by V. cholerae for quorum sensing into E. coli. These sensor proteins have been further layered with a genetic inverter based on CRISPRi technology. Our design process was aided by computer models simulating in vivo behavior of the system. Our sensor shows high sensitivity to presence of V. cholerae supernatant with tight control of expression of output GFP protein.

  15. [Epidemic diseases in the Polish Kingdom in the thirties of the 19th century].

    Science.gov (United States)

    Rutkowski, Marek

    2004-01-01

    We can observe that after downfall of the November Insurrection the authorities of the Polish Kingdom were effectively engaged in the fight against numerous epidemic diseases plaguing the local society. Among "contagions" of the time there were varicella, "gastric-nervous fever", "gastric-rhinitis fever" and typhus (especially in 1836). As usual, cholera was the most dangerous one. All medical and epidemiological services in the Polish Kingdom were making effective remedial measures in order to neutralize results of the epidemics. The implemented methods were effective enough to limit considerably the incidence and number of deceased during the epidemic, which started in October 1836 and lasted till the next year. An obligation of effective cooperation between the Polish authorities and the Russian army was introduced then. The sanitary action against cholera in 1836-1837 should be very highly assessed from the logistic point of view. The wide action of protective vaccination against varicella and numerous sanitary rules completed the favorable image of the Polish Kingdom sanitary services. All the factors mentioned above lead to a conclusion that in the thirtieth of the 19th century both civil and military authorities of the Polish Kingdom did practically utmost in order to limit negative results of cyclical recurrences of epidemic diseases. It should be also stressed that the protective actions undertaken in that time were both direct and long lasting enterprises.

  16. Configuring the autism epidemic

    DEFF Research Database (Denmark)

    Christensen, Fie Lund Lindegaard; Seeberg, Jens

    2017-01-01

    Autism has been described as an epidemic, but this claim is contested and may point to an awareness epidemic, i.e. changes in the definition of what autism is and more attention being invested in diagnosis leading to a rise in registered cases. The sex ratio of children diagnosed with autism...... is skewed in favour of boys, and girls with autism tend to be diagnosed much later than boys. Building and further developing the notion of ‘configuration’ of epidemics, this article explores the configuration of autism in Denmark, with a particular focus on the health system and social support to families...... with children diagnosed with autism, seen from a parental perspective. The article points to diagnostic dynamics that contribute to explaining why girls with autism are not diagnosed as easily as boys. We unfold these dynamics through the analysis of a case of a Danish family with autism....

  17. The Epidemics of Corruption

    CERN Document Server

    Blanchard, P; Krüger, T; Martin, P; Blanchard, Ph.

    2005-01-01

    We study corruption as a generalized epidemic process on the graph of social relationships. The main difference to classical epidemic processes is the strong nonlinear dependence of the transmission probability on the local density of corruption and the mean field influence of the overall corruption in the society. Network clustering and the degree-degree correlation play an essential role in corruption dynamics. We discuss phase transitions, the influence of the graph structure and the implications for epidemic control. Structural and dynamical arguments are given why strongly hierarchically organized societies like systems with dictatorial tendency are more vulnerable to corruption than democracies. A similar type of modelling can be applied to other social contagion spreading processes like opinion formation, doping usage, social disorders or innovation dynamics.

  18. [Observations on the 1348 plague epidemic. Measures taken to combat its tragic effects and avoid epidemic recrudescence].

    Science.gov (United States)

    Sabbatani, Sergio

    2003-03-01

    When the "Black Death" swept through Europe from southern France in 1348, in the short space of two years the Europeans were hit by one of the most serious epidemics ever recorded in human history. Yersinia pestis reached Europe by sea, its contamination propagated by the Genoese ships coming from the Crimean port of Jaffa. For the first time the world experienced microbiological unification: East and West were equally involved in the tragedy that spread, and no town remained unscathed during the various epidemic waves which succeeded one another in the following three centuries. The authors of this article describe how and why the epidemic spread, as well as the factors that led to the swift, and often fatal, involment of millions of Europeans. The second part of the article deals with the measures taken by the healthcare authorities of European towns and countries in order to halt the proliferation of the disease. According to the data and observations by authoritative authors, selected among the many who studied the disease that from the 14th century spread like a scourge throughout the known world at the time, the epidemic could have been even more serious, in terms of mortality and morbidity, without the disciplinary and provisional health measures taken. The experience gained in Italy and all over Europe at the time proved useful not only to better manage the epidemics which cyclically broke out, but also to efficiently combat the cholera epidemics of the 19th century. With the 14th century plague epidemic, the Europeans and their political and administrative representatives may well have realized for the very first time that contamination could be combatted by adopting a set of rational, scientific norms - although in practice such rules were mostly inspired by misguided scientific theories. Humankind was no longer alone. A new society was emerging, one that was not going to passively accept the more or less mysterious ways of a superior being of fate. The

  19. Identification of Vibrio cholerae serotypes in high-risk marine products with non-gel sieving capillary electrophoresis.

    Science.gov (United States)

    Zhou, Chen; Li, Ming; Sun, Chengjun; Zou, Haimin; Wu, Xin; Zhang, Liyin; Tao, Siyuan; Wang, Bingyue; Li, Yongxin

    2016-02-01

    Vibrio cholerae, a natural inhabitant of the marine environment, poses a threat to human health, and its new epidemic variants have been reported. A method of multiplex polymerase chain reaction-capillary electrophoresis-laser-induced fluorescence (PCR-CE-LIF) detection has been developed to detect and identify V. cholerae in marine products sensitively, rapidly, and reliably. Four sets of primers were selected to amplify genus-specific VCC gene, O139 serogroup-specific O139 gene, O1 serogroup-specific O1 gene, and ctxA gene associated with the CT toxin of enterotoxigenic V. cholerae. The PCR products were detected using CE-LIF with SYBR Gold serving as the DNA fluorescent dye. The parameters of PCR and the separation conditions of CE-LIF were optimized. Under the optimal conditions, V. cholerae was detected and four serotypes were identified simultaneously within 8 min. The alignment analysis showed that the PCR products had good agreement with the published sequences from GenBank, indicating that the primers selected in this study had high specificity and the PCR results were reliable. The proposed method could detect 5 to 20 cfu/ml V. cholerae. The intraday precisions of migration time and peak area of DNA marker and PCR products were in the ranges of 1.60-2.56% and 1.60-6.29%, respectively. The specificity results showed that only five standard bacteria used in this study showed the specific peaks when the target bacteria were mixed with seven other common intestinal pathogenic bacteria at the same concentration. The assay was applied to 71 high-risk marine products, and different serotypes of V. cholerae could be identified sensitively and reliably.

  20. Model distinguishability and inference robustness in mechanisms of cholera transmission and loss of immunity.

    Science.gov (United States)

    Lee, Elizabeth C; Kelly, Michael R; Ochocki, Brad M; Akinwumi, Segun M; Hamre, Karen E S; Tien, Joseph H; Eisenberg, Marisa C

    2017-01-24

    Mathematical models of cholera and waterborne disease vary widely in their structures, in terms of transmission pathways, loss of immunity, and a range of other features. These differences can affect model dynamics, with different models potentially yielding different predictions and parameter estimates from the same data. Given the increasing use of mathematical models to inform public health decision-making, it is important to assess model distinguishability (whether models can be distinguished based on fit to data) and inference robustness (whether inferences from the model are robust to realistic variations in model structure). In this paper, we examined the effects of uncertainty in model structure in the context of epidemic cholera, testing a range of models with differences in transmission and loss of immunity structure, based on known features of cholera epidemiology. We fit these models to simulated epidemic and long-term data, as well as data from the 2006 Angola epidemic. We evaluated model distinguishability based on fit to data, and whether the parameter values, model behavior, and forecasting ability can accurately be inferred from incidence data. In general, all models were able to successfully fit to all data sets, both real and simulated, regardless of whether the model generating the simulated data matched the fitted model. However, in the long-term data, the best model fits were achieved when the loss of immunity structures matched those of the model that simulated the data. Two parameters, one representing person-to-person transmission and the other representing the reporting rate, were accurately estimated across all models, while the remaining parameters showed broad variation across the different models and data sets. The basic reproduction number (R0) was often poorly estimated even using the correct model, due to practical unidentifiability issues in the waterborne transmission pathway which were consistent across all models. Forecasting

  1. Transmission of Infectious Vibrio cholerae through Drinking Water among the Household Contacts of Cholera Patients (CHoBI7 Trial)

    Science.gov (United States)

    Rafique, Raisa; Rashid, Mahamud-ur; Monira, Shirajum; Rahman, Zillur; Mahmud, Md. Toslim; Mustafiz, Munshi; Saif-Ur-Rahman, K. M.; Johura, Fatema-Tuz; Islam, Saiful; Parvin, Tahmina; Bhuyian, Md. Sazzadul I.; Sharif, Mohsena B.; Rahman, Sabita R.; Sack, David A.; Sack, R. Bradley; George, Christine M.; Alam, Munirul

    2016-01-01

    Recurrent cholera causes significant morbidity and mortality among the growing population of Dhaka, the capital city of Bangladesh. Previous studies have demonstrated that household contacts of cholera patients are at >100 times higher risk of cholera during the week after the presentation of the index patient. Our prospective study investigated the mode of transmission of Vibrio cholerae, the cause of cholera, in the households of cholera patients in Dhaka city. Out of the total 420 rectal swab samples analyzed from 84 household contacts and 330 water samples collected from 33 households, V. cholerae was isolated from 20%(17/84) of household contacts, 18%(6/33) of stored drinking water, and 27%(9/33) of source water samples. Phenotypic and molecular analyses results confirmed the V. cholerae isolates to be toxigenic and belonging to serogroup O1 biotype El Tor (ET) possessing cholera toxin of classical biotype (altered ET). Phylogenetic analysis by pulsed-field gel electrophoresis (PFGE) showed the V. cholerae isolates to be clonally linked, as >95% similarity was confirmed by sub-clustering patterns in the PFGE (NotI)-based dendrogram. Mapping results showed cholera patients to be widely distributed across 25 police stations. The data suggesting the transmission of infectious V. cholerae within the household contacts of cholera patients through drinking water underscores the need for safe water to prevent spread of cholera and related deaths in Dhaka city. PMID:27803695

  2. Transmission of Infectious Vibrio cholerae Through Drinking Water among the Household Contacts of Cholera Patients (CHoBI7 Trial

    Directory of Open Access Journals (Sweden)

    Raisa Rafique

    2016-10-01

    Full Text Available Recurrent cholera causes significant morbidity and mortality among the growing population of Dhaka, the capital city of Bangladesh. Previous studies have demonstrated that household contacts of cholera patients are at >100 times higher risk of cholera during the week after the presentation of the index patient. Our prospective study investigated the mode of transmission of Vibrio cholerae, the cause of cholera, in the households of cholera patients in Dhaka city. Of total 420 rectal swab samples analyzed from 84 household contacts and 330 water samples collected from 33 households, V. cholerae was isolated from 20%(17/84 of household contacts, 18%(6/33 of stored drinking water, and 27%(9/33 of source water samples. Phenotypic and molecular analyses results confirmed the V. cholerae isolates to be toxigenic and belonging to serogroup O1 biotype El Tor (ET possessing cholera toxin of classical biotype (altered ET. Phylogenetic analysis by pulsed-field gel electrophoresis (PFGE showed the V. cholerae isolates to be clonally linked, as >95% similarity was confirmed by sub-clustering patterns in the PFGE (NotI-based dendrogram. Mapping results showed cholera patients to be widely distributed across 25 police stations with the highest incidence in households near the major rivers and polluted water bodies. The data presented on the transmission of infectious V. cholerae within the household contacts of cholera patients through drinking water underscores the need for safe water to prevent spread of cholera and related deaths in Dhaka city.

  3. Introduction on molecular biological techniques for Vibrio cholerae%霍乱弧菌分子生物学检测技术介绍

    Institute of Scientific and Technical Information of China (English)

    熊长辉

    2012-01-01

    随着医学分子生物学的迅速发展,大量的分子生物学技术被用于霍乱弧菌的研究,为霍乱弧菌快速检测及分型提供了重要依据,也进一步从分子水平阐明了霍乱弧菌的变异和不同菌株之间的遗传关系,以及霍乱疫情的溯源、菌株类型和流行性质.%Molecular biological techniques provide an important basis for the rapid detection of Vibrio cholerae with the rapid development of Medical Molecular Biology, increasing number of molecular biology techniques were used to detect Vibrio cholerae variation and genetic relationships between different strains, the origin, strain type and nature of the epidemic cholera.

  4. Immunizing Canada geese against avian cholera

    Science.gov (United States)

    Price, J.I.

    1985-01-01

    A small flock of captive giant Canada geese were vaccinated with the experimental bac- terin in Nebraska to test its efficacy under field conditions. Only 2 of 157 vaccinates died from avian cholera during an annual spring die-off.

  5. 霍乱口服疫苗的研究与应用%Development of oral cholera vaccine and its vaccination

    Institute of Scientific and Technical Information of China (English)

    阚飙

    2015-01-01

    应用疫苗是人群霍乱防控的重要策略之一.霍乱疫苗研制强调黏膜免疫策略,使之发挥诱导抗菌抗毒素免疫的作用.疫苗配方中如果带有毒素B亚单位(包括在灭活疫苗中添加以及在活疫苗中进行表达),能通过交叉免疫发挥预防其他一些病原导致腹泻病的作用.口服灭活疫苗已成熟,活疫苗的研制与应用也在积极探索之中.霍乱疫苗的研发还不仅仅在于技术层面,根据流行地区和人群的特点,也要求低成本、储运条件简单、接种次数少.对危险人群以及出现疫情的地区如何使用霍乱疫苗,虽然以往存在争论,但通过评估和在疫情中的应用,已逐步形成了共识.%The application of the cholera vaccine is one of the cholera prevention and control strategies.Cholera vaccines stimulate mucosal immune to play the role of antibacteria and antitoxin.When the cholera toxin B subunit is added in the cholera vaccine,it could also defend against some diarrhea associated pathogens by cross-protection.Oral inactivated cholera vaccines are commercially available now.The oral live vaccine candidates are under development.The development of cholera vaccine is not only on the technical aspect,based on the situations of epidemic areas and population,cost,storage and transportation condition should also be considered.Though the argument on the use of cholera vaccine in epidemic areas and population in high risk existed previously,its vaccination has reached agreement now based on the clinical trials and evaluations during epidemic period.

  6. Mapping to Support Fine Scale Epidemiological Cholera Investigations: A Case Study of Spatial Video in Haiti.

    Science.gov (United States)

    Curtis, Andrew; Blackburn, Jason K; Smiley, Sarah L; Yen, Minmin; Camilli, Andrew; Alam, Meer Taifur; Ali, Afsar; Morris, J Glenn

    2016-02-03

    The cartographic challenge in many developing world environments suffering a high disease burden is a lack of granular environmental covariates suitable for modeling disease outcomes. As a result, epidemiological questions, such as how disease diffuses at intra urban scales are extremely difficult to answer. This paper presents a novel geospatial methodology, spatial video, which can be used to collect and map environmental covariates, while also supporting field epidemiology. An example of epidemic cholera in a coastal town of Haiti is used to illustrate the potential of this new method. Water risks from a 2012 spatial video collection are used to guide a 2014 survey, which concurrently included the collection of water samples, two of which resulted in positive lab results "of interest" (bacteriophage specific for clinical cholera strains) to the current cholera situation. By overlaying sample sites on 2012 water risk maps, a further fifteen proposed water sample locations are suggested. These resulted in a third spatial video survey and an additional "of interest" positive water sample. A potential spatial connection between the "of interest" water samples is suggested. The paper concludes with how spatial video can be an integral part of future fine-scale epidemiological investigations for different pathogens.

  7. Mapping to Support Fine Scale Epidemiological Cholera Investigations: A Case Study of Spatial Video in Haiti

    Directory of Open Access Journals (Sweden)

    Andrew Curtis

    2016-02-01

    Full Text Available The cartographic challenge in many developing world environments suffering a high disease burden is a lack of granular environmental covariates suitable for modeling disease outcomes. As a result, epidemiological questions, such as how disease diffuses at intra urban scales are extremely difficult to answer. This paper presents a novel geospatial methodology, spatial video, which can be used to collect and map environmental covariates, while also supporting field epidemiology. An example of epidemic cholera in a coastal town of Haiti is used to illustrate the potential of this new method. Water risks from a 2012 spatial video collection are used to guide a 2014 survey, which concurrently included the collection of water samples, two of which resulted in positive lab results “of interest” (bacteriophage specific for clinical cholera strains to the current cholera situation. By overlaying sample sites on 2012 water risk maps, a further fifteen proposed water sample locations are suggested. These resulted in a third spatial video survey and an additional “of interest” positive water sample. A potential spatial connection between the “of interest” water samples is suggested. The paper concludes with how spatial video can be an integral part of future fine-scale epidemiological investigations for different pathogens.

  8. Sketching War

    DEFF Research Database (Denmark)

    Engberg-Pedersen, Anders

    2014-01-01

    During the Napoleonic Wars the military croquis, or sketch map, played an important role in the spatial management of the various campaigns. Presumably, many of these sketch maps were destroyed or discarded after their immediate use. Those that survive have received little scholarly notice...

  9. War games

    DEFF Research Database (Denmark)

    Kural, René

    2005-01-01

    Artiklen omhandler Imperial War Museum North tegnet af den polsk-amerikanske arkitekt Daniel Libeskind. Det er hans første projekt i Storbritannien og Englands femte krigsmuseum. Libeskind vand konkurrencen allerede i 1997, men først 5. juli 2002 kunne dørene slås op. Artiklen diskuterer om der er...

  10. Rutherford's war

    Science.gov (United States)

    Campbell, John

    2016-02-01

    Seagulls, sea lions and the comic-book hero Professor Radium were all recruited to fight the threat of submarines during the First World War. But as John Campbell explains, it was Ernest Rutherford who led the way a century ago in using acoustics to deter these deadly craft.

  11. FOWL CHOLERA IN A BREEDER FLOCK

    Directory of Open Access Journals (Sweden)

    Z. Parveen, A. A. Nasir, K.Tasneem and A. Shah

    2003-12-01

    Full Text Available During January, 2003 Pasteurella multocida the causative agent of fowl cholera was isolated from a breeder flock in Lahore District. The age of the flock was 245 days. Increased mortality, swollen wattles and lameness were the clinical findings present in almost all the affected birds, while gross lesions were typical of fowl cholera. To prove the virulence of the organism, mice and six-week old cockerals were infected and P. multocida was reisolated.

  12. Association of Drought with Typhus Epidemics in Central Mexico

    Science.gov (United States)

    Acuna-Soto, R.; Stahle, D.; Villanueva Diaz, J.; Therrell, M.

    2007-05-01

    Typhus is an acute infectious disease caused by the bacteria Rickettsia prowazekii, which is transmitted among humans by the body lice (Pediculus humanus corporis). The disease is highly contagious and transmission is favored in populations living in crowded conditions. Under these circumstances, typhus transmission is facilitated by factors that favor the colonization and proliferation of body lice such as absence of personal hygiene and wearing the same clothes for long periods of time. Historically, periods of war and famine were associated with devastating epidemics with high mortality rates in many parts of the world. Central Mexico has a long record of typhus epidemics. In this region, at > 2000 meters above sea level, the disease was endemic and occurred with a seasonal pattern in winter, with occasional large epidemics. Recently, we completed a chronology of epidemics in Mexico. A total of 22 well-defined major typhus epidemics were identified between 1650 and 1920. All of them caused periods of increased mortality that lasted 2 - 4 years (more than one standard deviation from the previous ten year period). The record of typhus epidemics was evaluated against the tree-ring record of Cuauhtmoc La Fragua, Puebla. This chronology, based on Douglas fir, has demonstrated to be a faithful record of precipitation in central Mexico. The results indicate that a statistically significant drought (t test, p < .05) prevailed during the first year of all 22 large outbreaks of typhus in recent Mexican history. No distinction is made between times of peace and war. This indicates that drought alone was capable of inducing the social conditions for increased transmission of typhus in pre-industrial central Mexico.

  13. The Obesity Epidemic

    Centers for Disease Control (CDC) Podcasts

    2011-07-18

    Learn about obesity and the community initiatives taking place to prevent and reduce this epidemic.  Created: 7/18/2011 by National Center for Chronic Disease Prevention and Health Promotion, Division of Nutrition, Physical Activity and Obesity.   Date Released: 7/18/2011.

  14. Estimating Climate Impacts on Cholera in Piura, Peru during the 1997-98 El Niño

    Science.gov (United States)

    Ramirez, I. J.

    2012-12-01

    In this retrospective study, I examine the impacts of climate on cholera incidence in Piura, Peru during the strongest El Niño of the 20th century in 1998. Bivariate regression analyses were conducted to assess the impact of climate variables (a) Niño 3.4 sea surface temperature anomaly (SSTA), (b) Niño 1+2 SSTA, (c) Paita SSTA, (d) maximum temperature anomaly (TMAXA), (e) minimum temperature anomaly (TMINA), (f) mean temperature anomaly (TMEANA), and (g) total rainfall on cholera incidence at the district level. Temporal lag associations from zero to 7 months were also explored. The strongest associations were mapped in ArcGIS 9.2 to explore the spatial variation of the climate-cholera associations. The results showed that the strength of associations varied by climate variable, temporal lag and district. The climate variable with the strongest association was rainfall (1 and 2 month lags) and explains how cholera may have spread via flooding during the 1997-98 El Niño. Impacts were generally found in districts located on the west coast of Piura; however, associations were also observed in central Piura. This study illustrates the potential usefulness of temporal-spatial climate and health information for future epidemic preparedness and infectious disease prevention. It also demonstrates the challenges faced by public health scientists, particularly in developing countries, in the assessment of climate impacts on human health.

  15. Catechol Siderophore Transport by Vibrio cholerae

    Science.gov (United States)

    Allred, Benjamin E.; Raymond, Kenneth N.; Payne, Shelley M.

    2015-01-01

    ABSTRACT Siderophores, small iron-binding molecules secreted by many microbial species, capture environmental iron for transport back into the cell. Vibrio cholerae synthesizes and uses the catechol siderophore vibriobactin and also uses siderophores secreted by other species, including enterobactin produced by Escherichia coli. E. coli secretes both canonical cyclic enterobactin and linear enterobactin derivatives likely derived from its cleavage by the enterobactin esterase Fes. We show here that V. cholerae does not use cyclic enterobactin but instead uses its linear derivatives. V. cholerae lacked both a receptor for efficient transport of cyclic enterobactin and enterobactin esterase to promote removal of iron from the ferrisiderophore complex. To further characterize the transport of catechol siderophores, we show that the linear enterobactin derivatives were transported into V. cholerae by either of the catechol siderophore receptors IrgA and VctA, which also transported the synthetic siderophore MECAM [1,3,5-N,N′,N″-tris-(2,3-dihydroxybenzoyl)-triaminomethylbenzene]. Vibriobactin is transported via the additional catechol siderophore receptor ViuA, while the Vibrio fluvialis siderophore fluvibactin was transported by all three catechol receptors. ViuB, a putative V. cholerae siderophore-interacting protein (SIP), functionally substituted for the E. coli ferric reductase YqjH, which promotes the release of iron from the siderophore in the bacterial cytoplasm. In V. cholerae, ViuB was required for the use of vibriobactin but was not required for the use of MECAM, fluvibactin, ferrichrome, or the linear derivatives of enterobactin. This suggests the presence of another protein in V. cholerae capable of promoting the release of iron from these siderophores. IMPORTANCE Vibrio cholerae is a major human pathogen and also serves as a model for the Vibrionaceae, which include other serious human and fish pathogens. The ability of these species to persist and

  16. Household Transmission of Vibrio cholerae in Bangladesh.

    Directory of Open Access Journals (Sweden)

    Jonathan D Sugimoto

    2014-11-01

    Full Text Available Vibrio cholerae infections cluster in households. This study's objective was to quantify the relative contribution of direct, within-household exposure (for example, via contamination of household food, water, or surfaces to endemic cholera transmission. Quantifying the relative contribution of direct exposure is important for planning effective prevention and control measures.Symptom histories and multiple blood and fecal specimens were prospectively collected from household members of hospital-ascertained cholera cases in Bangladesh from 2001-2006. We estimated the probabilities of cholera transmission through 1 direct exposure within the household and 2 contact with community-based sources of infection. The natural history of cholera infection and covariate effects on transmission were considered. Significant direct transmission (p-value<0.0001 occurred among 1414 members of 364 households. Fecal shedding of O1 El Tor Ogawa was associated with a 4.9% (95% confidence interval: 0.9%-22.8% risk of infection among household contacts through direct exposure during an 11-day infectious period (mean length. The estimated 11-day risk of O1 El Tor Ogawa infection through exposure to community-based sources was 2.5% (0.8%-8.0%. The corresponding estimated risks for O1 El Tor Inaba and O139 infection were 3.7% (0.7%-16.6% and 8.2% (2.1%-27.1% through direct exposure, and 3.4% (1.7%-6.7% and 2.0% (0.5%-7.3% through community-based exposure. Children under 5 years-old were at elevated risk of infection. Limitations of the study may have led to an underestimation of the true risk of cholera infection. For instance, available covariate data may have incompletely characterized levels of pre-existing immunity to cholera infection. Transmission via direct exposure occurring outside of the household was not considered.Direct exposure contributes substantially to endemic transmission of symptomatic cholera in an urban setting. We provide the first estimate of

  17. Trends in the genomic epidemiology of Vibrio cholerae O1 isolated worldwide since 1961.

    Science.gov (United States)

    Jaiswal, Abhishek; Sarkar, Sounak; Das, Parijat; Nandy, Suman; Koley, Hemanta; Sarkar, Banwarilal

    2015-10-01

    Here we describe the international scenario of Vibrio cholerae with a comparative analysis of different aspects of typing. Representative V. cholerae strains (n=108) associated with endemic cholera regions from 29 states of India and worldwide were subjected to microbiological, molecular and phylogenetic study. All of the strains were V. cholerae serogroup O1 biotype El Tor and were typed according to both the new phage (NP) type and Basu & Mukherjee (BM) typing schemes. The predominant phage type was T-27 (NP)/T-4 (BM) (65.7%; n=71), followed by phage type T-27 (NP)/T-2 (BM) (14.8%; n=16), T-26 (NP)/T4 (BM) (12.0%; n=13), T-13 (NP)/T-4 (BM) (2.8%; n=3), T-20 (NP)/T-4 (BM) (1.9%; n=2), T-3 (NP)/T-4 (BM) (0.9%; n=1), T-23 (NP)/T-4 (BM) (0.9%; n=1) and T-24 (NP)/T-2 (BM) (0.9%; n=1). Mismatch amplification mutation assay PCR (MAMA-PCR) findings showed the dominance of ctxB El Tor genotype (77.1%; 54/70) from 1961-1991, whilst the next two epochs showed the supremacy of ctxB classical genotype. Multidrug-resistant strains showed resistance to erythromycin, streptomycin, trimethoprim/sulfamethoxazole, norfloxacin and ampicillin. The regional resistance of epidemic clones in India draws a layout of the rapid dissemination of resistance in the past 30 years and the necessity of proper treatment to protect populations at risk.

  18. 5-hydroxytryptamine release into human jejunum by cholera toxin.

    OpenAIRE

    Bearcroft, C P; Perrett, D.; Farthing, M J

    1996-01-01

    BACKGROUND: Cholera toxin produces intestinal secretion by activation of the adenylate cyclase complex. However animal studies have shown 5-hydroxytryptamine may be released after exposure to cholera toxin, and thereby contribute to the secretory state. AIM: To determine whether cholera toxin releases 5-hydroxytryptamine in human jejunum. SUBJECTS: Seven male subjects were given a subclinical dose of cholera toxin in a paired, controlled, randomised, double blind study. METHODS: A closed 10 c...

  19. Resilience of epidemics on networks

    CERN Document Server

    Lu, Dan; Zhang, Jiaquan; Wang, Huijuan; Li, Daqing

    2016-01-01

    Epidemic propagation on complex networks has been widely investigated, mostly with invariant parameters. However, the process of epidemic propagation is not always constant. Epidemics can be affected by various perturbations, and may bounce back to its original state, which is considered resilient. Here, we study the resilience of epidemics on networks, by introducing a different infection rate ${\\lambda_{2}}$ during SIS (susceptible-infected-susceptible) epidemic propagation to model perturbations (control state), whereas the infection rate is ${\\lambda_{1}}$ in the rest of time. Through simulations and theoretical analysis, we find that even for ${\\lambda_{2}<\\lambda_{c}}$, epidemics eventually could bounce back if control duration is below a threshold. This critical control time for epidemic resilience, i.e., ${cd_{max}}$ can be predicted by the diameter (${d}$) of the underlying network, with the quantitative relation ${cd_{max}\\sim d^{\\alpha}}$. Our findings can help to design a better mitigation stra...

  20. Isolation frequency and susceptibility pattern of non-O1 and non-O139 Vibrio cholerae in a tertiary health care laboratory, 1999-2012.

    Science.gov (United States)

    Irfan, S; Fasih, N; Ghanchi, N K; Khan, E

    2016-04-28

    In the past decade the importance of non-O1 and non-O139 strains of Vibrio cholerae has been highlighted globally. This study aimed to evaluate the frequency and antimicrobial susceptibility profile of non-O1 and non-O139 V. cholerae in Pakistan. Data of stool specimens yielding growth of non-O1 and non-O139 V. cholerae isolated at a national referral laboratory from 1999 to 2012 were retrospectively analysed and evaluated for resistance to ampicillin, tetracycline, chloramphenicol, co-trimoxazole and ofloxacin. A total of 95 800 stool samples submitted over 1999-2012 yielded 3668 strains of V. cholerae, of which 6% were non-O1 and non-O139 V. cholerae. A high isolation rate was found in the summer season, with a peak in the year 2003. Antimicrobial susceptibility data revealed increasing resistance to co-trimoxazole and ampicillin, but strains remained highly susceptible to ofloxacin. Active surveillance of serotypes and antimicrobial susceptibility is essential to predict future epidemics and define measures to curtail the disease.

  1. Genetic relatedness of selected clinical Vibrio cholerae O139 isolates from the southern coastal area of China over a 20-year period.

    Science.gov (United States)

    Li, B S; Xiao, Y; Wang, D C; Tan, H L; Ke, B X; He, D M; Ke, C W; Zhang, Y H

    2016-09-01

    Vibrio cholerae O139 emerged as a causative agent of epidemic cholera in 1992 in India and Bangladesh, and was subsequently reported in China in 1993. The genetic relatedness and molecular characteristics of V. cholerae O139 in Guangdong Province, located in the southern coastal area of China, remains undetermined. In this study, we investigated 136 clinical V. cholerae O139 isolates from 1993 to 2013 in Guangdong. By conventional PCR, 123 (90·4%) isolates were positive for ctxB, ace and zot. Sequencing of the positive amplicons indicated 113 (91·7%) isolates possessed the El Tor allele of ctxB (genotype 3); seven carried the classical ctxB type (genotype 1) and three harboured a novel ctxB type (genotype 5). With respect to tcpA, 123 (90·4%) isolates were positive for the El Tor allele. In addition, pulsed-field gel electrophoresis (with NotI digestion) differentiated the isolates into clusters A and B. Cluster A contained seven of the non-toxigenic isolates from 1998 to 2000; another six non-toxigenic isolates (from 1998 and 2007) and all of the toxigenic isolates formed cluster B. Our results suggest that over a 20-year period, the predominant O139 clinical isolates have maintained a relatively tight clonal structure, although some genetic variance and shift has occurred. Our data highlight the persistence of toxigenic V. cholerae O139 in clinical settings in the southern coastal area of China.

  2. Cholera risk factors, Papua New Guinea, 2010

    Directory of Open Access Journals (Sweden)

    Rosewell Alexander

    2012-11-01

    Full Text Available Abstract Background Cholera is newly emergent in Papua New Guinea but may soon become endemic. Identifying the risk factors for cholera provides evidence for targeted prevention and control measures. Methods We conducted a hospital-based case–control study to identify cholera risk factors. Using stool culture as the standard, we evaluated a cholera point of care test in the field. Results 176 participants were recruited: 54 cases and 122 controls. Independent risk factors for cholera were: being over 20 years of age (aOR 2.5; 95%CI 1.1, 5.4, defecating in the open air (or river (aOR 4.5; 95% CI 1.4, 14.4 and knowing someone who travelled to a cholera affected area (aOR 4.1; 95%CI 1.6, 10.7; while the availability of soap for handwashing at home was protective (aOR 0.41; 95%CI 0.19, 0.87. Those reporting access to a piped water distribution system in the home were twice as likely to report the availability of soap for handwashing. The sensitivity and specificity of the rapid test were 72% (95% CI 47–90 and 71% (95%CI 44–90%. Conclusions Improving population access to the piped water distribution system and sanitation will likely reduce transmission by enabling enhanced hygiene and limiting the contamination of water sources. The One step V. cholerae O1/O139 Antigen Test is of limited utility for clinical decision making in a hospital setting with access to traditional laboratory methods. Settlement dwellers and mobile populations of all age groups should be targeted for interventions in Papua New Guinea.

  3. Avian cholera in Nebraska's Rainwater Basin

    Science.gov (United States)

    Windingstad, R.M.; Hurt, J.J.; Trout, A.K.; Cary, J.

    1984-01-01

    The first report of avian cholera in North America occurred in northwestern Texas in winter 1944 (Quortrup et al. 1946). In 1975, mortality from avian cholera occurred for the first time in waterfowl in the Rainwater Basin of Nebraska when an estimated 25,000 birds died (Zinkl et al. 1977). Avian cholera has continued to cause mortality in wild birds in specific areas of the Basin each spring since. Losses of waterfowl from avian cholera continue to be much greater in some of the wetlands in the western part of the Basin than in the east. Several wetlands in the west have consistently higher mortality and are most often the wetlands where initial mortality is noticed each spring (Figure 1). The establishment of this disease in Nebraska is of considerable concern because of the importance of the Rainwater Basin as a spring staging area for waterfowl migrating to their breeding grounds. The wetlands in this area are on a major migration route used by an estimated 5 to 9 million ducks and several hundred thousand geese. A large portion of the western mid-continental greater white-fronted goose (Anser albifrons) population stage in the Basin each spring. Occasionally, whooping cranes (Grus americana) use these wetlands during migration, and lesser sandhill cranes (Grus canadensis) staging on the nearby Platte River sometimes use wetlands where avian cholera occurs (Anonymous 1981). Our objectives were to determine whether certain water quality variables in the Rainwater Basin differed between areas of high and low avian cholera incidence. These results would then be used for laboratory studies involving the survivability of Pasteurella multocida, the causative bacterium of avian cholera. Those studies will be reported elsewhere.

  4. Proximity Networks and Epidemics

    CERN Document Server

    Toroczkai, Z

    2007-01-01

    Disease spread in most biological populations requires the proximity of agents. In populations where the individuals have spatial mobility, the contact graph is generated by the "collision dynamics" of the agents, and thus the evolution of epidemics couples directly to the spatial dynamics of the population. We first briefly review the properties and the methodology of an agent-based simulation (EPISIMS) to model disease spread in realistic urban dynamic contact networks. Using the data generated by this simulation, we introduce the notion of dynamic proximity networks which takes into account the relevant time scales for disease spread: contact duration, infectivity period and rate of contact creation. This approach promises to be a good candidate for a unified treatment of epidemic types that are driven by agent collision dynamics. In particular, using a simple model, we show that it can can account for the observed qualitative differences between the degree distributions of contact graphs of diseases with ...

  5. 21 CFR 866.3930 - Vibrio cholerae serological reagents.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Vibrio cholerae serological reagents. 866.3930... cholerae serological reagents. (a) Identification. Vibrio cholerae serological reagents are devices that are used in the agglutination (an antigen-antibody clumping reaction) test to identify Vibrio...

  6. Whole-Genome Sequences of 26 Vibrio cholerae Isolates

    Science.gov (United States)

    Watve, Samit S.; Chande, Aroon T.; Rishishwar, Lavanya; Jordan, I. King

    2016-01-01

    The human pathogen Vibrio cholerae employs several adaptive mechanisms for environmental persistence, including natural transformation and type VI secretion, creating a reservoir for the spread of disease. Here, we report whole-genome sequences of 26 diverse V. cholerae isolates, significantly increasing the sequence diversity of publicly available V. cholerae genomes. PMID:28007852

  7. Cross-Border Cholera Outbreaks in Sub-Saharan Africa, the Mystery behind the Silent Illness: What Needs to Be Done?

    Directory of Open Access Journals (Sweden)

    Godfrey Bwire

    affected age groups. To successfully prevent and control these outbreaks, guidelines and strategies should be reviewed to assign clear roles and responsibilities to cholera actors on collaboration, prevention, detection, monitoring and control of these epidemics.

  8. Cross-Border Cholera Outbreaks in Sub-Saharan Africa, the Mystery behind the Silent Illness: What Needs to Be Done?

    Science.gov (United States)

    Mwesawina, Maurice; Baluku, Yosia; Kanyanda, Setiala S. E.; Orach, Christopher Garimoi

    2016-01-01

    school going children were the most affected age groups. To successfully prevent and control these outbreaks, guidelines and strategies should be reviewed to assign clear roles and responsibilities to cholera actors on collaboration, prevention, detection, monitoring and control of these epidemics. PMID:27258124

  9. Phylogenetic Diversity of Vibrio cholerae Associated with Endemic Cholera in Mexico from 1991 to 2008

    Directory of Open Access Journals (Sweden)

    Seon Young Choi

    2016-03-01

    Full Text Available An outbreak of cholera occurred in 1991 in Mexico, where it had not been reported for more than a century and is now endemic. Vibrio cholerae O1 prototype El Tor and classical strains coexist with altered El Tor strains (1991 to 1997. Nontoxigenic (CTX− V. cholerae El Tor dominated toxigenic (CTX+ strains (2001 to 2003, but V. cholerae CTX+ variant El Tor was isolated during 2004 to 2008, outcompeting CTX−V. cholerae. Genomes of six Mexican V. cholerae O1 strains isolated during 1991 to 2008 were sequenced and compared with both contemporary and archived strains of V. cholerae. Three were CTX+ El Tor, two were CTX− El Tor, and the remaining strain was a CTX+ classical isolate. Whole-genome sequence analysis showed the six isolates belonged to five distinct phylogenetic clades. One CTX− isolate is ancestral to the 6th and 7th pandemic CTX+V. cholerae isolates. The other CTX− isolate joined with CTX− non-O1/O139 isolates from Haiti and seroconverted O1 isolates from Brazil and Amazonia. One CTX+ isolate was phylogenetically placed with the sixth pandemic classical clade and the V. cholerae O395 classical reference strain. Two CTX+ El Tor isolates possessing intact Vibrio seventh pandemic island II (VSP-II are related to hybrid El Tor isolates from Mozambique and Bangladesh. The third CTX+ El Tor isolate contained West African-South American (WASA recombination in VSP-II and showed relatedness to isolates from Peru and Brazil. Except for one isolate, all Mexican isolates lack SXT/R391 integrative conjugative elements (ICEs and sensitivity to selected antibiotics, with one isolate resistant to streptomycin. No isolates were related to contemporary isolates from Asia, Africa, or Haiti, indicating phylogenetic diversity.

  10. Promotion of Cholera Awareness Among Households of Cholera Patients: A Randomized Controlled Trial of the Cholera-Hospital-Based-Intervention-for-7 Days (CHoBI7) Intervention.

    Science.gov (United States)

    Saif-Ur-Rahman, K M; Parvin, Tahmina; Bhuyian, Sazzadul Islam; Zohura, Fatema; Begum, Farzana; Rashid, Mahamud-Ur; Biswas, Shwapon Kumar; Sack, David; Sack, R Bradley; Monira, Shirajum; Alam, Munirul; Shaly, Nusrat Jahan; George, Christine Marie

    2016-12-07

    Previous studies have demonstrated that household contacts of cholera patients are highly susceptible to cholera infections for a 7-day period after the presentation of the index patient in the hospital. However, there is no standard of care to prevent cholera transmission in this high-risk population. Furthermore, there is limited information available on awareness of cholera transmission and prevention among cholera patients and their household contacts. To initiate a standard of care for this high-risk population, we developed the Cholera-Hospital-Based-Intervention-for-7-Days (CHoBI7), which delivers a handwashing with soap and water treatment intervention to household contacts during the time they spend with the admitted cholera patient in the hospital and reinforces these messages through home visits. To test CHoBI7, we conducted a randomized controlled trial among 302 intervention cholera patient household members and 302 control cholera patient household members in Dhaka, Bangladesh. In this study, we evaluated the effectiveness of the CHoBI7 intervention in increasing awareness of cholera transmission and prevention, and the key times for handwashing with soap. We observed a significant increase in cholera knowledge score in the intervention arm compared with the control arm at both the 1-week follow-up {score coefficient = 2.34 (95% confidence interval [CI] = 1.96, 2.71)} and 6 to 12-month follow-up period (score coefficient = 1.59 [95% CI = 1.05, 2.13]). This 1-week hospital- and home-based intervention led to a significant increase in knowledge of cholera transmission and prevention which was sustained 6 to 12 months post-intervention. These findings suggest that the CHoBI7 intervention presents a promising approach to increase cholera awareness among this high-risk population.

  11. Global climate and infectious disease: The cholera paradigm

    Energy Technology Data Exchange (ETDEWEB)

    Colwell, R.R. [Univ. of Maryland Biotechnology Inst., College Park, MD (United States)

    1996-12-20

    Historically, infectious diseases have had a profound effect on human populations, including their evolution and cultural development. Despite significant advances in medical science, infectious diseases continue to impact human populations in many parts of the world. Emerging diseases are considered to be those infections that either are newly appearing in the population or are rapidly increasing in incidence or expanding in geographic range. Emergence of disease is not a simple phenomenon, mainly because infectious diseases are dynamic. Most new infections are not caused by truly new pathogens but are microorganisms (viruses, bacteria, fungi, protozoa, and helminths) that find a new way to enter a susceptible host and are newly recognized because of recently developed, sensitive techniques. Human activities drive emergence of disease and a variety of social, economic, political, climatic, technological, and environmental factors can shape the pattern of a disease and influence its emergence into populations. For example, travel affects emergence of disease, and human migrations have been the main source of epidemics throughout history. Trade caravans, religious pilgrimage, and military campaigns facilitated the spread of plague, smallpox, and cholera. Global travel is a fact of modern life and, equally so, the continued evolution of microorganisms; therefore, new infections will continue to emerge, and known infections will change in distribution, frequency, and severity. 88 refs., 1 fig.

  12. Landscape changes in the environment due to military actions and their epidemic risks

    Directory of Open Access Journals (Sweden)

    Krushelnitsky A.D.

    2016-05-01

    Full Text Available The article considers the influence of the military-ecological and man-caused-anthropogenic factors on the environment state and natural processes. Epidemic risks and consequences resulted from landscapic changes of the environment which arise as a result of war and destruction of ecosystems are described.

  13. Application of a paper based device containing a new culture medium to detect Vibrio cholerae in water samples collected in Haiti.

    Science.gov (United States)

    Briquaire, Romain; Colwell, Rita R; Boncy, Jacques; Rossignol, Emmanuel; Dardy, Aline; Pandini, Isabelle; Villeval, François; Machuron, Jean-Louis; Huq, Anwar; Rashed, Shah; Vandevelde, Thierry; Rozand, Christine

    2017-02-01

    Cholera is now considered to be endemic in Haiti, often with increased incidence during rainy seasons. The challenge of cholera surveillance is exacerbated by the cost of sample collection and laboratory analysis. A diagnostic tool is needed that is low cost, easy-to-use, and able to detect and quantify Vibrio cholerae accurately in water samples within 18-24h, and perform reliably in remote settings lacking laboratory infrastructure and skilled staff. The two main objectives of this study were to develop and evaluate a new culture medium embedded in a new diagnostic tool (PAD for paper based analytical device) for detecting Vibrio cholerae from water samples collected in Haiti. The intent is to provide guidance for corrective action, such as chlorination, for water positive for V. cholerae epidemic strains. For detecting Vibrio cholerae, a new chromogenic medium was designed and evaluated as an alternative to thiosulfate citrate bile salts sucrose (TCBS) agar for testing raw water samples. Sensitivity and specificity of the medium were assessed using both raw and spiked water samples. The Vibrio cholerae chromogenic medium was proved to be highly selective against most of the cultivable bacteria in the water samples, without loss of sensitivity in detection of V. cholerae. Thus, reliability of this new culture medium for detection of V. cholerae in the presence of other Vibrio species in water samples offers a significant advantage. A new paper based device containing the new chromogenic medium previously evaluated was compared with reference methods for detecting V. cholerae from spiked water sample. The microbiological PAD specifications were evaluated in Haiti. More precisely, a total of 185 water samples were collected at five sites in Haiti, June 2014 and again in June 2015. With this new tool, three V. cholerae O1 and 17 V. cholerae non-O1/O139 strains were isolated. The presence of virulence-associated and regulatory genes, including ctxA, zot, ace, and tox

  14. Pathophysiological mechanisms of diarrhea caused by the Vibrio cholerae O1 El Tor variant: an in vivo study in mice.

    Science.gov (United States)

    Satitsri, Saravut; Pongkorpsakol, Pawin; Srimanote, Potjanee; Chatsudthipong, Varanuj; Muanprasat, Chatchai

    2016-10-01

    Cholera is caused by infection with Vibrio cholerae. This study aimed to investigate the pathophysiology of diarrhea caused by the V. cholerae O1 El Tor variant (EL), a major epidemic strain causing severe diarrhea in several regions. In the ligated ileal loop model of EL-induced diarrhea in the ICR mice, a cystic fibrosis transmembrane conductance regulator (CFTR) inhibitor and a calcium-activated chloride channel (CaCC) inhibitor similarly inhibited intestinal fluid secretion. In addition, barrier disruption and NF-κB-mediated inflammatory responses, e.g., iNOS and COX-2 expression, were observed in the infected ileal loops. Interestingly, intestinal fluid secretion and barrier disruption were suppressed by NF-κB and COX-2 inhibitors, whereas an iNOS inhibitor suppressed barrier disruption without affecting fluid secretion. Furthermore, EP2 and EP4 PGE2 receptor antagonists ameliorated the fluid secretion in the infected ileal loops. The amount of cholera toxin (CT) produced in the ileal loops by the EL was ∼2.4-fold of the classical biotype. The CT transcription inhibitor virstatin, a toll-like receptor-4 (TLR-4) antibody and a CT antibody suppressed the EL-induced intestinal fluid secretion, barrier disruption and COX-2 expression. The CT at levels detected during EL infection induced mild intestinal barrier disruption without inducing inflammatory responses in mouse intestine. Collectively, this study indicates that CT-induced intestinal barrier disruption and subsequent TLR-4-NF-κB-mediated COX-2 expression are involved in the pathogenesis of EL-induced diarrhea and represent promising novel therapeutic targets of cholera.

  15. Understanding Climate Change Impacts in a Cholera Endemic Megacity: Disease Trends, Hydroclimatic Indicators and Near Future-Term Projections

    Science.gov (United States)

    Akanda, A. S. S.; Hasan, M. A.; Serman, E. A.; Jutla, A.; Huq, A.; Colwell, R. R.

    2015-12-01

    The last three decades of surveillance data shows a drastic increase of cholera prevalence in the largest cholera-endemic city in the world - Dhaka, Bangladesh. While an endemic trend is getting stronger in the dry season, the post-monsoon season shows increased variability and is epidemic in nature. The pre-monsoon dry season is becoming the dominant cholera season of the year, followed by monsoon flood related propagation in later months of the year. Although the heavily populated and rapidly urbanizing Dhaka region has experienced noticeable shifts in pre monsoon temperature and precipitation patterns and subsequent monsoon variations, to date, there has not been any systematic study on linking the long-term disease trends with observed changes in hydroclimatic indicators. Here, we focus on the past 30-year dynamics of urban cholera prevalence in Dhaka with changes in climatic or anthropogenic forcings to develop projections for the next 30-year period. We focus on the dry and the wet season indicators individually, and develop trends of maximum rainfall intensity, lowest rainfall totals in the pre-monsoon period, number of consecutive dry days, number of wet days, and number of rainy days with greater than 500mm rainfall using a recently developed gridded data product - and compare with regional hydrology, flooding, water usage, changes in distribution systems, population growth and density in urban settlements, and frequency of natural disasters. We then use a bias correction method to develop the next 30 years projections of CMIP5 Regional Climate Model outputs and impacts on cholera prevalence using a probabilistic forecasting approach.

  16. Epidemiological analysis of cholera O139 in Nantong from 1999 to 2011%南通市1999~2011年O139霍乱疫情流行病学分析

    Institute of Scientific and Technical Information of China (English)

    张烽; 朱平; 马平

    2013-01-01

    目的 分析南通市O139霍乱流行特征,为制定防控策略提供依据.方法 采用描述流行病学方法对南通市1999~2011年O139霍乱疫情资料进行分析.结果 南通市1999~2011年共报告O139霍乱72例,以散发疫情为主;流行高峰在7~10月;职业分布以农民为主,发病年龄有老年化的倾向;病例临床分型以中重型为主;大部分发病与聚餐或食用不洁食物有关.结论 针对南通市O139霍乱流行特点,应落实“三管一灭”,开展卫生宣教,加强疫情监测,坚持“早、小、严、实”的原则开展疫点处理,防止疫情扩散蔓延.%OBJECTIVE To provide strategies for prevention and control of cholera O139 through analyzing the epidemic characteristics of cholera O139 in Nantong.METHODS Analysis of cholera O139 was carried out with descriptive epidemiological method in Nantong from 1999 to 2011.RESULTS Altogether 72 cholera O139 cases were reported in Nantong from 1999 to 2011,sporadic disease was the major form of occurrence; the epidemic peak was from July to October; the patients were mainly farmers and getting older gradually; most of them were moderate or severe cases; mostly were relate to participating dinners or eating contaminated foods.CONCLUSION According to the epidemic characteristics of cholera O139 in Nantong,comprehensive prevention and control measures such as clean water and foods supply,proper feces disposal,flies elimination and education should be adopted.Supervision of cholera O139 epidemic should be strengthened.It should take strict treatment in the epidemic regions earlier to prevent the spread of cholera O139.

  17. Vibrio cholerae as a predator: lessons from evolutionary principles

    Directory of Open Access Journals (Sweden)

    Stefan ePukatzki

    2013-12-01

    Full Text Available Diarrheal diseases are the second-most common cause of death among children under the age of five worldwide. Cholera alone, caused by the marine bacterium Vibrio cholerae, is responsible for several million cases and over 120,000 deaths annually. When contaminated water is ingested, V. cholerae passes through the gastric acid barrier, penetrates the mucin layer of the small intestine, and adheres to the underlying epithelial lining. V. cholerae multiplies rapidly, secretes cholera toxin, and exits the human host in vast numbers during diarrheal purges. How V. cholerae rapidly reaches such high numbers during each purge is not clearly understood. We propose that V. cholerae employs its bactericidal type VI secretion system to engage in intraspecies and intraguild predation for nutrient acquisition to support rapid growth and multiplication.

  18. Population-Level Effect of Cholera Vaccine on Displaced Populations, South Sudan, 2014.

    Science.gov (United States)

    Azman, Andrew S; Rumunu, John; Abubakar, Abdinasir; West, Haley; Ciglenecki, Iza; Helderman, Trina; Wamala, Joseph Francis; Vázquez, Olimpia de la Rosa; Perea, William; Sack, David A; Legros, Dominique; Martin, Stephen; Lessler, Justin; Luquero, Francisco J

    2016-06-01

    Following mass population displacements in South Sudan, preventive cholera vaccination campaigns were conducted in displaced persons camps before a 2014 cholera outbreak. We compare cholera transmission in vaccinated and unvaccinated areas and show vaccination likely halted transmission within vaccinated areas, illustrating the potential for oral cholera vaccine to stop cholera transmission in vulnerable populations.

  19. Population-Level Effect of Cholera Vaccine on Displaced Populations, South Sudan, 2014

    OpenAIRE

    Azman, AS; Rumunu, J; Abubakar, A.; West, H.; Ciglenecki, I; Helderman, T; Wamala, JF; Vázquez, OR; W Perea; Sack, DA; Legros, D; Martin, S; Lessler, J; Luquero, FJ

    2016-01-01

    Following mass population displacements in South Sudan, preventive cholera vaccination campaigns were conducted in displaced persons camps before a 2014 cholera outbreak. We compare cholera transmission in vaccinated and unvaccinated areas and show vaccination likely halted transmission within vaccinated areas, illustrating the potential for oral cholera vaccine to stop cholera transmission in vulnerable populations.

  20. Evidence that a non-O1 Vibrio cholerae produces enterotoxin that is similar but not identical to cholera enterotoxin.

    OpenAIRE

    Yamamoto, K.; Takeda, Y.; Miwatani, T; Craig, J. P.

    1983-01-01

    Cholera-like enterotoxin produced by a non-O1 strain of Vibrio cholerae, S7 (S7 enterotoxin), isolated from human diarrheal stool, was purified, and its physicochemical, biological, and immunological properties were compared with those of cholera enterotoxin from V. cholerae O1 569B (CT) and an enterotoxin produced by another non-O1 V. cholerae (E8498 enterotoxin) reported previously (Yamamoto et al., Infect. Immun. 39:1128-1135, 1983). The purified S7 enterotoxin had physicochemical properti...

  1. Detection of Vibrio cholerae and Acanthamoeba species from same natural water samples collected from different cholera endemic areas in Sudan

    Directory of Open Access Journals (Sweden)

    Saeed Amir

    2011-04-01

    Full Text Available Abstract Background Vibrio cholerae O1 and V. cholerae O139 infect humans, causing the diarrheal and waterborne disease cholera, which is a worldwide health problem. V. cholerae and the free-living amoebae Acanthamoeba species are present in aquatic environments, including drinking water and it has shown that Acanthamoebae support bacterial growth and survival. Recently it has shown that Acanthamoeba species enhanced growth and survival of V. cholerae O1 and O139. Water samples from different cholera endemic areas in Sudan were collected with the aim to detect both V. cholerae and Acanthamoeba species from same natural water samples by polymerase chain reaction (PCR. Findings For the first time both V. cholerae and Acanthamoeba species were detected in same natural water samples collected from different cholera endemic areas in Sudan. 89% of detected V. cholerae was found with Acanthamoeba in same water samples. Conclusions The current findings disclose Acanthamoedae as a biological factor enhancing survival of V. cholerae in nature.

  2. Cholera Toxin Production Induced upon Anaerobic Respiration is Suppressed by Glucose Fermentation in Vibrio cholerae.

    Science.gov (United States)

    Oh, Young Taek; Lee, Kang-Mu; Bari, Wasimul; Kim, Hwa Young; Kim, Hye Jin; Yoon, Sang Sun

    2016-03-01

    The causative agent of pandemic cholera, Vibrio cholerae, infects the anaerobic environment of the human intestine. Production of cholera toxin (CT), a major virulence factor of V. cholerae, is highly induced during anaerobic respiration with trimethylamine N-oxide (TMAO) as an alternative electron acceptor. However, the molecular mechanism of TMAO-stimulated CT production is not fully understood. Herein, we reveal that CT production during anaerobic TMAO respiration is affected by glucose fermentation. When the seventh pandemic V. cholerae O1 strain N16961 was grown with TMAO and additional glucose, CT production was markedly reduced. Furthermore, an N16961 Δcrp mutant, devoid of cyclic AMP receptor protein (CRP), was defective in CT production during growth by anaerobic TMAO respiration, further suggesting a role of glucose metabolism in regulating TMAO-mediated CT production. TMAO reductase activity was noticeably decreased when grown together with glucose or by mutation of the crp gene. A CRP binding region was identified in the promoter region of the torD gene, which encodes a structural subunit of the TMAO reductase. Gel shift assays further confirmed the binding of purified CRP to the torD promoter sequence. Together, our results suggest that the bacterial ability to respire using TMAO is controlled by CRP, whose activity is dependent on glucose availability. Our results reveal a novel mechanism for the regulation of major virulence factor production by V. cholerae under anaerobic growth conditions.

  3. Antibody-secreting cell responses after Vibrio cholerae O1 infection and oral cholera vaccination in adults in Bangladesh.

    Science.gov (United States)

    Rahman, Atiqur; Rashu, Rasheduzzaman; Bhuiyan, Taufiqur Rahman; Chowdhury, Fahima; Khan, Ashraful Islam; Islam, Kamrul; LaRocque, Regina C; Ryan, Edward T; Wrammert, Jens; Calderwood, Stephen B; Qadri, Firdausi; Harris, Jason B

    2013-10-01

    Infection with Vibrio cholerae and oral cholera vaccines (OCVs) induce transient circulating plasmablast responses that peak within approximately 7 days after infection or vaccination. We previously demonstrated that plasmablast responses strongly correlate with subsequent levels of V. cholerae-specific duodenal antibodies up to 6 months after V. cholerae infection. Hence, plasmablast responses provide an early window into the immunologic memory at the mucosal surface. In this study, we characterized plasmablast responses following V. cholerae infection using a flow cytometrically defined population and compared V. cholerae-specific responses in adult patients with V. cholerae O1 infection and vaccinees who received the OCV Dukoral (Crucell Vaccines Canada). Among flow cytometrically sorted populations of gut-homing plasmablasts, almost 50% of the cells recognized either cholera toxin B subunit (CtxB) or V. cholerae O1 lipopolysaccharide (LPS). Using a traditional enzyme-linked immunosorbent spot assay (ELISPOT), we found that infection with V. cholerae O1 and OCVs induce similar responses to the protein antigen CtxB, but responses to LPS were diminished after OCV compared to those after natural V. cholerae infection. A second dose of OCV on day 14 failed to boost circulating V. cholerae-specific plasmablast responses in Bangladeshi adults. Our results differ from those in studies from areas where cholera is not endemic, in which a second vaccination on day 14 significantly boosts plasmablast responses. Given these results, it is likely that the optimal boosting strategies for OCVs differ significantly between areas where V. cholerae infection is endemic and those where it is not.

  4. The World of Wars

    DEFF Research Database (Denmark)

    Harste, Gorm

    2014-01-01

    The world of the future will not be one without wars. The many hopes we have about a future peace governed by a more or less confederal state will not make wars obsolete. Regular wars and irregular wars will continue and probably about different subjects than we are used to. The article proposes ...

  5. Vietnam: Historians at War

    Science.gov (United States)

    Moyar, Mark

    2008-01-01

    Although the Vietnam War ended more than thirty years ago, historians remain as divided on what happened as the American people were during the war. Mark Moyar maps the ongoing battle between "orthodox" and "revisionist" Vietnam War historians: the first group, those who depict Vietnam as a bad war that the United States should…

  6. Swedish isolates of Vibrio cholerae enhance their survival when interacted intracellularly with Acanthamoeba castellanii

    Directory of Open Access Journals (Sweden)

    Salah Shanan

    2016-04-01

    Full Text Available Vibrio cholerae is a Gram-negative bacterium that occurs naturally in aquatic environment. Only V. cholerae O1 and V. cholerae O139 produce cholera toxin and cause cholera, other serogroups can cause gastroenteritis, open wounds infection, and septicaemia. V. cholerae O1 and V. cholerae O139 grow and survive inside Acanthamoeba castellanii. The aim of this study is to investigate the interactions of the Swedish clinical isolates V. cholerae O3, V. cholerae O4, V. cholerae O5, V. cholerae O11, and V. cholerae O160 with A. castellanii. The interaction between A. castellanii and V. cholerae strains was studied by means of amoeba cell counts, viable counts of the bacteria in the absence or presence of amoebae, and of the intracellularly growing bacteria, visualised by electron microscopy. These results show that all V. cholerae can grow and survive outside and inside the amoebae, disclosing that V. cholerae O3, V. cholerae O4, V. cholerae O5, V. cholerae O11, and V. cholerae O160 all can be considered as facultative intracellular bacteria.

  7. Swedish isolates of Vibrio cholerae enhance their survival when interacted intracellularly with Acanthamoeba castellanii.

    Science.gov (United States)

    Shanan, Salah; Bayoumi, Magdi; Saeed, Amir; Sandström, Gunnar; Abd, Hadi

    2016-01-01

    Vibrio cholerae is a Gram-negative bacterium that occurs naturally in aquatic environment. Only V. cholerae O1 and V. cholerae O139 produce cholera toxin and cause cholera, other serogroups can cause gastroenteritis, open wounds infection, and septicaemia. V. cholerae O1 and V. cholerae O139 grow and survive inside Acanthamoeba castellanii. The aim of this study is to investigate the interactions of the Swedish clinical isolates V. cholerae O3, V. cholerae O4, V. cholerae O5, V. cholerae O11, and V. cholerae O160 with A. castellanii. The interaction between A. castellanii and V. cholerae strains was studied by means of amoeba cell counts, viable counts of the bacteria in the absence or presence of amoebae, and of the intracellularly growing bacteria, visualised by electron microscopy. These results show that all V. cholerae can grow and survive outside and inside the amoebae, disclosing that V. cholerae O3, V. cholerae O4, V. cholerae O5, V. cholerae O11, and V. cholerae O160 all can be considered as facultative intracellular bacteria.

  8. Surface-attachment sequence in Vibrio Cholerae

    Science.gov (United States)

    Utada, Andrew; Gibiansky, Maxsim; Wong, Gerard

    2013-03-01

    Vibrio cholerae is a gram-negative bacterium that causes the human disease cholera. It is found natively in brackish costal waters in temperate climates, where it attaches to the surfaces of a variety of different aquatic life. V. cholerae has a single polar flagellum making it highly motile, as well as a number of different pili types, enabling it to attach to both biotic and abiotic surfaces. Using in-house built tracking software we track all surface-attaching bacteria from high-speed movies to examine the early-time attachment profile of v. cholerae onto a smooth glass surface. Similar to previous work, we observe right-handed circular swimming trajectories near surfaces; however, in addition we see a host of distinct motility mechanisms that enable rapid exploration of the surface before forming a more permanent attachment. Using isogenic mutants we show that the motility mechanisms observed are due to a complex combination of hydrodynamics and pili-surface interactions. Lauga, E., DiLuzio, W. R., Whitesides, G. M., Stone, H. A. Biophys. J. 90, 400 (2006).

  9. Maladi Kolera 2 PSA (:30) (Cholera 2)

    Centers for Disease Control (CDC) Podcasts

    2010-02-18

    This is an important public health announcement about cholera prevention and food preparation tips you can use to prevent the spread of disease. Language: Haitian Creole.  Created: 2/18/2010 by Centers for Disease Control and Prevention (CDC).   Date Released: 2/18/2010.

  10. Maladi Kolera 1 PSA (:30) (Cholera 1)

    Centers for Disease Control (CDC) Podcasts

    2010-02-18

    This is an important public health announcement about cholera symptoms and ways you can prevent the spread of disease. Language: Haitian Creole.  Created: 2/18/2010 by Centers for Disease Control and Prevention (CDC).   Date Released: 2/18/2010.

  11. EFFECT OF AGGREGATION ON VIBRIO CHOLERAE INACTIVATION

    Science.gov (United States)

    Extensive research has shown that microorganisms exhibit increased resistance due to clumping, aggregation, particle association, or modification of antecedent growth conditions. During the course of investigating a major water-borne Vibrio cholerae outbreak in Peru, U.S. EPA inv...

  12. Preventing Maritime Transfer of Toxigenic Vibrio cholerae

    Science.gov (United States)

    Slaten, Douglas D.; Marano, Nina; Tappero, Jordan W.; Wellman, Michael; Albert, Ryan J.; Hill, Vincent R.; Espey, David; Handzel, Thomas; Henry, Ariel; Tauxe, Robert V.

    2012-01-01

    Organisms, including Vibrio cholerae, can be transferred between harbors in the ballast water of ships. Zones in the Caribbean region where distance from shore and water depth meet International Maritime Organization guidelines for ballast water exchange are extremely limited. Use of ballast water treatment systems could mitigate the risk for organism transfer. PMID:23017338

  13. A Natural Vaccine Candidate Strain Against Cholera

    Institute of Scientific and Technical Information of China (English)

    LIUYAN-QING; QIGUO-MING; 等

    1995-01-01

    El Tor Vibrio cholerae(EVC)strains may be classified into two kinds-epidemigenic(EEVC)strains and non-epidemigenic(NEEVC)strains-based on a phage-biotyping system.A large number of EEVC strains have been screened for toxigenic and putative colonization attributes.One such naturally occurring strain(designated IEM101)has been found which is devoid of genes encoding cholera toxin(CT),accessory cholera enterotoxin(ACE),zonula occludens toxin(ZOT),but possesses RS1 sequences and toixn-coregulated pilus A gene(tcpA)although tcpA is poorly expressed.It expresses type B pili but does not posses type C pili.It is an El Tor Ogawa strain and does not cause fluid accumulation in rabbit ileal loop tests.Active immunization of rabbits with strain IEM101 elicited good protection against challenge with virulent strains of V.cholerae Ol.Oral administration cased no side effects in 15 human volunteers.colonized the gut for four to ten days and elicited good immune responses.

  14. Genome assortment, not serogroup, defines Vibrio cholerae pandemic strains

    Energy Technology Data Exchange (ETDEWEB)

    Brettin, Thomas S [Los Alamos National Laboratory; Bruce, David C [Los Alamos National Laboratory; Challacombe, Jean F [Los Alamos National Laboratory; Detter, John C [Los Alamos National Laboratory; Han, Cliff S [Los Alamos National Laboratory; Munik, A C [Los Alamos National Laboratory; Chertkov, Olga [Los Alamos National Laboratory; Meincke, Linda [Los Alamos National Laboratory; Saunders, Elizabeth [Los Alamos National Laboratory; Choi, Seon Y [SEOUL NATL. UNIV.; Haley, Bradd J [U. MARYLAND; Taviani, Elisa [U. MARYLAND; Jeon, Yoon - Seong [INTL. VACCINE INST. SEOUL; Kim, Dong Wook [INTL. VACCINE INST. SEOUL; Lee, Jae - Hak [SEOUL NATL. UNIV.; Walters, Ronald A [PNNL; Hug, Anwar [NATL. INST. CHOLERIC ENTERIC DIS.; Colwell, Rita R [U. MARYLAND

    2009-01-01

    Vibrio cholerae, the causative agent of cholera, is a bacterium autochthonous to the aquatic environment, and a serious public health threat. V. cholerae serogroup O1 is responsible for the previous two cholera pandemics, in which classical and El Tor biotypes were dominant in the 6th and the current 7th pandemics, respectively. Cholera researchers continually face newly emerging and re-emerging pathogenic clones carrying combinations of new serogroups as well as of phenotypic and genotypic properties. These genotype and phenotype changes have hampered control of the disease. Here we compare the complete genome sequences of 23 strains of V. cholerae isolated from a variety of sources and geographical locations over the past 98 years in an effort to elucidate the evolutionary mechanisms governing genetic diversity and genesis of new pathogenic clones. The genome-based phylogeny revealed 12 distinct V. cholerae phyletic lineages, of which one, designated the V. cholerae core genome (CG), comprises both O1 classical and EI Tor biotypes. All 7th pandemic clones share nearly identical gene content, i.e., the same genome backbone. The transition from 6th to 7th pandemic strains is defined here as a 'shift' between pathogenic clones belonging to the same O1 serogroup, but from significantly different phyletic lineages within the CG clade. In contrast, transition among clones during the present 7th pandemic period can be characterized as a 'drift' between clones, differentiated mainly by varying composition of laterally transferred genomic islands, resulting in emergence of variants, exemplified by V.cholerae serogroup O139 and V.cholerae O1 El Tor hybrid clones that produce cholera toxin of classical biotype. Based on the comprehensive comparative genomics presented in this study it is concluded that V. cholerae undergoes extensive genetic recombination via lateral gene transfer, and, therefore, genome assortment, not serogroup, should be used to

  15. Clinical isolates of Vibrio cholerae O1 El Tor Ogawa of 2009 from Kolkata, India: preponderance of SXT element and presence of Haitian ctxB variant.

    Directory of Open Access Journals (Sweden)

    Braj M R N S Kutar

    Full Text Available BACKGROUND: Increase in the number of multidrug resistant pathogens and the accompanied rise in case fatality rates has hampered the treatment of many infectious diseases including cholera. Unraveling the mechanisms responsible for multidrug resistance in the clinical isolates of Vibrio cholerae would help in understanding evolution of these pathogenic bacteria and their epidemic potential. This study was carried out to identify genetic factors responsible for multiple drug resistance in clinical isolates of Vibrio cholerae O1, serotype Ogawa, biotype El Tor isolated from the patients admitted to the Infectious Diseases Hospital, Kolkata, India, in 2009. METHODOLOGY/PRINCIPAL FINDINGS: One hundred and nineteen clinical isolates of V. cholerae were analysed for their antibiotic resistance phenotypes. Antibiogram analysis revealed that majority of the isolates showed resistance to co-trimoxazole, nalidixic acid, polymixin B and streptomycin. In PCR, SXT integrase was detected in 117 isolates and its sequence showed 99% identity notably to ICEVchInd5 from Sevagram, India, ICEVchBan5 from Bangladesh and VC1786ICE sequence from Haiti outbreak among others. Antibiotic resistance traits corresponding to SXT element were transferred from the parent Vibrio isolate to the recipient E. coli XL-1 Blue cells during conjugation. Double-mismatch-amplification mutation assay (DMAMA revealed the presence of Haitian type ctxB allele of genotype 7 in 55 isolates and the classical ctxB allele of genotype 1 in 59 isolates. Analysis of topoisomerase sequences revealed the presence of mutation Ser83 → Ile in gyrA and Ser85→ Leu in parC. This clearly showed the circulation of SXT-containing V. cholerae as causative agent for cholera in Kolkata. CONCLUSIONS: There was predominance of SXT element in these clinical isolates from Kolkata region which also accounted for their antibiotic resistance phenotype typical of this element. DMAMA PCR showed them to be a mixture

  16. 应用PFGE分析广州稻叶型霍乱弧菌的同源性%Homology analysis of strains of Vibrio cholerae serotype Inaba isolated in Guangzhou by pulsed-field gel electrophoresis analysis (PFGE)

    Institute of Scientific and Technical Information of China (English)

    李孝权; 庞杏林; 张欣强; 邓志爱; 李美霞; 陈守义; 邓小玲; 王鸣

    2011-01-01

    Objective To analyze the characteristics of pathogenicity-associated genes and PFGE features of 40 strains of Vibrio cholerae (V.cholerae)serotype Inaba isolated in Guangzhou,and study homology and features of cholera epidemic caused by V.cholerae. Methods Polymerase Chain Reaction (PCR)assay was utilized to detect the four pathogenicity-associated genes of these isolates. PFGE using restriction enzyme Not I was employed in the molecular subtyping of V.cholerae isolates and PFGE patterns were analyzed by BioNumerics Version 4.0 software to perform cluster analysis and homology analysis. Pattem profiles were compared by utilizing the Dice coefficient and UPGMA (unweighted pair group method with arithmetic averages). Results Genotype A strains were found in most of the epidemic involved V. cholerae serotype Inaba. Most of environmentally isolated strains belonged to genotype C and genotype B. Eighteen distinct pulsotypes were distributed among 40 isolates typeable by PFGE. Closely related pulsotypes existed among V. cholerae isolates from cholera epidemic(with similarity value above 98% ) and pulsotypes of environmental strains demonstrated obvious diversity. Conclusions One of the major differences of V. cholerae serotype lnaba from cholera epidemic and the environment is whether they carry ctxA gene. Relative low homology was observed among V.cholerae serotype lnaba strains from these two sources, but it is still necessary to enforce the homology analysis and track the source of V. cholerae.%目的 分析广州40株稻叶型霍乱弧菌的毒力基因和PFGE特征,探讨菌株的同源性和广州稻叶型霍乱弧菌流行的特点.方法 应用PCR方法 检测稻叶型菌株的4种毒力基因,采用限制性内切酶Not I对菌株进行PFGE分型,使用BioNumerics Version 4.0软件(复选Dice相关系数和UPGMA方法 )对菌株进行聚类和同源分析.结果 绝大多数水型稻叶霍乱疫情相关菌株为genotype A型菌,而绝大多数环境分

  17. Collateral Damage and Communicable Disease with Particular Reference to Tactical Nuclear War in Europe.

    Science.gov (United States)

    1978-10-31

    assess the impact of wartime disruption on the frequency of disease outbreaks . Given the poor state of pre- dictability of epidemiology for peacetime...34since the end of World War II, there has not been a single outbreak of the classical com- municable diseases in Europe, Canada and the United States...former scourges, such as cholera, smallpox, plague and typhus fever. Scarlet fever, infectious hepatitis and salmonellosis are the diseases with the

  18. Rugose atypical Vibrio cholerae O1 El Tor responsible for 2009 cholera outbreak in India.

    Science.gov (United States)

    Chowdhury, Goutam; Bhadra, Rupak K; Bag, Satyabrata; Pazhani, Gururaja P; Das, Bhabatosh; Basu, Pallabi; Nagamani, K; Nandy, Ranjan K; Mukhopadhyay, Asish K; Ramamurthy, Thandavarayan

    2016-10-01

    Vibrio cholerae causes cholera outbreaks in endemic regions where the water quality and sanitation facilities remain poor. Apart from biotype and serotype changes, V. cholerae undergoes phase variation, which results in the generation of two morphologically different variants termed smooth and rugose. In this study, 12 rugose (R-VC) and 6 smooth (S-VC) V. cholerae O1 Ogawa isolates were identified in a cholera outbreak that occurred in Hyderabad, India. Antimicrobial susceptibility results showed that all the isolates were resistant to ampicillin, furazolidone and nalidixic acid. In addition, R-VC isolates were resistant to ciprofloxacin (92 %), streptomycin (92 %), erythromycin (83 %), trimethoprim-sulfamethoxazole (75 %) and tetracycline (75 %). Based on the ctxB gene analysis, all the isolates were identified as El Tor variant with mutation in two positions of ctxB, similar to the classical biotype. The R-VC isolates specifically showed excessive biofilm formation and were comparatively less motile. In addition, the majority of these isolates (~83 %) displayed random mutations in the hapR gene, which encodes haemagglutinin protease regulatory protein. In the PFGE analysis, R-VC and S-VC were placed in distinct clusters but remained clonally related. In the ribotyping analysis, all the R-VC isolates exhibited R-III pattern, which is a prevailing type among the current El Tor isolates. A hapR deletion mutant generated using an S-VC isolate expressed rugose phenotype. To our knowledge, this is the first report on the association of rugose V. cholerae O1 in a large cholera outbreak with extended antimicrobial resistance and random mutations in the haemagglutinin protease regulatory protein encoding gene (hapR).

  19. Accessory cholera enterotoxin, Ace, from Vibrio cholerae: structure, unfolding, and virstatin binding.

    Science.gov (United States)

    Chatterjee, Tanaya; Mukherjee, Debadrita; Dey, Sucharita; Pal, Aritrika; Hoque, Kazi Mirajul; Chakrabarti, Pinak

    2011-04-12

    Vibrio cholerae accessory cholera enterotoxin (Ace) is the third toxin, along with cholera toxin (CT) and zonula occludens toxin (Zot), that causes the endemic disease cholera. Structural characterization of Ace has been restricted because of the limited production of this toxic protein by V. cholerae. We have cloned, overexpressed, and purified Ace from V. cholerae strain O395 in Escherichia coli to homogeneity and determined its biological activity. The unfolding of the purified protein was investigated using circular dichroism and intrinsic tryptophan fluorescence. Because Ace is predominantly a hydrophobic protein, the degree of exposure of hydrophobic regions was identified from the spectral changes of the environment-sensitive fluorescent probe 4,4'-dianilino-1,1'-binaphthyl-5,5'-disulfonic acid (bis-ANS) that quenches the fluorescence of tryptophan residues of Ace in a concentration-dependent manner. Results showed that bis-ANS binds one monomeric unit of Ace with a 1:1 stoichiometry and a K' of 0.72 μM. Ace exists as a dimer, with higher oligomeric forms appearing upon glutaraldehyde cross-linking. This study also reports the binding of virstatin, a small molecule that inhibits virulence regulation in V. cholerae, to Ace. The binding constant (K=9×10(4) M(-1)) and the standard free energy change (ΔG°=-12 kcal mol(-1)) of Ace-virstatin interaction have been evaluated by the fluorescence quenching method. The binding does not affect the oligomeric status of Ace. A cell viability assay of the antibacterial activity of Ace has been performed using various microbial strains. A homology model of Ace, consistent with the experimental results, has been constructed.

  20. Outer membrane vesicles mediate transport of biologically active Vibrio cholerae cytolysin (VCC from V. cholerae strains.

    Directory of Open Access Journals (Sweden)

    Sridhar Elluri

    Full Text Available Outer membrane vesicles (OMVs released from Gram-negative bacteria can serve as vehicles for the translocation of virulence factors. Vibrio cholerae produce OMVs but their putative role in translocation of effectors involved in pathogenesis has not been well elucidated. The V. cholerae cytolysin (VCC, is a pore-forming toxin that lyses target eukaryotic cells by forming transmembrane oligomeric β-barrel channels. It is considered a potent toxin that contributes to V. cholerae pathogenesis. The mechanisms involved in the secretion and delivery of the VCC have not been extensively studied.OMVs from V. cholerae strains were isolated and purified using a differential centrifugation procedure and Optiprep centrifugation. The ultrastructure and the contents of OMVs were examined under the electron microscope and by immunoblot analyses respectively. We demonstrated that VCC from V. cholerae strain V:5/04 was secreted in association with OMVs and the release of VCC via OMVs is a common feature among V. cholerae strains. The biological activity of OMV-associated VCC was investigated using contact hemolytic assay and epithelial cell cytotoxicity test. It showed toxic activity on both red blood cells and epithelial cells. Our results indicate that the OMVs architecture might play a role in stability of VCC and thereby can enhance its biological activities in comparison with the free secreted VCC. Furthermore, we tested the role of OMV-associated VCC in host cell autophagy signalling using confocal microscopy and immunoblot analysis. We observed that OMV-associated VCC triggered an autophagy response in the target cell and our findings demonstrated for the first time that autophagy may operate as a cellular defence mechanism against an OMV-associated bacterial virulence factor.Biological assays of OMVs from the V. cholerae strain V:5/04 demonstrated that OMV-associated VCC is indeed biologically active and induces toxicity on mammalian cells and

  1. Cholera toxin structure, gene regulation and pathophysiological and immunological aspects.

    Science.gov (United States)

    Sánchez, J; Holmgren, J

    2008-05-01

    Many notions regarding the function, structure and regulation of cholera toxin expression have remained essentially unaltered in the last 15 years. At the same time, recent findings have generated additional perspectives. For example, the cholera toxin genes are now known to be carried by a non-lytic bacteriophage, a previously unsuspected condition. Understanding of how the expression of cholera toxin genes is controlled by the bacterium at the molecular level has advanced significantly and relationships with cell-density-associated (quorum-sensing) responses have recently been discovered. Regarding the cell intoxication process, the mode of entry and intracellular transport of cholera toxin are becoming clearer. In the immunological field, the strong oral immunogenicity of the non-toxic B subunit of cholera toxin (CTB) has been exploited in the development of a now widely licensed oral cholera vaccine. Additionally, CTB has been shown to induce tolerance against co-administered (linked) foreign antigens in some autoimmune and allergic diseases.

  2. Expression and secretion of cholera toxin B subunit in lactobacilli.

    Science.gov (United States)

    Okuno, Takahiro; Kashige, Nobuhiro; Satho, Tomomitsu; Irie, Keiichi; Hiramatsu, Yukihiro; Sharmin, Tanjina; Fukumitsu, Yuki; Uyeda, Saori; Yamada, Seitaro; Harakuni, Tetsuya; Miyata, Takeshi; Arakawa, Takeshi; Imoto, Masumi; Toda, Akihisa; Nakashima, Yukihiko; Miake, Fumio

    2013-01-01

    Lactic acid bacteria (LAB) are used in various fields, including in food and medical supplies. There has been a great deal of research into vaccine development using LAB as carriers due to their "generally recognized as safe" status. Cholera is an infectious disease that causes diarrhea due to cholera toxin (CT) produced by Vibrio cholerae. The pentameric cholera toxin B (CTB) subunit has no toxicity, and is used as an antigen in cholera vaccines and as a delivery molecule in vaccines to various diseases. In this study, we generated recombinant LAB expressing and secreting CTB. Here, we first report that CTB expressed and secreted from LAB bound to GM1 ganglioside. The secreted CTB was purified, and its immunogenicity was determined by intranasal administration into mice. The results of the present study suggested that it may be useful as the basis of a new oral cholera vaccine combining LAB and CTB.

  3. Chemoproteomic profiling of host and pathogen enzymes active in cholera

    Science.gov (United States)

    Hatzios, Stavroula K.; Hubbard, Troy; Sasabe, Jumpei; Munera, Diana; Clark, Lars; Bachovchin, Daniel A.; Qadri, Firdausi; Ryan, Edward T.; Davis, Brigid M.; Weerapana, Eranthie; Waldor, Matthew K.

    2016-01-01

    Activity-based protein profiling (ABPP) is a chemoproteomic tool for detecting active enzymes in complex biological systems. We used ABPP to identify secreted bacterial and host serine hydrolases that are active in animals infected with the cholera pathogen Vibrio cholerae. Four V. cholerae proteases were consistently active in infected rabbits, and one, VC0157 (renamed IvaP), was also active in human cholera stool. Inactivation of IvaP influenced the activity of other secreted V. cholerae and rabbit enzymes in vivo, while genetic disruption of all four proteases increased the abundance and binding of an intestinal lectin—intelectin—to V. cholerae in infected rabbits. Intelectin also bound to other enteric bacterial pathogens, suggesting it may constitute a previously unrecognized mechanism of bacterial surveillance in the intestine that is inhibited by pathogen-secreted proteases. Our work demonstrates the power of activity-based proteomics to reveal host-pathogen enzymatic dialogue in an animal model of infection. PMID:26900865

  4. Cholera outbreaks caused by an altered Vibrio cholerae O1 El Tor biotype strain producing classical cholera toxin B in Vietnam in 2007 to 2008.

    Science.gov (United States)

    Nguyen, Binh Minh; Lee, Je Hee; Cuong, Ngo Tuan; Choi, Seon Young; Hien, Nguyen Tran; Anh, Dang Duc; Lee, Hye Ri; Ansaruzzaman, M; Endtz, Hubert P; Chun, Jongsik; Lopez, Anna Lena; Czerkinsky, Cecil; Clemens, John D; Kim, Dong Wook

    2009-05-01

    Vibrio cholerae O1 isolates collected during cholera outbreaks occurring from late 2007 to early 2008 in northern Vietnam were revealed to represent an altered strain containing the RS1 element followed by a CTX prophage harboring El Tor type rstR and classical ctxB on the large chromosome.

  5. Epidemic dynamics on complex networks

    Institute of Scientific and Technical Information of China (English)

    ZHOU Tao; FU Zhongqian; WANG Binghong

    2006-01-01

    Recently, motivated by the pioneer work in revealing the small-world effect and scale-free property of various real-life networks, many scientists devote themselves to studying complex networks. One of the ultimate goals is to understand how the topological structures affect the dynamics upon networks. In this paper, we give a brief review on the studies of epidemic dynamics on complex networks, including the description of classical epidemic models, the epidemic spread on small-world and scale-free networks, and network immunization. Finally, perspectives and some interesting problems are proposed.

  6. Epidemic Diffusion on Complex Networks

    Institute of Scientific and Technical Information of China (English)

    WU Xiao-Yan; LIU Zong-Hua

    2007-01-01

    Boyh diffusion and epidemic are well studied in the stochastic systems and complex networks,respetively.Here we combine these two fields and study epidemic diffusion in complex networks.Instead of studying the threshold of infection,which was focused on in previous works,we focus on the diffusion.behaviour.We find that the epidemic diffusion in a complex network is an anomalous superdiffusion with varyingg diffusion exponext γand that γ is influenced seriously by the network structure,such as the clustering coefficient and the degree distribution.Numerical simulations have confirmed the theoretical predictions.

  7. Stochastic epidemic models: a survey

    CERN Document Server

    Britton, Tom

    2009-01-01

    This paper is a survey paper on stochastic epidemic models. A simple stochastic epidemic model is defined and exact and asymptotic model properties (relying on a large community) are presented. The purpose of modelling is illustrated by studying effects of vaccination and also in terms of inference procedures for important parameters, such as the basic reproduction number and the critical vaccination coverage. Several generalizations towards realism, e.g. multitype and household epidemic models, are also presented, as is a model for endemic diseases.

  8. The Transmission and Antibiotic Resistance Variation in a Multiple Drug Resistance Clade of Vibrio cholerae Circulating in Multiple Countries in Asia.

    Science.gov (United States)

    Pang, Bo; Du, Pengcheng; Zhou, Zhemin; Diao, Baowei; Cui, Zhigang; Zhou, Haijian; Kan, Biao

    2016-01-01

    Vibrio cholerae has caused massive outbreaks and even trans-continental epidemics. In 2008 and 2010, at least 3 remarkable cholera outbreaks occurred in Hainan, Anhui and Jiangsu provinces of China. To address the possible transmissions and the relationships to the 7th pandemic strains of those 3 outbreaks, we sequenced the whole genomes of the outbreak isolates and compared with the global isolates from the 7th pandemic. The three outbreaks in this study were caused by a cluster of V. cholerae in clade 3.B which is parallel to the clade 3.C that was transmitted from Nepal to Haiti and caused an outbreak in 2010. Pan-genome analysis provided additional evolution information on the mobile element and acquired multiple antibiotic resistance genes. We suggested that clade 3.B should be monitored because the multiple antibiotic resistant characteristics of this clade and the 'amplifier' function of China in the global transmission of current Cholera pandemic. We also show that dedicated whole genome sequencing analysis provided more information than the previous techniques and should be applied in the disease surveillance networks.

  9. The Transmission and Antibiotic Resistance Variation in a Multiple Drug Resistance Clade of Vibrio cholerae Circulating in Multiple Countries in Asia.

    Directory of Open Access Journals (Sweden)

    Bo Pang

    Full Text Available Vibrio cholerae has caused massive outbreaks and even trans-continental epidemics. In 2008 and 2010, at least 3 remarkable cholera outbreaks occurred in Hainan, Anhui and Jiangsu provinces of China. To address the possible transmissions and the relationships to the 7th pandemic strains of those 3 outbreaks, we sequenced the whole genomes of the outbreak isolates and compared with the global isolates from the 7th pandemic. The three outbreaks in this study were caused by a cluster of V. cholerae in clade 3.B which is parallel to the clade 3.C that was transmitted from Nepal to Haiti and caused an outbreak in 2010. Pan-genome analysis provided additional evolution information on the mobile element and acquired multiple antibiotic resistance genes. We suggested that clade 3.B should be monitored because the multiple antibiotic resistant characteristics of this clade and the 'amplifier' function of China in the global transmission of current Cholera pandemic. We also show that dedicated whole genome sequencing analysis provided more information than the previous techniques and should be applied in the disease surveillance networks.

  10. When, how, and where can oral cholera vaccines be used to interrupt cholera outbreaks?

    Science.gov (United States)

    Clemens, John; Holmgren, Jan

    2014-01-01

    Cholera continues to be a major global health problem, at times causing major and prolonged outbreaks in both endemic and nonendemic settings in developing countries. While improved water quality, sanitation, and hygiene (WASH) will provide the ultimate solution to prevention of this disease burden, this is a far-off goal for most developing countries. Oral cholera vaccines cholera vaccines (OCVs) have been demonstrated to be effective in the control of cholera outbreaks, and constitute useful tools to be used in conjunction with efforts to improve WASH. Two killed OCVs are prequalified by WHO for purchase by UN agencies for international use. Recently, WHO has launched a global stockpile stockpile of killed OCVs for use to control outbreaks. Rational deployment of OCV from this stockpile will require consideration of costs, feasibility, disease epidemiology epidemiology , and the protective characteristics of the vaccine deployed, as well as effective and rapid coordination of processes and logistics logistics used to make decisions on deployment and delivery of the vaccine to the population in need. Despite not having data on all the questions of relevance as to how to use OCVs to control cholera outbreaks in different settings, there is clearly more than enough evidence to initiate their use, as answers to remaining questions and refinement of policies will mainly come with experience.

  11. Transmission dynamics of cholera: Mathematical modeling and control strategies

    Science.gov (United States)

    Sun, Gui-Quan; Xie, Jun-Hui; Huang, Sheng-He; Jin, Zhen; Li, Ming-Tao; Liu, Liqun

    2017-04-01

    Cholera, as an endemic disease around the world, has generated great threat to human society and caused enormous morbidity and mortality with weak surveillance system. In this paper, we propose a mathematical model to describe the transmission of Cholera. Moreover, basic reproduction number and the global dynamics of the dynamical model are obtained. Then we apply our model to characterize the transmission process of Cholera in China. It was found that, in order to avoid its outbreak in China, it may be better to increase immunization coverage rate and make effort to improve environmental management especially for drinking water. Our results may provide some new insights for elimination of Cholera.

  12. The new epidemic.

    Science.gov (United States)

    Allen, Jeanne V; Mellin, Grace C

    2014-03-01

    Editor's note: From its first issue in 1900 through to the present day, AJN has unparalleled archives detailing nurses' work and lives over the last century. These articles not only chronicle nursing's growth as a profession within the context of the events of the day, but they also reveal prevailing societal attitudes about women, health care, and human rights. Today's nursing school curricula rarely include nursing's history, but it's a history worth knowing. To this end, From the AJN Archives will be a frequent column, containing articles selected to fit today's topics and times.This month's article, from the November 1982 issue, is the first AJN article published on AIDS. It was early in the epidemic; only 608 cases of Kaposi's sarcoma and opportunistic infections had been reported to the Centers for Disease Control and Prevention-a mere trickle in the flood that was to come. Reading it now, aware of all we've learned since, we have a sense of how much we were fumbling around in the dark in those early days, searching for a cause and a cure, often going in wrong directions. The closest we had come to the true nature of the syndrome was an understanding that "life-style factors seem to be involved and the agent appears to be infectious." To read the complete article from our archives, go to http://bit.ly/1iswhZe.

  13. [Epidemic parotiditis, a reportable disease].

    Science.gov (United States)

    Boverhoff, J C; Baart, J A

    2013-01-01

    Three consecutive patients with an acute swelling of one of the cheeks, were diagnosed with epidemic parotiditis. The first phase of the diagnostic procedure for an acute cheek swelling is to eliminate the possibility of odontogenic causes. When odontogenic problems have been excluded, non-dentition-related causes may be considered. An acute, progressive swelling in the preauricular area can often be attributed to an inflammation of the parotid gland, but epidemic parotiditis should also be considered. Epidemic parotiditis, or mumps, is caused by the mumps virus. Contamination occurs aerogenically. In the Netherlands, mumps vaccine is an ingredient of the governmental combined mump-measles-rubella inoculation programme. However, in recent years several small-scale parotiditis epidemics have broken out, predominantly among young, inoculated adults. Oropharyngeal mucus and blood samples are needed to diagnose the disease. Each case of the disease should be reported to the community healthcare service.

  14. Human mobility and epidemic invasion

    Science.gov (United States)

    Colizza, Vittoria

    2010-03-01

    The current H1N1 influenza pandemic is just the latest example of how human mobility helps drive infectious diseases. Travel has grown explosively in the last decades, contributing to an emerging complex pattern of traffic flows that unfolds at different scales, shaping the spread of epidemics. Restrictions on people's mobility are thus investigated to design possible containment measures. By considering a theoretical framework in terms of reaction-diffusion processes, it is possible to study the invasion dynamics of epidemics in a metapopulation system with heterogeneous mobility patterns. The system is found to exhibit a global invasion threshold that sets the critical mobility rate below which the epidemic is contained. The results provide a general framework for the understanding of the numerical evidence from detailed data-driven simulations that show the limited benefit provided by travel flows reduction in slowing down or containing an emerging epidemic.

  15. Epidemic Network Failures in Optical Transport Networks

    DEFF Research Database (Denmark)

    Ruepp, Sarah Renée; Katsikas, Dimitrios; Fagertun, Anna Manolova

    2013-01-01

    This paper presents a failure propagation model for transport networks which are affected by epidemic failures. The network is controlled using the GMPLS protocol suite. The Susceptible Infected Disabled (SID) epidemic model is investigated and new signaling functionality of GMPLS to support...... epidemic failure resolution is proposed. The results provide important input to service recovery mechanisms under epidemic failures....

  16. Genomic and phenotypic characterization of Vibrio cholerae non-O1 isolates from a US Gulf Coast cholera outbreak.

    Directory of Open Access Journals (Sweden)

    Bradd J Haley

    Full Text Available Between November 2010, and May 2011, eleven cases of cholera, unrelated to a concurrent outbreak on the island of Hispaniola, were recorded, and the causative agent, Vibrio cholerae serogroup O75, was traced to oysters harvested from Apalachicola Bay, Florida. From the 11 diagnosed cases, eight isolates of V. cholerae were isolated and their genomes were sequenced. Genomic analysis demonstrated the presence of a suite of mobile elements previously shown to be involved in the disease process of cholera (ctxAB, VPI-1 and -2, and a VSP-II like variant and a phylogenomic analysis showed the isolates to be sister taxa to toxigenic V. cholerae V51 serogroup O141, a clinical strain isolated 23 years earlier. Toxigenic V. cholerae O75 has been repeatedly isolated from clinical cases in the southeastern United States and toxigenic V. cholerae O141 isolates have been isolated globally from clinical cases over several decades. Comparative genomics, phenotypic analyses, and a Caenorhabditis elegans model of infection for the isolates were conducted. This analysis coupled with isolation data of V. cholerae O75 and O141 suggests these strains may represent an underappreciated clade of cholera-causing strains responsible for significant disease burden globally.

  17. Comparative microscopy study of Vibrio cholerae flagella

    Science.gov (United States)

    Konnov, Nikolai P.; Baiburin, Vil B.; Zadnova, Svetlana P.; Volkov, Uryi P.

    1999-06-01

    A fine structure of bacteria flagella is an important problem of molecular cell biology. Bacteria flagella are the self-assembled structures that allow to use the flagellum protein in a number of biotechnological applications. However, at present, there is a little information about high resolution scanning probe microscopy study of flagellum structure, in particular, about investigation of Vibrio cholerae flagella. In our lab have been carried out the high resolution comparative investigation of V. cholerae flagella by means of various microscopes: tunneling (STM), scanning force (SFM) and electron transmission. As a scanning probe microscope is used designed in our lab versatile SPM with replaceable measuring heads. Bacteria were grown, fixed and treated according to the conventional techniques. For STM investigations samples were covered with Pt/Ir thin films by rotated vacuum evaporation, in SFM investigations were used uncovered samples. Electron microscopy of the negatively stained bacteria was used as a test procedure.

  18. Epidemic spreading in complex networks

    Institute of Scientific and Technical Information of China (English)

    Jie ZHOU; Zong-hua LIU

    2008-01-01

    The study of epidemic spreading in complex networks is currently a hot topic and a large body of results have been achieved.In this paper,we briefly review our contributions to this field,which includes the underlying mechanism of rumor propagation,the epidemic spreading in community networks,the influence of varying topology,and the influence of mobility of agents.Also,some future directions are pointed out.

  19. Exoproteome and secretome derived broad spectrum novel drug and vaccine candidates in Vibrio cholerae targeted by Piper betel derived compounds.

    Directory of Open Access Journals (Sweden)

    Debmalya Barh

    Full Text Available Vibrio cholerae is the causal organism of the cholera epidemic, which is mostly prevalent in developing and underdeveloped countries. However, incidences of cholera in developed countries are also alarming. Because of the emergence of new drug-resistant strains, even though several generic drugs and vaccines have been developed over time, Vibrio infections remain a global health problem that appeals for the development of novel drugs and vaccines against the pathogen. Here, applying comparative proteomic and reverse vaccinology approaches to the exoproteome and secretome of the pathogen, we have identified three candidate targets (ompU, uppP and yajC for most of the pathogenic Vibrio strains. Two targets (uppP and yajC are novel to Vibrio, and two targets (uppP and ompU can be used to develop both drugs and vaccines (dual targets against broad spectrum Vibrio serotypes. Using our novel computational approach, we have identified three peptide vaccine candidates that have high potential to induce both B- and T-cell-mediated immune responses from our identified two dual targets. These two targets were modeled and subjected to virtual screening against natural compounds derived from Piper betel. Seven compounds were identified first time from Piper betel to be highly effective to render the function of these targets to identify them as emerging potential drugs against Vibrio. Our preliminary validation suggests that these identified peptide vaccines and betel compounds are highly effective against Vibrio cholerae. Currently we are exhaustively validating these targets, candidate peptide vaccines, and betel derived lead compounds against a number of Vibrio species.

  20. Catechol Siderophore Transport by Vibrio cholerae

    OpenAIRE

    Wyckoff, Elizabeth E.; Allred, Benjamin E.; Raymond, Kenneth N.; Payne, Shelley M

    2015-01-01

    Siderophores, small iron-binding molecules secreted by many microbial species, capture environmental iron for transport back into the cell. Vibrio cholerae synthesizes and uses the catechol siderophore vibriobactin and also uses siderophores secreted by other species, including enterobactin produced by Escherichia coli. E. coli secretes both canonical cyclic enterobactin and linear enterobactin derivatives likely derived from its cleavage by the enterobactin esterase Fes. We show here that V....

  1. Origins of the current seventh cholera pandemic.

    Science.gov (United States)

    Hu, Dalong; Liu, Bin; Feng, Lu; Ding, Peng; Guo, Xi; Wang, Min; Cao, Boyang; Reeves, Peter R; Wang, Lei

    2016-11-29

    Vibrio cholerae has caused seven cholera pandemics since 1817, imposing terror on much of the world, but bacterial strains are currently only available for the sixth and seventh pandemics. The El Tor biotype seventh pandemic began in 1961 in Indonesia, but did not originate directly from the classical biotype sixth-pandemic strain. Previous studies focused mainly on the spread of the seventh pandemic after 1970. Here, we analyze in unprecedented detail the origin, evolution, and transition to pandemicity of the seventh-pandemic strain. We used high-resolution comparative genomic analysis of strains collected from 1930 to 1964, covering the evolution from the first available El Tor biotype strain to the start of the seventh pandemic. We define six stages leading to the pandemic strain and reveal all key events. The seventh pandemic originated from a nonpathogenic strain in the Middle East, first observed in 1897. It subsequently underwent explosive diversification, including the spawning of the pandemic lineage. This rapid diversification suggests that, when first observed, the strain had only recently arrived in the Middle East, possibly from the Asian homeland of cholera. The lineage migrated to Makassar, Indonesia, where it gained the important virulence-associated elements Vibrio seventh pandemic island I (VSP-I), VSP-II, and El Tor type cholera toxin prophage by 1954, and it then became pandemic in 1961 after only 12 additional mutations. Our data indicate that specific niches in the Middle East and Makassar were important in generating the pandemic strain by providing gene sources and the driving forces for genetic events.

  2. Activation of cholera toxin production by anaerobic respiration of trimethylamine N-oxide in Vibrio cholerae.

    Science.gov (United States)

    Lee, Kang-Mu; Park, Yongjin; Bari, Wasimul; Yoon, Mi Young; Go, Junhyeok; Kim, Sang Cheol; Lee, Hyung-Il; Yoon, Sang Sun

    2012-11-16

    Vibrio cholerae is a gram-negative bacterium that causes cholera. Although the pathogenesis caused by this deadly pathogen takes place in the intestine, commonly thought to be anaerobic, anaerobiosis-induced virulence regulations are not fully elucidated. Anerobic growth of the V. cholerae strain, N16961, was promoted when trimethylamine N-oxide (TMAO) was used as an alternative electron acceptor. Strikingly, cholera toxin (CT) production was markedly induced during anaerobic TMAO respiration. N16961 mutants unable to metabolize TMAO were incapable of producing CT, suggesting a mechanistic link between anaerobic TMAO respiration and CT production. TMAO reductase is transported to the periplasm via the twin arginine transport (TAT) system. A similar defect in both anaerobic TMAO respiration and CT production was also observed in a N16961 TAT mutant. In contrast, the abilities to grow on TMAO and to produce CT were not affected in a mutant of the general secretion pathway. This suggests that V. cholerae may utilize the TAT system to secrete CT during TMAO respiration. During anaerobic growth with TMAO, N16961 cells exhibit green fluorescence when stained with 2',7'-dichlorofluorescein diacetate, a specific dye for reactive oxygen species (ROS). Furthermore, CT production was decreased in the presence of an ROS scavenger suggesting a positive role of ROS in regulating CT production. When TMAO was co-administered to infant mice infected with N16961, the mice exhibited more severe pathogenic symptoms. Together, our results reveal a novel anaerobic growth condition that stimulates V. cholerae to produce its major virulence factor.

  3. The Vaccine Candidate Vibrio cholerae 638 Is Protective against Cholera in Healthy Volunteers

    Science.gov (United States)

    García, Luis; Jidy, Manuel Díaz; García, Hilda; Rodríguez, Boris L.; Fernández, Roberto; Año, Gemma; Cedré, Bárbara; Valmaseda, Tania; Suzarte, Edith; Ramírez, Margarita; Pino, Yadira; Campos, Javier; Menéndez, Jorge; Valera, Rodrigo; González, Daniel; González, Irma; Pérez, Oliver; Serrano, Teresita; Lastre, Miriam; Miralles, Fernando; del Campo, Judith; Maestre, Jorge Luis; Pérez, José Luis; Talavera, Arturo; Pérez, Antonio; Marrero, Karen; Ledón, Talena; Fando, Rafael

    2005-01-01

    Vibrio cholerae 638 is a living candidate cholera vaccine strain attenuated by deletion of the CTXΦ prophage from C7258 (O1, El Tor Ogawa) and by insertion of the Clostridium thermocellum endoglucanase A gene into the hemagglutinin/protease coding sequence. This vaccine candidate was previously found to be well tolerated and immunogenic in volunteers. This article reports a randomized, double-blind, placebo-controlled trial conducted to test short-term protection conferred by 638 against subsequent V. cholerae infection and disease in volunteers in Cuba. A total of 45 subjects were enrolled and assigned to receive vaccine or placebo. The vaccine contained 109 CFU of freshly harvested 638 buffered with 1.3% NaHCO3, while the placebo was buffer alone. After vaccine but not after placebo intake, 96% of volunteers had at least a fourfold increase in vibriocidal antibody titers, and 50% showed a doubling of at least the lipopolysaccharide-specific immunoglobulin A titers in serum. At 1 month after vaccination, five volunteers from the vaccine group and five from the placebo group underwent an exploratory challenge study with 109 CFU of ΔCTXΦ attenuated mutant strain V. cholerae 81. Only two volunteers from the vaccine group shed strain 81 in their feces, but none of them experienced diarrhea; in the placebo group, all volunteers excreted the challenge strain, and three had reactogenic diarrhea. An additional 12 vaccinees and 9 placebo recipients underwent challenge with 7 × 105 CFU of virulent strain V. cholerae 3008 freshly harvested from a brain heart infusion agar plate and buffered with 1.3% NaHCO3. Three volunteers (25%) from the vaccine group and all from the placebo group shed the challenge agent in their feces. None of the 12 vaccinees but 7 volunteers from the placebo group had diarrhea, and 2 of the latter exhibited severe cholera (>5,000 g of diarrheal stool). These results indicate that at 1 month after ingestion of a single oral dose (109 CFU) of strain

  4. Synthetic multivalent ligands for cholera & cholera-like toxins: Protected cyclic neoglycopeptides.

    Science.gov (United States)

    Kumar, Vajinder; Yadav, Narender; Kartha, K P Ravindranathan

    2016-08-05

    Synthesis of a set of novel glycopeptide analogues as potential cholera/cholera-like toxin inhibitors in their protected form is described. They include di-, tri-, tetra- and pentavalent scaffolds. The synthetic steps were achieved using a combination of solvent-free mechanochemical as well as the conventional solution-phase reactions. During the conventional DIC-HOBt-mediated peptide coupling followed for the preparation of certain glycopeptide analogues an interesting in situ Fmoc deprotection was observed which has been demonstrated to hold potential for synthesiszing glycopeptides/neoglycopeptides with extended polyamide chains.

  5. A Failed War

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    The Iraq War has done the United States more harm than good the removal of all U.S. combat troops from Iraq in August signaled the approaching end of the Iraq War,which is the most significant regional war at the beginning of this century.

  6. A Failed War

    Institute of Scientific and Technical Information of China (English)

    TIAN WENLIN

    2010-01-01

    @@ The removal of all U.S. combat troops from Iraq in August signaled the approaching end of the Iraq War, which is the most significant regional war at the beginning of this century. Although there remain quite a few uncertainties, an honest review shows the war is a failure for the United States.

  7. Mathematicians at War

    CERN Document Server

    Mazliak, Laurent

    2009-01-01

    Italian mathematician Volterra struggled to carry Italy into the World War I in May 1915 and then developed a frenetic activity to support the war effort. This activity found an adequate echo what did his French colleagues Borel, Hadamard and Picard. This book proposes the transcription of the correspondence they exchanged during the war

  8. Multidrug-Resistant Vibrio cholerae O1 was Responsible for a Cholera Outbreak in 2013 in Bagalkot, North Karnataka.

    Science.gov (United States)

    Bhattacharya, Debdutta; Dey, Shuchismita; Roy, Subarna; Parande, Mahantesh V; Telsang, M; Seema, M H; Parande, Aisha V; Mantur, Basappa G

    2015-01-01

    Cholera is a major cause of illness in the developing world. During the monsoon season, small sporadic clusters of cholera cases are reported on an annual basis in Karnataka, India. During the monsoons of 2013, there was a cholera outbreak in Badami, a remote area of Bagalkot district in Karnataka. The multi-drug-resistant Vibrio cholerae O1 serotype Ogawa was found to be responsible for this outbreak. On 5 August 2013, a 30-year-old woman presented with severe dehydration and watery diarrhea at the Aganwadi Health Centre in Badami. A total of 49 suspected cholera cases were reported, with an attack rate of 3.5%. The V. cholerae isolates exhibited resistance to a wide range of drugs, including ampicillin, co-trimoxazole, nitrofurantoin, carbenicillin, and third generation cephalosporins, and showed reduced susceptibility to third generation fluoroquinolones. All of the cephalosporin-resistant V. cholerae strains produced extended-spectrum beta-lactamase. All V. cholerae O1 isolates harbored virulent genes (ctxA, ctxB, tcpA El Tor, Tox S, VPI, ToxT, ToxR, ToxRS, ace, zot, and tcpP) and were found to be genetically similar as determined by randomly amplified polymorphic DNA fingerprinting assay. To the best of our knowledge, this is the first report of a cholera outbreak in the district of Bagalkot. The resistance of V. cholerae to commonly used antimicrobial drugs is becoming a major public health concern in the region as clinicians are left with a limited choice of antibiotics for the treatment of cholera.

  9. Whole genome PCR scanning reveals the syntenic genome structure of toxigenic Vibrio cholerae strains in the O1/O139 population.

    Directory of Open Access Journals (Sweden)

    Bo Pang

    Full Text Available Vibrio cholerae is commonly found in estuarine water systems. Toxigenic O1 and O139 V. cholerae strains have caused cholera epidemics and pandemics, whereas the nontoxigenic strains within these serogroups only occasionally lead to disease. To understand the differences in the genome and clonality between the toxigenic and nontoxigenic strains of V. cholerae serogroups O1 and O139, we employed a whole genome PCR scanning (WGPScanning method, an rrn operon-mediated fragment rearrangement analysis and comparative genomic hybridization (CGH to analyze the genome structure of different strains. WGPScanning in conjunction with CGH revealed that the genomic contents of the toxigenic strains were conservative, except for a few indels located mainly in mobile elements. Minor nucleotide variation in orthologous genes appeared to be the major difference between the toxigenic strains. rrn operon-mediated rearrangements were infrequent in El Tor toxigenic strains tested using I-CeuI digested pulsed-field gel electrophoresis (PFGE analysis and PCR analysis based on flanking sequence of rrn operons. Using these methods, we found that the genomic structures of toxigenic El Tor and O139 strains were syntenic. The nontoxigenic strains exhibited more extensive sequence variations, but toxin coregulated pilus positive (TCP+ strains had a similar structure. TCP+ nontoxigenic strains could be subdivided into multiple lineages according to the TCP type, suggesting the existence of complex intermediates in the evolution of toxigenic strains. The data indicate that toxigenic O1 El Tor and O139 strains were derived from a single lineage of intermediates from complex clones in the environment. The nontoxigenic strains with non-El Tor type TCP may yet evolve into new epidemic clones after attaining toxigenic attributes.

  10. Cholera with severe renal failure in an Italian tourist returning from Cuba, July 2013.

    Science.gov (United States)

    Mascarello, M; Deiana, M L; Maurel, C; Lucarelli, C; Luzzi, I; Luzzati, R

    2013-08-29

    In July 2013, an Italian tourist returning from Cuba was hospitalised in Trieste, Italy, for cholera caused by Vibrio cholerae O1 serotype Ogawa with severe renal failure. An outbreak of cholera was reported in Cuba in January 2013. Physicians should consider the diagnosis of cholera in travellers returning from Cuba presenting with acute watery diarrhoea.

  11. Characterisation of cholera toxin by liquid chromatography - Electrospray mass spectrometry

    NARCIS (Netherlands)

    Baar, B.L.M. van; Hulst, A.G.; Wils, E.R.J.

    1999-01-01

    Cholera toxin, one of the toxins that may be generated by various strains of the bacterium Vibrio cholerae, can be considered as a substance possibly used in biological warfare. The possibilities of characterising the toxin by liquid chromatography electrospray mass spectrometry (LC-ES-MS) were inve

  12. Genome sequence of the human pathogen Vibrio cholerae Amazonia.

    NARCIS (Netherlands)

    Thompson, C.C.; Marin, M.A.; Dias, G.M.; Dutilh, B.E.; Edwards, R.A.; Iida, T.; Thompson, F.L.; Vicente, A.C.

    2011-01-01

    Vibrio cholerae O1 Amazonia is a pathogen that was isolated from cholera-like diarrhea cases in at least two countries, Brazil and Ghana. Based on multilocus sequence analysis, this lineage belongs to a distinct profile compared to strains from El Tor and classical biotypes. The genomic analysis rev

  13. Malonate inhibits virulence gene expression in Vibrio cholerae.

    Science.gov (United States)

    Minato, Yusuke; Fassio, Sara R; Häse, Claudia C

    2013-01-01

    We previously found that inhibition of the TCA cycle, either through mutations or chemical inhibition, increased toxT transcription in Vibrio cholerae. In this study, we found that the addition of malonate, an inhibitor of succinate dehydrogenase (SDH), decreased toxT transcription in V. cholerae, an observation inconsistent with the previous pattern observed. Unlike another SDH inhibitor, 2-thenoyltrifluoroacetone (TTFA), which increased toxT transcription and slightly inhibited V. cholerae growth, malonate inhibited toxT transcription in both the wild-type strain and TCA cycle mutants, suggesting malonate-mediated inhibition of virulence gene expression is independent to TCA cycle activity. Addition of malonate also inhibited ctxB and tcpA expressions but did not affect aphA, aphB, tcpP and toxR expressions. Malonate inhibited cholera toxin (CT) production in both V. cholerae classical biotype strains O395N1 and CA401, and El Tor biotype strain, N16961. Consistent with previous reports, we confirmed that these strains of V. cholerae did not utilize malonate as a primary carbon source. However, we found that the addition of malonate to the growth medium stimulated V. cholerae growth. All together, these results suggest that metabolizing malonate as a nutrient source negatively affects virulence gene expression in V. cholerae.

  14. Satellite Water Impurity Marker (SWIM) for predicting seasonal cholera outbreaks

    Science.gov (United States)

    Jutla, A. S.; Akanda, A. S.; Islam, S.

    2011-12-01

    Prediction of outbreaks of cholera, a deadly water related disease, remains elusive. Since coastal brackish water provides a natural ecological niche for cholera bacteria and because a powerful evidence of new biotypes is emerging, it is highly unlikely that cholera will be fully eradicated. Therefore, it is necessary to develop cholera prediction model with several months' of lead time. Satellite based estimates of chlorophyll, a surrogate for phytoplankton abundance, has been associated with proliferation of cholera bacteria. However, survival of cholera bacteria in a variety of coastal ecological environment put constraints on predictive abilities of chlorophyll algorithm since it only measures greenness in coastal waters. Here, we propose a new remote sensing reflectance based statistical index: Satellite Water Impurity Marker, or SWIM. This statistical index estimates impurity levels in the coastal waters and is based on the variability observed in the difference between the blue (412nm) and green (555nm) wavelengths in coastal waters. The developed index is bounded between clear and impure water and shows the ability to predict cholera outbreaks in the Bengal Delta with a predicted r2 of 78% with two months lead time. We anticipate that a predictive system based on SWIM will provide essential lead time allowing effective intervention and mitigation strategies to be developed for other cholera endemic regions of the world.

  15. USE OF MODIFIED CAMP TEST FOR PRELIMINARY NONSEROLOGIC IDENTIFICATION OF VIBRIO CHOLERAE IN STOOL SPECIMENS

    Directory of Open Access Journals (Sweden)

    Murad Lesmana

    2012-09-01

    Full Text Available Suatu modifikasi uji CAMP digunakan bersama dengan reaksi biokimiawi untuk identifikasi Vibrio cholerae pada sampel klinis. Dari 579 usap dubur penderita diare, 92 (16% memberikan hasil isolasi V. cholerae 01 biotipe El Tor dan 34 (6% V. cholerae non-01. Semua isolat V. cholerae 01 El Tor menunjukkan reaksi CAMP positif kuat dengan gambaran hemolisis sinergistik lengkap berbentuk sosis; sedangkan V. cholerae non-01 memberikan reaksi CAMP yang sempit dengan pola hemolisis menyerupai bulan sabit. Hasil uji CAMP yang dilakukan bersama dengan reaksi biokimiawi sesuai dengan metode biakan konvensional yang menyertakan tes aglutinasi dengan antiserum V. cholerae 01 untuk mengidentifikasi V. cholerae.

  16. Investigation of household contamination of Vibrio cholerae in Bangladesh

    DEFF Research Database (Denmark)

    Hossain, Zenat Zebin; Farhana, Israt; Mohan Tulsiani, Suhella

    The role of in-house transmission on the incidence of Vibrio cholerae, the deadly waterborne pathogen, is still not developed. The aim of the current study was to investigate possible contamination routes in household domain for effective cholera control in Bangladesh. To examine the prevalence...... and water supply may be the reason behind this relatively high presence of virulence factors in food plates and water pots. Direct exposure routes of disease transmission should be a major consideration in cholera prevention policies. Investigation of household contamination of Vibrio cholerae in Bangladesh........ Available from: https://www.researchgate.net/publication/305215719_Investigation_of_household_contamination_of_Vibrio_cholerae_in_Bangladesh [accessed Oct 14, 2016]....

  17. epidemiological and Clinical Characteristics of 28 cases of Cholera

    Institute of Scientific and Technical Information of China (English)

    2014-01-01

    The data of 35 246 patients with intestinal diseases were retrospectively analyzed, 28 cases of cholera patients were screened in 17 years, of which 23 cases had suspicious unclean food history, 10 cases were migrant workers, 8 cases had history of coastal city tour in one week. All of the 28 patients were positive for Vibrio cholerae culture, 19 cases were identiifed as O1 serotype Ogawa and 6 were identiifed as O1 serotype Inaba, 3 were identified as O139. Twenty-three patients were mild, five cases were moderate, patients with severe diseases were not found. It was found in this study that O1 serotype Vibrio cholerae was still dominant, 82%of cholera patients were mild cases. Tourists who had a incompletely heated seafood intake history and migrant people are susceptible to cholera.

  18. War and Power

    DEFF Research Database (Denmark)

    Carter, Dale

    2017-01-01

    Whether as context or prospect, reference or substance, warfare invariably features in Pynchon’s fiction: the war of American independence in Mason & Dixon; world war one in Against the Day; world war two in Gravity’s Rainbow; the cold war in The Crying of Lot 49; various culture wars – hippies...... political or military but also social and psychological, economic and technological, cultural and imaginative. Using as its exemplar Pynchon’s treatment of world war two in Gravity’s Rainbow, this essay explores one key modulation in the nature of warfare: from the armed conflicts characteristic...... of an imperial order to the struggles for security – not just physical but also ideological and discursive, conceptual and representational – that mark the post-imperial, cold (and post-cold) war order. Through the personal identities and historical trajectories of a number of the novel’s representative figures...

  19. [Epidemics and diseases during the Independence period in Mexico].

    Science.gov (United States)

    Viesca-Treviño, Carlos

    2010-01-01

    The epidemics and endemic diseases in Mexico were not a problem before the Independence period. Hunger was less than in the past. The 1806 Influenza epidemics had been forgotten. Measles was considered a benign illness. In 1810, there was an increase in the number of cases of black vomit in Veracruz. Sixty percent of 541 hospitalized patients die of the disease. In 1812, an outbreak of yellow fever spread from Veracruz to Jalapa accompanying the movement of troops and killing over 300 soldiers of the Castilla's Battalion. The appearance of petechial fever, maybe typhus marketed in 1813 the onset of the most important epidemics. The preceding was the indirect effect of war: diseases of prisons and military quarters which became overwhelming in times where the movements of troops and of important groups of populations along with crowing, loss homes, hunger and bad hygiene habits. There was also Influenza or "pestilent cold." Measures of detection and quarantine were taken. "Naranjate" mixed with tartaric cremor was used against fever. Fumigation with nitric acid and burners, where they incinerated gun powder were among the health protection policies. It is noteworthy the advance and relief provided by the introduction of smallpox vaccine, the only preventive mean useful against smallpox which was a breakthrough in public health.

  20. Zebrafish as a natural host model for Vibrio cholerae colonization and transmission.

    Science.gov (United States)

    Runft, Donna L; Mitchell, Kristie C; Abuaita, Basel H; Allen, Jonathan P; Bajer, Sarah; Ginsburg, Kevin; Neely, Melody N; Withey, Jeffrey H

    2014-03-01

    The human diarrheal disease cholera is caused by the aquatic bacterium Vibrio cholerae. V. cholerae in the environment is associated with several varieties of aquatic life, including insect egg masses, shellfish, and vertebrate fish. Here we describe a novel animal model for V. cholerae, the zebrafish. Pandemic V. cholerae strains specifically colonize the zebrafish intestinal tract after exposure in water with no manipulation of the animal required. Colonization occurs in close contact with the intestinal epithelium and mimics colonization observed in mammals. Zebrafish that are colonized by V. cholerae transmit the bacteria to naive fish, which then become colonized. Striking differences in colonization between V. cholerae classical and El Tor biotypes were apparent. The zebrafish natural habitat in Asia heavily overlaps areas where cholera is endemic, suggesting that zebrafish and V. cholerae evolved in close contact with each other. Thus, the zebrafish provides a natural host model for the study of V. cholerae colonization, transmission, and environmental survival.

  1. Multi-locus variable number tandem repeat analysis of Vibrio cholerae isolates from 2012 to 2013 cholera outbreaks in Iran.

    Science.gov (United States)

    Ranjbar, R; Sadeghy, J; Shokri Moghadam, M; Bakhshi, B

    2016-08-01

    Cholera remains to be an international threat, with high rates of illness and death. In 2012 and 2013, two cholera outbreak happened in Iran, affecting lots of people. Vibrio cholerae O1 was confirmed as the etiological agent. Source identification and controlling the spread of the cholera disease are two critical approaches in cholera outbreaks. In this study, thirty V. cholerae O1 isolates were selected and has been evaluated for antimicrobial resistant as well as molecular typing by multilocus variable-number tandem-repeat analysis (MLVA) method. Twenty-nine (97%) isolates were sero-grouped as El Tor (one isolate was classical) and 100% were related to Inaba serotype. All of the isolates were susceptible to ciprofloxacin, chloramphenicol, ampicillin and gentamicin. On the other hand, 60% of the isolates were MDR (resistant to 3 or more classes). There were three resistance patterns. The most prevalent pattern was resistance to streptomycin, erythromycin, trimethoprim-sulfamethoxazole, and tetracycline (ST-SXT-E-T) which was seen in 50% of isolates. Using MLVA method 14 MLVA types were identified. MLVA type 2 (5-7-7-16-15) accounted for 43% of isolates. Isolates with the same genotype often did not have the same antibiogram. Overall, the data indicate that the Iranian V. cholerae were MDR and clonaly related. Furthermore, the results of this study shows that MLVA can be used as useful method for V. cholerae genotyping in epidemiological investigations.

  2. Epidemic spreading by objective traveling

    Science.gov (United States)

    Tang, Ming; Liu, Zonghua; Li, Baowen

    2009-07-01

    A fundamental feature of agent traveling in social networks is that traveling is usually not a random walk but with a specific destination and goes through the shortest path from starting to destination. A serious consequence of the objective traveling is that it may result in a fast epidemic spreading, such as SARS etc. In this letter we present a reaction-traveling model to study how the objective traveling influences the epidemic spreading. We consider a random scale-free meta-population network with sub-population at each node. Through a SIS model we theoretically prove that near the threshold of epidemic outbreak, the objective traveling can significantly enhance the final infected population and the infected fraction at a node is proportional to its betweenness for the traveling agents and approximately proportional to its degree for the non-traveling agents. Numerical simulations have confirmed the theoretical predictions.

  3. Immunization with cholera toxin B subunit induces high-level protection in the suckling mouse model of cholera.

    Directory of Open Access Journals (Sweden)

    Gregory A Price

    Full Text Available Cholera toxin (CT is the primary virulence factor responsible for severe cholera. Vibrio cholerae strains unable to produce CT show severe attenuation of virulence in animals and humans. The pentameric B subunit of CT (CTB contains the immunodominant epitopes recognized by antibodies that neutralize CT. Although CTB is a potent immunogen and a promising protective vaccine antigen in animal models, immunization of humans with detoxified CT failed to protect against cholera. We recently demonstrated however that pups reared from mice immunized intraperitoneally (IP with 3 doses of recombinant CTB were well protected against a highly lethal challenge dose of V. cholerae N16961. The present study investigated how the route and number of immunizations with CTB could influence protective efficacy in the suckling mouse model of cholera. To this end female mice were immunized with CTB intranasally (IN, IP, and subcutaneously (SC. Serum and fecal extracts were analyzed for anti-CTB antibodies by quantitative ELISA, and pups born to immunized mothers were challenged orogastrically with a lethal dose of V. cholerae. Pups from all immunized groups were highly protected from death by 48 hours (64-100% survival. Cox regression showed that percent body weight loss at 24 hours predicted death by 48 hours, but we were unable to validate a specific amount of weight loss as a surrogate marker for protection. Although CTB was highly protective in all regimens, three parenteral immunizations showed trends toward higher survival and less weight loss at 24 hours post infection. These results demonstrate that immunization with CTB by any of several routes and dosing regimens can provide protection against live V. cholerae challenge in the suckling mouse model of cholera. Our data extend the results of previous studies and provide additional support for the inclusion of CTB in the development of a subunit vaccine against V. cholerae.

  4. Immunization with cholera toxin B subunit induces high-level protection in the suckling mouse model of cholera.

    Science.gov (United States)

    Price, Gregory A; McFann, Kim; Holmes, Randall K

    2013-01-01

    Cholera toxin (CT) is the primary virulence factor responsible for severe cholera. Vibrio cholerae strains unable to produce CT show severe attenuation of virulence in animals and humans. The pentameric B subunit of CT (CTB) contains the immunodominant epitopes recognized by antibodies that neutralize CT. Although CTB is a potent immunogen and a promising protective vaccine antigen in animal models, immunization of humans with detoxified CT failed to protect against cholera. We recently demonstrated however that pups reared from mice immunized intraperitoneally (IP) with 3 doses of recombinant CTB were well protected against a highly lethal challenge dose of V. cholerae N16961. The present study investigated how the route and number of immunizations with CTB could influence protective efficacy in the suckling mouse model of cholera. To this end female mice were immunized with CTB intranasally (IN), IP, and subcutaneously (SC). Serum and fecal extracts were analyzed for anti-CTB antibodies by quantitative ELISA, and pups born to immunized mothers were challenged orogastrically with a lethal dose of V. cholerae. Pups from all immunized groups were highly protected from death by 48 hours (64-100% survival). Cox regression showed that percent body weight loss at 24 hours predicted death by 48 hours, but we were unable to validate a specific amount of weight loss as a surrogate marker for protection. Although CTB was highly protective in all regimens, three parenteral immunizations showed trends toward higher survival and less weight loss at 24 hours post infection. These results demonstrate that immunization with CTB by any of several routes and dosing regimens can provide protection against live V. cholerae challenge in the suckling mouse model of cholera. Our data extend the results of previous studies and provide additional support for the inclusion of CTB in the development of a subunit vaccine against V. cholerae.

  5. Commemoration of a cold war

    DEFF Research Database (Denmark)

    Farbøl, Rosanna

    2015-01-01

    This article brings together the fields of Cold War studies and memory studies. In Denmark, a remarkable institutionalisation of Cold War memory has taken place in the midst of a heated ideological battle over the past and whether to remember the Cold War as a ‘war’. Using Danish Cold War museums...... and heritage sites as case studies, this article sheds new light on the politics of history involved in Cold War commemoration. It suggests that the Cold War is commemorated as a war, yet this war memory is of a particular kind: it is a war memory without victims....

  6. Removal of Cholera Toxin from Aqueous Solution by Probiotic Bacteria

    Directory of Open Access Journals (Sweden)

    Jussi A. O. Meriluoto

    2012-06-01

    Full Text Available Cholera remains a serious health problem, especially in developing countries where basic hygiene standards are not met. The symptoms of cholera are caused by cholera toxin, an enterotoxin, which is produced by the bacterium Vibrio cholerae. We have recently shown that human probiotic bacteria are capable of removing cyanobacterial toxins from aqueous solutions. In the present study we investigate the ability of the human probiotic bacteria, Lactobacillus rhamnosus strain GG (ATCC 53103 and Bifidobacterium longum 46 (DSM 14583, to remove cholera toxin from solution in vitro. Lactobacillus rhamnosus strain GG and Bifidobacterium longum 46 were able to remove 68% and 59% of cholera toxin from aqueous solutions during 18 h of incubation at 37 °C, respectively. The effect was dependent on bacterial concentration and L. rhamnosus GG was more effective at lower bacterial concentrations. No significant effect on cholera toxin concentration was observed when nonviable bacteria or bacterial supernatant was used.

  7. Molecular tools in understanding the evolution of Vibrio cholerae.

    Science.gov (United States)

    Rahaman, Md Habibur; Islam, Tarequl; Colwell, Rita R; Alam, Munirul

    2015-01-01

    Vibrio cholerae, the etiological agent of cholera, has been a scourge for centuries. Cholera remains a serious health threat for developing countries and has been responsible for millions of deaths globally over the past 200 years. Identification of V. cholerae has been accomplished using a variety of methods, ranging from phenotypic strategies to DNA based molecular typing and currently whole genomic approaches. This array of methods has been adopted in epidemiological investigations, either singly or in the aggregate, and more recently for evolutionary analyses of V. cholerae. Because the new technologies have been developed at an ever increasing pace, this review of the range of fingerprinting strategies, their relative advantages and limitations, and cholera case studies was undertaken. The task was challenging, considering the vast amount of the information available. To assist the study, key references representative of several areas of research are provided with the intent to provide readers with a comprehensive view of recent advances in the molecular epidemiology of V. cholerae. Suggestions for ways to obviate many of the current limitations of typing techniques are also provided. In summary, a comparative report has been prepared that includes the range from traditional typing to whole genomic strategies.

  8. Cholera in Indonesia: epidemiologic studies of transmission in Aceh Province.

    Science.gov (United States)

    Glass, R I; Alim, A R; Eusof, A; Snyder, J D; Jusuf, B; Anwar, S; Bakri, Z; Helmi, C; Winardi, B

    1984-09-01

    To determine the modes of transmission of cholera in the regency of Pidie, Indonesia, and to consider strategies for its control, we set up a laboratory to identify Vibrio cholerae 01 from patients with severe diarrhea in all government clinics in the regency and questioned culture-positive cases and neighborhood controls about possible exposures to V. cholerae 01. Between 12 July and 15 August 1982, 63 of 138 suspected cholera cases were confirmed by the laboratory; 53 of these patients were seen and followed up. We were unable to identify a single, indisputable mode of transmission for cholera which was amenable to immediate control. Nonetheless, a number of factors, including exposure to water from the Tiro-Sigli River and consumption of ice, were associated with disease. Other findings bring into question the value of current practices of chlorinating dugwells and disinfecting homes with Lysol during a cholera outbreak. The case-control approach to investigating the mode of transmission of cholera has distinct limitations when applied in endemic setting where there may not be a single predominant vehicle of transmission, or where the vehicle such as river water is used by all and is only periodically contaminated.

  9. Survival of Vibrio cholerae O1 on fomites.

    Science.gov (United States)

    Farhana, Israt; Hossain, Zenat Zebin; Tulsiani, Suhella Mohan; Jensen, Peter Kjær Mackie; Begum, Anowara

    2016-09-01

    It is well established that the contamination sources of cholera causing bacteria, Vibrio cholerae, are water and food, but little is known about the transmission role of the fomites (surfaces that can carry pathogens) commonly used in households. In the absence of appropriate nutrients or growth conditions on fomites, bacteria have been known to assume a viable but non-culturable (VBNC) state after a given period of time. To investigate whether and when V. cholerae O1 assumes such a state, this study investigated the survival and viable quantification on a range of fomites such as paper, wood, glass, plastic, cloth and several types of metals under laboratory conditions. The fomites were inoculated with an outbreak strain of V. cholerae and its culturability was examined by drop plate count method at 30 min intervals for up to 6 h. For molecular detection, the viable/dead stain ethidium monoazide (EMA) which inhibits amplification of DNA from dead cells was used in combination with real-time polymerase chain reaction (EMA-qPCR) for direct quantitative analyses of viable V. cholerae at 2, 4, 6, 24 h and 7 day time intervals. Results showed that V. cholerae on glass and aluminum surfaces lost culturability within one hour after inoculation but remained culturable on cloth and wood for up to four hours. VBNC V. cholerae on dry fomite surfaces was detected and quantified by EMA-qPCR even 7 days after inoculation. In conclusion, the prolonged survival of V. cholerae on various household fomites may play vital role in cholera transmission and needs to be further investigated.

  10. Stochastic Processes in Epidemic Theory

    CERN Document Server

    Lefèvre, Claude; Picard, Philippe

    1990-01-01

    This collection of papers gives a representative cross-selectional view of recent developments in the field. After a survey paper by C. Lefèvre, 17 other research papers look at stochastic modeling of epidemics, both from a theoretical and a statistical point of view. Some look more specifically at a particular disease such as AIDS, malaria, schistosomiasis and diabetes.

  11. Visual Mining of Epidemic Networks

    CERN Document Server

    Clémençon, Stéphan; Rossi, Fabrice; Tran, Viet Chi; 10.1007/978-3-642-21498-1_35

    2012-01-01

    We show how an interactive graph visualization method based on maximal modularity clustering can be used to explore a large epidemic network. The visual representation is used to display statistical tests results that expose the relations between the propagation of HIV in a sexual contact network and the sexual orientation of the patients.

  12. Epidemic Spread in Human Networks

    CERN Document Server

    Sahneh, Faryad Darabi

    2011-01-01

    One of the popular dynamics on complex networks is the epidemic spreading. An epidemic model describes how infections spread throughout a network. Among the compartmental models used to describe epidemics, the Susceptible-Infected-Susceptible (SIS) model has been widely used. In the SIS model, each node can be susceptible, become infected with a given infection rate, and become again susceptible with a given curing rate. In this paper, we add a new compartment to the classic SIS model to account for human response to epidemic spread. Each individual can be infected, susceptible, or alert. Susceptible individuals can become alert with an alerting rate if infected individuals exist in their neighborhood. An individual in the alert state is less probable to become infected than an individual in the susceptible state; due to a newly adopted cautious behavior. The problem is formulated as a continuous-time Markov process on a general static graph and then modeled into a set of ordinary differential equations using...

  13. Epidemic Synchronization in Robotic Swarms

    DEFF Research Database (Denmark)

    Schiøler, Henrik; Nielsen, Jens Frederik Dalsgaard; Ngo, Trung Dung

    2009-01-01

    Clock synchronization in swarms of networked mobile robots is studied in a probabilistic, epidemic framework. In this setting communication and synchonization is considered to be a randomized process, taking place at unplanned instants of geographical rendezvous between robots. In combination wit...

  14. Legalisation of Civil Wars

    DEFF Research Database (Denmark)

    Buhl, Kenneth Øhlenschlæger

    2009-01-01

    -international armed conflict' is used here. Civil wars are usually limited to the territory of a state. Considering that international law is generally concerned with the legal relations between states – being a legal system based on the system of states with states as its subjects – the main question is how civil......This article is concerned with the legal challenges of regulating civil wars in international humanitarian law. Civil war is not a term used in international law; it falls however, withing the context of the legal term 'armed conflicts not of an international character', although the shorter 'non...... wars as internal conflicts have become subject to international humanitarian law....

  15. [Isolation of the R'his plasmids of Vibrio cholerae].

    Science.gov (United States)

    Rusina, O Iu; Tiganova, I G; Aleshkin, G I; Andreeva, I V; Skavronskaia, A G

    1987-06-01

    V. cholerae strain VT5104 capable of donor activity in conjugation has been constructed by the genetic technique based on plasmid RP4::Mucts62 integration into V. cholerae chromosome due to plasmid homology with Mucts62 inserted into the chromosome. The gene for histidine synthesis has been mobilized and transferred into the recipient cells from VT5104 donor. The conjugants obtained are able to efficiently transfer his+ gene included into the plasmid structure in conjugation with eltor recipient. Thus, the constructed strain VT5104 generates R' plasmids carrying V. cholerae chromosomal genes.

  16. In Vitro Inhibition of Cholera Toxin Production in Vibrio cholerae by Methanol Extract of Sweet Fennel Seeds and Its Components.

    Science.gov (United States)

    Chatterjee, Shruti; Zahid, M Shamim Hasan; Awasthi, Sharda Prasad; Chowdhury, Nityananda; Asakura, Masahiro; Hinenoya, Atsushi; Ramamurthy, T; Iwaoka, Emiko; Aoki, Shunji; Yamasaki, Shinji

    2016-09-21

    A newly emerged Vibrio cholerae O1 El Tor variant strain with multidrug resistance is considered a threat to public health. Recent strategies to suppress virulence factors production instead of bacterial growth may lead to less selective pressure for the emergence of resistant strains. The use of spices and their active constituents as the inhibitory agents against cholera toxin (CT) production in V. cholerae may be an alternative approach to treat cholera. In this study, we examined the potential of sweet fennel seed (Foeniculum vulgare Miller var. dulce) methanol extract to inhibit CT production in V. cholerae without affecting viability. The methanol extract of sweet fennel seeds significantly inhibited CT production in various V. cholerae strains, regardless of serogroup or biotype. Interestingly, trans-anethole and 4-allylanisole, essential oil components of sweet fennel seeds, also demonstrated similar effects. Here, we report that sub-bactericidal concentrations of sweet fennel seed methanol extract and its major components can drastically inhibit CT production in various V. cholerae strains.

  17. Epidemics spreading in interconnected complex networks

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Y. [School of Electrical and Electronic Engineering, Nanyang Technological University, Singapore 639798 (Singapore); Institute of High Performance Computing, Agency for Science, Technology and Research (A-STAR), Singapore 138632 (Singapore); Xiao, G., E-mail: egxxiao@ntu.edu.sg [School of Electrical and Electronic Engineering, Nanyang Technological University, Singapore 639798 (Singapore)

    2012-09-03

    We study epidemic spreading in two interconnected complex networks. It is found that in our model the epidemic threshold of the interconnected network is always lower than that in any of the two component networks. Detailed theoretical analysis is proposed which allows quick and accurate calculations of epidemic threshold and average outbreak/epidemic size. Theoretical analysis and simulation results show that, generally speaking, the epidemic size is not significantly affected by the inter-network correlation. In interdependent networks which can be viewed as a special case of interconnected networks, however, impacts of inter-network correlation on the epidemic threshold and outbreak size are more significant. -- Highlights: ► We study epidemic spreading in two interconnected complex networks. ► The epidemic threshold is lower than that in any of the two networks. And Interconnection correlation has impacts on threshold and average outbreak size. ► Detailed theoretical analysis is proposed which allows quick and accurate calculations of epidemic threshold and average outbreak/epidemic size. ► We demonstrated and proved that Interconnection correlation does not affect epidemic size significantly. ► In interdependent networks, impacts of inter-network correlation on the epidemic threshold and outbreak size are more significant.

  18. [The knowledge of the population about cholera].

    Science.gov (United States)

    de la Cruz, A M; de Rojas, V; Delgado, J; Alonso, A; Finlay, C M

    1996-01-01

    In order to determine the impact of the educational campaign about cholera on the knowledge and believes of the population, a survey was made in 1993 among 1324 persons from 14 provinces and from Isla de la Juventud special municipality. 85% were 20-59 years old and 89% had an secondary basic or higher educational level. 69% had the minimum knowledge to face the disease, 90% would see a doctor if they had and suspicion, 72% knew that diarrhea is the main symptom of cholera, 54% new how it is transmitted 89% thought that they may be infected by drinking water, 54% understood the importance of giving liquids to the sick subject, and 78% realized the significance of washing their hands before eating anf cooking. It is concluded that even though our population has a general knowledge about the disease, due to the fact that our country is located in an endemic zone, health education must be reinforced, specifically those aspects connected with the communication and with the increase of liquids administration to the patients.

  19. Construction and evaluation of V. cholerae O139 mutant, VCUSM21P, as a safe live attenuated cholera vaccine.

    Science.gov (United States)

    Murugaiah, Chandrika; Nik Mohd Noor, Nik Zuraina; Mustafa, Shyamoli; Manickam, Ravichandran; Pattabhiraman, Lalitha

    2014-01-01

    Cholera is a major infectious disease, affecting millions of lives annually. In endemic areas, implementation of vaccination strategy against cholera is vital. As the use of safer live vaccine that can induce protective immunity against Vibrio cholerae O139 infection is a promising approach for immunization, we have designed VCUSM21P, an oral cholera vaccine candidate, which has ctxA that encodes A subunit of ctx and mutated rtxA/C, ace and zot mutations. VCUSM21P was found not to disassemble the actin of HEp2 cells. It colonized the mice intestine approximately 1 log lower than that of the Wild Type (WT) strain obtained from Hospital Universiti Sains Malaysia. In the ileal loop assay, unlike WT challenge, 1×10⁶ and 1×10⁸ colony forming unit (CFU) of VCUSM21P was not reactogenic in non-immunized rabbits. Whereas, the reactogenicity caused by the WT in rabbits immunized with 1×10¹⁰ CFU of VCUSM21P was found to be reduced as evidenced by absence of fluid in loops administered with 1×10²-1×10⁷ CFU of WT. Oral immunization using 1×10¹⁰ CFU of VCUSM21P induced both IgA and IgG against Cholera Toxin (CT) and O139 lipopolysaccharides (LPS). The serum vibriocidal antibody titer had a peak rise of 2560 fold on week 4. Following Removable Intestinal Tie Adult Rabbit Diarrhoea (RITARD) experiment, the non-immunized rabbits were found not to be protected against lethal challenge with 1×10⁹ CFU WT, but 100% of immunized rabbits survived the challenge. In the past eleven years, V. cholerae O139 induced cholera has not been observed. However, attenuated VCUSM21P vaccine could be used for vaccination program against potentially fatal endemic or emerging cholera caused by V. cholerae O139.

  20. Is Vibrio fluvialis emerging as a pathogen with epidemic potential in coastal region of eastern India following cyclone Aila?

    Science.gov (United States)

    Bhattacharjee, Subhajit; Bhattacharjee, Sayantani; Bal, Baishali; Pal, Reshmi; Niyogi, Swapan Kumar; Sarkar, Kamalesh

    2010-08-01

    An isolated area with diarrhoea epidemic was explored at Pakhirala village of the Sundarbans, a coastal region of South 24 Parganas district of West Bengal, eastern India. The Pakhirala village was surrounded by other villages affected by a similar epidemic. The affected villages experienced this epidemic following the cyclone Aila, which had hit the coastal region of the Sundarbans in eastern India. In Pakhirala, the situation was the worst. Within a span of six weeks (5 June-20 July 2009), 3,529 (91.2%) of 3,871 residents were affected by watery diarrhoea. Of all the cases (n = 3,529), 918 (26%) were affected by moderate to severe diarrhoea. In other villages, 28,550 (70%) of the 40,786 people were affected; of them, 3,997 (14%) had moderate to severe watery diarrhoea. The attack rate and the severity of the cases were significantly higher in Pakhirala village compared to other affected villages. The laboratory results revealed that Vibrio fluvialis was the predominant pathogen in Pakhirala village (5 of 6 laboratory-confirmed organisms) whereas Vibrio cholerae O1 Ogawa was the predominant pathogen in other villages of Gosaba block (7 of 9 bacteriologically-confirmed organisms). This result indicates that V fluvialis behaves more aggressively than V cholerae O1 in an epidemic situation with a higher attack rate and a different clinical picture. An in-depth study is required to explore its pathogenicity in detail, geographical distribution, and possible control measures, including development of specific vaccine preparation and determination of its efficacy.

  1. Cholera Toxin B: One Subunit with Many Pharmaceutical Applications

    Directory of Open Access Journals (Sweden)

    Keegan J. Baldauf

    2015-03-01

    Full Text Available Cholera, a waterborne acute diarrheal disease caused by Vibrio cholerae, remains prevalent in underdeveloped countries and is a serious health threat to those living in unsanitary conditions. The major virulence factor is cholera toxin (CT, which consists of two subunits: the A subunit (CTA and the B subunit (CTB. CTB is a 55 kD homopentameric, non-toxic protein binding to the GM1 ganglioside on mammalian cells with high affinity. Currently, recombinantly produced CTB is used as a component of an internationally licensed oral cholera vaccine, as the protein induces potent humoral immunity that can neutralize CT in the gut. Additionally, recent studies have revealed that CTB administration leads to the induction of anti-inflammatory mechanisms in vivo. This review will cover the potential of CTB as an immunomodulatory and anti-inflammatory agent. We will also summarize various recombinant expression systems available for recombinant CTB bioproduction.

  2. Survival of Vibrio cholerae O1 on fomites

    DEFF Research Database (Denmark)

    Farhana, Israt; Hossain, Zenat Zebin; Tulsiani, Suhella Mohan

    2016-01-01

    It is well established that the contamination sources of cholera causing bacteria, Vibrio cholerae, are water and food, but little is known about the transmission role of the fomites (surfaces that can carry pathogens) commonly used in households. In the absence of appropriate nutrients or growth...... conditions on fomites, bacteria have been known to assume a viable but non-culturable (VBNC) state after a given period of time. To investigate whether and when V. cholerae O1 assumes such a state, this study investigated the survival and viable quantification on a range of fomites such as paper, wood, glass......, plastic, cloth and several types of metals under laboratory conditions. The fomites were inoculated with an outbreak strain of V. cholerae and its culturability was examined by drop plate count method at 30 min intervals for up to 6 h. For molecular detection, the viable/dead stain ethidium monoazide (EMA...

  3. Cholera toxin B: one subunit with many pharmaceutical applications.

    Science.gov (United States)

    Baldauf, Keegan J; Royal, Joshua M; Hamorsky, Krystal Teasley; Matoba, Nobuyuki

    2015-03-20

    Cholera, a waterborne acute diarrheal disease caused by Vibrio cholerae, remains prevalent in underdeveloped countries and is a serious health threat to those living in unsanitary conditions. The major virulence factor is cholera toxin (CT), which consists of two subunits: the A subunit (CTA) and the B subunit (CTB). CTB is a 55 kD homopentameric, non-toxic protein binding to the GM1 ganglioside on mammalian cells with high affinity. Currently, recombinantly produced CTB is used as a component of an internationally licensed oral cholera vaccine, as the protein induces potent humoral immunity that can neutralize CT in the gut. Additionally, recent studies have revealed that CTB administration leads to the induction of anti-inflammatory mechanisms in vivo. This review will cover the potential of CTB as an immunomodulatory and anti-inflammatory agent. We will also summarize various recombinant expression systems available for recombinant CTB bioproduction.

  4. The Kawousan War reconsidered

    NARCIS (Netherlands)

    Kimba, I.; Abbink, J.; Bruijn, de M.E.; Walraven, van K.

    2003-01-01

    The Kawousan War (1916-1920) was one of the longest periods of resistance known in Niger and through it the local people - Tuareg, Hausa and others - fought to free their society from French colonial domination. Unlike other interpretations, this chapter looks at the structural causes of the war rel

  5. Fighting the Drug War.

    Science.gov (United States)

    The Journal of State Government, 1990

    1990-01-01

    All nine articles in this periodical issue focus on the theme of the war against illegal drug use, approaching the topic from a variety of perspectives. The articles are: "The Drug War: Meeting the Challenge" (Stanley E. Morris); "Ways to Fight Drug Abuse" (Bruce A. Feldman); "Treatment Key to Fighting Drugs" (Stan…

  6. War and Comics (Italy)

    OpenAIRE

    Bianchi, Roberto

    2015-01-01

    Comics played a very important role in the total mobilization in Italy. Firstly in the cities and then in the trenches, they were a new propaganda tool and explanation of the war for children and soldiers with low literacy. At the same time, the war changed the history of comics and the magazine market for children and youth

  7. Multiple routes transmitted epidemics on multiplex networks

    Energy Technology Data Exchange (ETDEWEB)

    Zhao, Dawei [Information Security Center, State Key Laboratory of Networking and Switching Technology, Beijing University of Posts and Telecommunications, P.O. Box 145, Beijing 100876 (China); National Engineering Laboratory for Disaster Backup and Recovery, Beijing University of Posts and Telecommunications, Beijing 100876 (China); Shandong Provincial Key Laboratory of Computer Network, Shandong Computer Science Center, Jinan 250014 (China); Li, Lixiang [Information Security Center, State Key Laboratory of Networking and Switching Technology, Beijing University of Posts and Telecommunications, P.O. Box 145, Beijing 100876 (China); National Engineering Laboratory for Disaster Backup and Recovery, Beijing University of Posts and Telecommunications, Beijing 100876 (China); Peng, Haipeng, E-mail: penghaipeng@bupt.edu.cn [Information Security Center, State Key Laboratory of Networking and Switching Technology, Beijing University of Posts and Telecommunications, P.O. Box 145, Beijing 100876 (China); National Engineering Laboratory for Disaster Backup and Recovery, Beijing University of Posts and Telecommunications, Beijing 100876 (China); Luo, Qun; Yang, Yixian [Information Security Center, State Key Laboratory of Networking and Switching Technology, Beijing University of Posts and Telecommunications, P.O. Box 145, Beijing 100876 (China); National Engineering Laboratory for Disaster Backup and Recovery, Beijing University of Posts and Telecommunications, Beijing 100876 (China)

    2014-02-01

    This letter investigates the multiple routes transmitted epidemic process on multiplex networks. We propose detailed theoretical analysis that allows us to accurately calculate the epidemic threshold and outbreak size. It is found that the epidemic can spread across the multiplex network even if all the network layers are well below their respective epidemic thresholds. Strong positive degree–degree correlation of nodes in multiplex network could lead to a much lower epidemic threshold and a relatively smaller outbreak size. However, the average similarity of neighbors from different layers of nodes has no obvious effect on the epidemic threshold and outbreak size. -- Highlights: •We studies multiple routes transmitted epidemic process on multiplex networks. •SIR model and bond percolation theory are used to analyze the epidemic processes. •We derive equations to accurately calculate the epidemic threshold and outbreak size. •ASN has no effect on the epidemic threshold and outbreak size. •Strong positive DDC leads to a lower epidemic threshold and a smaller outbreak size.

  8. Community-based assessment of safety and immunogenicity of the whole cell plus recombinant B subunit (WC/rBS) oral cholera vaccine in Peru.

    Science.gov (United States)

    Begue, R E; Castellares, G; Ruiz, R; Hayashi, K E; Sanchez, J L; Gotuzzo, E; Oberst, R B; Taylor, D N; Svennerholm, A M

    1995-05-01

    Every year since its introduction in 1991, there have been epidemics of cholera in Lima, Peru. Vaccination is one approach to the control of cholera. A pilot study was conducted to assess the safety and immunogenicity of a whole cell plus recombinant B subunit (WC/rBS) cholrea vaccine in Lima, Peru. Five hundred and forty-one volunteers aged 2-65 years received two doses two weeks apart of WC/rBS vaccine or Escherichia coli K12 placebo administered in bicarbonate buffered water. Symptoms were monitored on all subjects and blood was collected from 102 persons before the first dose and two weeks after the second dose. Mild post-vaccination gastrointestinal symptoms were reported with equal frequency for both the vaccine and placebo recipients. Among 51 vaccines, 49% had a twofold or greater increase in serum vibriocidal titers (GMT = 78; range < 1:10 to 1:5120); and 92% and 82% developed a twofold or greater serum anti-cholera toxin IgG and IgA response, respectively. Persons with elevated prevaccination vibriocidal titers had a decreased response to the WC/rBS. Age and blood group did not affect the immune response. The WC/rBS vaccine was safe and immunogenic in a group of native Peruvians.

  9. 近代中医对烈性霍乱的认识与定名%The recognition and denomination of drastic cholera in modern Traditional Chinese Medicine

    Institute of Scientific and Technical Information of China (English)

    吴文清

    2009-01-01

    This article mainly expounds on the recognition and denomination of drastic cholera in modern Traditional Chinese medicine. After cholera spread into China, some doctors found that this disease was different from "Huoluan" recorded in ancient Chinese medical books. They began to do research on the subject and invented new disease terminology such as Diaojiaosha, Bieluosha, Fuyin, Shiyihuoluan etc. Thereafter, more and more doctors of TCM began to accept the nomenclature and connotation of cholera in western medicine. Huoluan, the ancient TCM terminology has been given a new connotation which has been used until now, becoming the formally recognized name of the drastic epidemic disease.%本文主要论述近代中医在烈性霍乱病名方面的认识和探讨.霍乱传入我国后,一些医家发现其与中医古籍中所载"霍乱"不同,即对此展开研究,发明了吊脚痧、瘪螺痧、伏阴、时疫霍乱等病名;后来,越来越多的中医,逐渐接受西医学中霍乱病名及其内涵,"霍乱"这一古老的中医病名,被赋予新的含义,并被沿用至今,成为一种法定的烈性传染病病名.

  10. Civil War and Inoperativity

    DEFF Research Database (Denmark)

    Flohr, Mikkel

    2017-01-01

    This article analyses the penultimate publication in Giorgio Agambens Homo Sacer-series Stasis: Civil War as a Political Paradigm. It compares and contrasts the paradigm of civil war with the preceding paradigm of the exception, and identifies a significant displacement in the relationship between...... civil war and the sovereign state, in spite of Agamben’s insistence on their continuity. Agamben’s decoupling of civil war and the sovereign state facilitates novel political possibilities that unfortunately remain underdeveloped in the book. The article proceeds to develop Agamben’s brief intimations...... of inoperativity towards a concept of destituent power drawing on his other writings. It makes the argument for thinking civil war and inoperativity – stasis and stasis – together to derive a concept of destituent power as a form of revolution against the sovereign state, which does not constitute a new sovereign...

  11. Transcript changes in Vibrio cholerae in response to salt stress.

    Science.gov (United States)

    Fu, Xiuping; Liang, Weili; Du, Pengcheng; Yan, Meiying; Kan, Biao

    2014-01-01

    Vibrio cholerae, which is a serious human intestinal pathogen, often resides and thrives in estuaries but requires major self-regulation to overcome intestinal hyperosmotic stress or high salt stress in water and food. In the present study, we selected multiple O1 and O139 group V. cholerae strains that were isolated from different regions and during different years to study their salt tolerance. Based on the mechanisms that other bacteria use to respond to high salt stress, we selected salt stress-response related genes to study the mechanisms which V. cholerae responds to high salt stress. V. cholerae strains showed salt-resistance characteristics that varied in salt concentrations from 4% to 6%. However, group O1 and group O139 showed no significant difference in the degree of salt tolerance. The primary responses of bacteria to salt stress, including Na(+) exclusion, K(+) uptake and glutamate biosynthesis, were observed in V. cholerae strains. In addition, some sigma factors were up-regulated in V. cholerae strains, suggesting that V. cholerae may recruit common sigma factors to achieve an active salt stress response. However, some changes in gene transcript levels in response to salt stress in V. cholerae were strain-specific. In particular, hierarchical clustering of differentially expressed genes indicated that transcript levels of these genes were correlated with the degree of salt tolerance. Therefore, elevated transcript levels of some genes, including sigma factors and genes involved in peptidoglycan biosynthesis, may be due to the salt tolerance of strains. In addition, high salt-tolerant strains may recruit common as well as additional sigma factors to activate the salt stress response.

  12. Virulenzregulationskaskade und Chitobiose-Metabolismus in Vibrio cholerae

    OpenAIRE

    Berg, Thorsten

    2008-01-01

    Vibrio cholerae, der Erreger der gastrointestinalen Erkrankung Cholera, ist ein Gram- negatives, fakultativ anaerobes gekrümmtes Stäbchenbakterium und zugleich der wohl bekannteste Vertreter der Familie Vibrionaceae. Es persisitiert die meiste Zeit in aquatischen Ökosystemen wie Flüssen, Seen oder Meeresküsten, wo das Bakterium meist mit Crustaceen oder anderen Organismen mit Chitin-haltigen Oberflächen assoziiert vorliegt. Über orale Aufnahme kontaminierter Lebensmittel oder von Wasser kann ...

  13. Community health facility preparedness for a cholera surge in Haiti.

    Science.gov (United States)

    Mobula, Linda Meta; Jacquet, Gabrielle A; Weinhauer, Kristin; Alcidas, Gladys; Thomas, Hans-Muller; Burnham, Gilbert

    2013-01-01

    With increasing population displacement and worsening water insecurity after the 2010 earthquake, Haiti experienced a large cholera outbreak. Our goal was to evaluate the strengths and weaknesses of seven community health facilities' ability to respond to a surge in cholera cases. Since 2010, Catholic Relief Services (CRS) with a number of public and private donors has been working with seven health facilities in an effort to reduce morbidity and mortality from cholera infection. In November 2012, CRS through the Centers for Disease Control and Prevention (CDC)'s support, asked the Johns Hopkins Center for Refugee and Disaster Response to conduct a cholera surge simulation tabletop exercise at these health facilities to improve each facility's response in the event of a cholera surge. Using simulation development guidelines from the Pan American Health Organization and others, a simulation scenario script was produced that included situations of differing severity, supply chain, as well as a surge of patients. A total of 119 hospital staff from seven sites participated in the simulation exercise including community health workers, clinicians, managers, pharmacists, cleaners, and security guards. Clinics that had challenges during the simulated clinical care of patients were those that did not appropriately treat all cholera patients according to protocol, particularly those that were vulnerable, those that would need additional staff to properly treat patients during a surge of cholera, and those that required a better inventory of supplies. Simulation-based activities have the potential to identify healthcare delivery system vulnerabilities that are amenable to intervention prior to a cholera surge.

  14. Epidemiological investigation, disposal and effect evaluation of an imported cholera%1起输入性霍乱疫情的流行病学调查处置及效果评价

    Institute of Scientific and Technical Information of China (English)

    吴波青; 岳太科; 刘爱聪; 李昆宏; 韩继周; 张新灵; 线安相

    2011-01-01

    目的 查明本次疫情来源,规范处置疫情,为制订霍乱预防控制策略提供科学依据.方法 按照《霍乱防治手册》进行现场流行病学调查,实验室检测、消毒处理、疫情搜索及处置.结果 从患者呕吐物标本细菌培养检出01群霍乱弧菌,经血清学鉴定为稻叶型.经科学、规范、及时处置,疫情得到完全控制,未出现死亡及二代病例.结论 建立监测敏感、反应迅速的卫生应急队伍,科学规范及时地开展相关处置工作,是本次疫情处置取得圆满成效的关键.%Objective To ascertain the source of this epidemic and standard the disposal, provide scientific basis for making control and prevention strategy of cholera. Method According Cholera Control Manual to carry out field epidemio-logical investigation, lab detection, disinfection, epidemic situation search and disposition. Results We had detected 01 vibrio cholerae in patients vomitus by bacteria culture, it was serotype inaba identified by serological identification. Under the scientific, standard and timely disposition, the epidemic had control, and no death and second generation cases appeared. Conclusions The key of successful control the epidemic were that, we had building up a monitoring sensitive and response rapid health emergency team and scientific, standard and timely carried out disposition.

  15. Hepatocellular carcinoma and industrial epidemics

    Institute of Scientific and Technical Information of China (English)

    Alain Braillon; Gérard Dubois

    2011-01-01

    Worldwide, the burden of the non viral causes of hepatocellular carcinoma (HCC) is usually underestimated. Clearly industrial goods, tobacco, alcohol and processed foods are the agents of new epidemics in modern times which far outscore the burden of infectious agents on morbidity and mortality. Smoking, a dose-related contributing factor for HCC, receives too little attention in clinical practice. In France, tobacco, hepatitis B and C virus and alcohol are the main risk factors for HCC mortality (33%, 31% and 26%, respectively). In developing countries, where tobacco consumption is dramatically increasing, this epidemic may soon surpass hepatitis B. Obesity and diabetes are the contributing factors too. The role of industrial processed foods in the increase of the prevalence of obesity and diabetes cannot be ignored.

  16. The Economics of Epidemic Diseases.

    Science.gov (United States)

    Dimitri, Nicola

    2015-01-01

    Epidemic, infectious, diseases affect a large number of individuals across developing as well as developed countries. With reference to some very simple diffusion models, in this paper we consider how available economic resources could be optimally allocated by health authorities to mitigate, possibly eradicate, the disease. Optimality was defined as the minimization of the long run number of infected people. The main goal of the work has been to introduce a methodology for deciding if it would be best to concentrate resources to prevent contact between individuals and with an external source, or to develop a new treatment for curing the disease, or both. The analysis suggests that this depends on the cost functions, that is the available technology, for controlling the relevant parameters underlying the epidemics as well as on the available financial resources. In the case of the recent Ebola outbreak, the suggestions of the model have been consistent with the policies adopted.

  17. The repertoire of glycosphingolipids recognized by Vibrio cholerae.

    Directory of Open Access Journals (Sweden)

    John Benktander

    Full Text Available The binding of cholera toxin to the ganglioside GM1 as the initial step in the process leading to diarrhea is nowadays textbook knowledge. In contrast, the knowledge about the mechanisms for attachment of Vibrio cholerae bacterial cells to the intestinal epithelium is limited. In order to clarify this issue, a large number of glycosphingolipid mixtures were screened for binding of El Tor V. cholerae. Several specific interactions with minor complex non-acid glycosphingolipids were thereby detected. After isolation of binding-active glycosphingolipids, characterization by mass spectrometry and proton NMR, and comparative binding studies, three distinct glycosphingolipid binding patterns were defined. Firstly, V. cholerae bound to complex lacto/neolacto glycosphingolipids with the GlcNAcβ3Galβ4GlcNAc sequence as the minimal binding epitope. Secondly, glycosphingolipids with a terminal Galα3Galα3Gal moiety were recognized, and the third specificity was the binding to lactosylceramide and related compounds. V. cholerae binding to lacto/neolacto glycosphingolipids, and to the other classes of binding-active compounds, remained after deletion of the chitin binding protein GbpA. Thus, the binding of V. cholerae to chitin and to lacto/neolacto containing glycosphingolipids represents two separate binding specificities.

  18. Hybrid microarray based on double biomolecular markers of DNA and carbohydrate for simultaneous genotypic and phenotypic detection of cholera toxin-producing Vibrio cholerae.

    Science.gov (United States)

    Shin, Hwa Hui; Seo, Jeong Hyun; Kim, Chang Sup; Hwang, Byeong Hee; Cha, Hyung Joon

    2016-05-15

    Life-threatening diarrheal cholera is usually caused by water or food contaminated with cholera toxin-producing Vibrio cholerae. For the prevention and surveillance of cholera, it is crucial to rapidly and precisely detect and identify the etiological causes, such as V. cholerae and/or its toxin. In the present work, we propose the use of a hybrid double biomolecular marker (DBM) microarray containing 16S rRNA-based DNA capture probe to genotypically identify V. cholerae and GM1 pentasaccharide capture probe to phenotypically detect cholera toxin. We employed a simple sample preparation method to directly obtain genomic DNA and secreted cholera toxin as target materials from bacterial cells. By utilizing the constructed DBM microarray and prepared samples, V. cholerae and cholera toxin were detected successfully, selectively, and simultaneously; the DBM microarray was able to analyze the pathogenicity of the identified V. cholerae regardless of whether the bacteria produces toxin. Therefore, our proposed DBM microarray is a new effective platform for identifying bacteria and analyzing bacterial pathogenicity simultaneously.

  19. Networked SIS Epidemics with Awareness

    CERN Document Server

    Paarporn, Keith; Weitz, Joshua S; Shamma, Jeff S

    2016-01-01

    We study an SIS epidemic process over a static contact network where the nodes have partial information about the epidemic state. They react by limiting their interactions with their neighbors when they believe the epidemic is currently prevalent. A node's awareness is weighted by the fraction of infected neighbors in their social network, and a global broadcast of the fraction of infected nodes in the entire network. The dynamics of the benchmark (no awareness) and awareness models are described by discrete-time Markov chains, from which mean-field approximations (MFA) are derived. The states of the MFA are interpreted as the nodes' probabilities of being infected. We show a sufficient condition for existence of a "metastable", or endemic, state of the awareness model coincides with that of the benchmark model. Furthermore, we use a coupling technique to give a full stochastic comparison analysis between the two chains, which serves as a probabilistic analogue to the MFA analysis. In particular, we show that...

  20. Characterization of tryptophanase from Vibrio cholerae.

    Science.gov (United States)

    Nuidate, Taiyeebah; Tansila, Natta; Chomchuen, Piraporn; Phattaranit, Phattiphong; Eangchuan, Supachok; Vuddhakul, Varaporn

    2015-01-01

    Tryptophanase (Trpase) is a pyridoxal phosphate (PLP)-dependent enzyme responsible for the production of indole, an important intra- and interspecies signaling molecule in bacteria. In this study, the tnaA gene of Vibrio cholerae coding for VcTrpase was cloned into the pET-20b(+) vector and expressed in Escherichia coli BL21(DE3) tn5:tnaA. Using Ni(2+)-nitrilotriacetic acid (NTA) chromatography, VcTrpase was purified, and it possessed a molecular mass of ∼49 kDa with specific absorption peaks at 330 and 435 nm and a specific activity of 3 U/mg protein. The VcTrpase had an 80 % homology to the Trpase of Haemophilus influenzae and E. coli, but only around 50 % identity to the Trpase of Proteus vulgaris and Porphyromonas gingivalis. The optimum conditions for the enzyme were at pH 9.0 and 45 °C. Recombinant VcTrpase exhibited analogous kinetic reactivity to the EcTrpase with K m and k cat values of 0.612 × 10(-3) M and 5.252 s(-1), respectively. The enzyme catalyzed S-methyl-L-cysteine and S-benzyl-L-cysteine degradation, but not L-phenylalanine and L-serine. Using a site-directed mutagenesis technique, eight residues (Thr52, Tyr74, Arg103, Asp137, Arg230, Lys269, Lys270, and His463) were conserved for maintaining enzyme catalysis. All amino acid substitutions at these sites either eliminated or remarkably diminished Trpase activity. These sites are thus potential targets for the design of drugs to control the V. cholerae Trpase and to further investigate its functions.

  1. Vampire,Cholera and Imperial Maladies---the Disease Construction in Dracula from the Perspective of Medical Sociology%吸血鬼、霍乱与帝国顽疾--医学社会学视角看《德库拉》的疾病建构

    Institute of Scientific and Technical Information of China (English)

    王亭亭; 蒋天平

    2014-01-01

    19世纪四次大规模的霍乱爆发给维多利亚时代的英国带来了巨大的灾难,也对其社会文化产生了深远的影响。文章从医学社会学视角出发,结合霍乱疫情分析了布拉姆·斯托克的哥特小说《德库拉》中对霍乱从想象到认知的疾病建构过程,并对大英帝国在霍乱疫情中所暴露出的诸多问题进行了讨论。%The four large-scale outbreaks of cholera in the 19th century brought great suffering to the Victorian Britain and profound influence to its society and culture as well .From the perspec-tive of medical sociology and based on the cholera epidemic situation ,this paper analyses the dis-ease construction process from imagination to cognition of cholera in Bram Stoker ’s Gothic fiction Dracula and discusses the various problems exposed by the cholera epidemic situation in the Great Britain .

  2. Myths of the Great War

    OpenAIRE

    Harrison, Mark

    2014-01-01

    We review some "myths" of the Great War of 1914 to 1918: that the war broke out inadvertently, that the western front saw needless slaughter, that the Allies used the food weapon to strangle Germany, and that the peace treaty that ended the war caused the rise of Hitler and the still greater war that followed.\\ud

  3. Somatic hypotheses of war syndromes

    NARCIS (Netherlands)

    Soetekouw, P.M.M.B.; Vries, M. de; Bergen, L.F.J.M. van; Galama, J.M.D.; Keyser, A.J.M.; Bleijenberg, G.; Meer, J.W.M. van der

    2000-01-01

    Since the end of the American Civil War, unexplained symptoms in military personnel arising after a war or peace mission have frequently been described. The pattern of symptoms is highly similar for all of the various war syndromes although the conditions of each war or peace mission are widely diff

  4. Thinking About Preventing Nuclear War.

    Science.gov (United States)

    Ground Zero, Washington, DC.

    Potential paths to nuclear war and the available means of prevention of nuclear war are discussed. Presented is a detailed description of six nuclear war scenarios, and brief examples of types of potential deterrents to nuclear war (firebreaks) which are relevant for each. To be effective, the right combination of firebreaks must be used, the…

  5. War No Longer Exists

    Science.gov (United States)

    2012-03-22

    understanding that industrial ability decides a war…”58 Russell Wrigley , in his famous book “The American Way of War,” argues that America...2003, 82, no.4, 41. 60 Colin S Gray, “The American Way of War: Critique and Implications,” Rethinking the Principles of War,” Anthony D. McIvor...12, 2012). 91 Anthony H. Cordesman, “The New US Defense Strategy and the Priorities and Changes in FY2013 Budget,” Center for Strategic and

  6. The Vietnam War

    DEFF Research Database (Denmark)

    Godbolt, James; Larsen, Chris Holmsted; Rasmussen, Søren Hein

    2009-01-01

    This article investigates the role of the Vietnam War in Danish and Norwegian politics. We argue that Danish and Norwegian membership in NATO and an unstable parliamentary situation may explain why these countries, unlike Sweden, did not take on the lead in the international protest against the war...... in Denmark, Sweden and Norway, and in all three countries powerful protest movements emerged that were remarkably similar. The Vietnam War strengthened the left in general and promoted a leftist politics of solidarity that influenced Swedish, Danish and Norwegian foreign policy-making of the 1970s....

  7. Avian Cholera emergence in Arctic-nesting northern Common Eiders: using community-based, participatory surveillance to delineate disease outbreak patterns and predict transmission risk

    Directory of Open Access Journals (Sweden)

    Samuel A. Iverson

    2016-12-01

    Full Text Available Emerging infectious diseases are a growing concern in wildlife conservation. Documenting outbreak patterns and determining the ecological drivers of transmission risk are fundamental to predicting disease spread and assessing potential impacts on population viability. However, evaluating disease in wildlife populations requires expansive surveillance networks that often do not exist in remote and developing areas. Here, we describe the results of a community-based research initiative conducted in collaboration with indigenous harvesters, the Inuit, in response to a new series of Avian Cholera outbreaks affecting Common Eiders (Somateria mollissima and other comingling species in the Canadian Arctic. Avian Cholera is a virulent disease of birds caused by the bacterium Pasteurella multocida. Common Eiders are a valuable subsistence resource for Inuit, who hunt the birds for meat and visit breeding colonies during the summer to collect eggs and feather down for use in clothing and blankets. We compiled the observations of harvesters about the growing epidemic and with their assistance undertook field investigation of 131 colonies distributed over >1200 km of coastline in the affected region. Thirteen locations were identified where Avian Cholera outbreaks have occurred since 2004. Mortality rates ranged from 1% to 43% of the local breeding population at these locations. Using a species-habitat model (Maxent, we determined that the distribution of outbreak events has not been random within the study area and that colony size, vegetation cover, and a measure of host crowding in shared wetlands were significantly correlated to outbreak risk. In addition, outbreak locations have been spatially structured with respect to hypothesized introduction foci and clustered along the migration corridor linking Arctic breeding areas with wintering areas in Atlantic Canada. At present, Avian Cholera remains a localized threat to Common Eider populations in the

  8. Time series analysis of cholera in Matlab, Bangladesh, during 1988-2001.

    Science.gov (United States)

    Ali, Mohammad; Kim, Deok Ryun; Yunus, Mohammad; Emch, Michael

    2013-03-01

    The study examined the impact of in-situ climatic and marine environmental variability on cholera incidence in an endemic area of Bangladesh and developed a forecasting model for understanding the magnitude of incidence. Diarrhoea surveillance data collected between 1988 and 2001 were obtained from a field research site in Matlab, Bangladesh. Cholera cases were defined as Vibrio cholerae O1 isolated from faecal specimens of patients who sought care at treatment centres serving the Matlab population. Cholera incidence for 168 months was correlated with remotely-sensed sea-surface temperature (SST) and in-situ environmental data, including rainfall and ambient temperature. A seasonal autoregressive integrated moving average (SARIMA) model was used for determining the impact of climatic and environmental variability on cholera incidence and evaluating the ability of the model to forecast the magnitude of cholera. There were 4,157 cholera cases during the study period, with an average of 1.4 cases per 1,000 people. Since monthly cholera cases varied significantly by month, it was necessary to stabilize the variance of cholera incidence by computing the natural logarithm to conduct the analysis. The SARIMA model shows temporal clustering of cholera at one- and 12-month lags. There was a 6% increase in cholera incidence with a minimum temperature increase of one degree celsius in the current month. For increase of SST by one degree celsius, there was a 25% increase in the cholera incidence at currrent month and 18% increase in the cholera incidence at two months. Rainfall did not influenc to cause variation in cholera incidence during the study period. The model forecast the fluctuation of cholera incidence in Matlab reasonably well (Root mean square error, RMSE: 0.108). Thus, the ambient and sea-surface temperature-based model could be used in forecasting cholera outbreaks in Matlab.

  9. Thapsigargin-induced transport of cholera toxin to the endoplasmic reticulum.

    OpenAIRE

    Sandvig, K.; Garred, O; van Deurs, B.

    1996-01-01

    Cholera toxin is normally observed only in the Golgi apparatus and not in the endoplasmic reticulum (ER) although the enzymatically active A subunit of cholera toxin has a KDEL sequence. Here we demonstrate transport of horseradish peroxidase-labeled cholera toxin to the ER by electron microscopy in thapsigargin-treated A431 cells. Thapsigargin treatment strongly increased cholera toxin-induced cAMP production, and the formation of the catalytically active A1 fragment was somewhat increased. ...

  10. Climate Variability and the Outbreaks of Cholera in Zanzibar, East Africa: A Time Series Analysis

    OpenAIRE

    Reyburn, Rita; Kim, Deok Ryun; Emch, Michael; Khatib, Ahmed; von Seidlein, Lorenz; Ali, Mohammad

    2011-01-01

    Global cholera incidence is increasing, particularly in sub-Saharan Africa. We examined the impact of climate and ocean environmental variability on cholera outbreaks, and developed a forecasting model for outbreaks in Zanzibar. Routine cholera surveillance reports between 1997 and 2006 were correlated with remotely and locally sensed environmental data. A seasonal autoregressive integrated moving average (SARIMA) model determined the impact of climate and environmental variability on cholera...

  11. Competing activation mechanisms in epidemics on networks

    CERN Document Server

    Castellano, Claudio

    2011-01-01

    In stark contrast to previous common wisdom that epidemic activity and thresholds in heterogeneous networks are dominated by the elements with the largest number of connections (the hubs), recent research has pointed out the role of the most efficient spreaders, located at the innermost, dense core of the network, in sustaining epidemic processes. Here we show that the mechanism responsible of epidemic spreading depends on the dynamical pattern of the epidemic process. For epidemics with a transient state, activity is essentially boosted by the innermost core of the network. On the contrary, epidemics allowing a steady state present a dual scenario, where either the vertex with the largest connectivity independently sustains activity and propagates it to the rest of the system, or, alternatively, the innermost core of the network collectively turns into the active state, maintaining it on a global scale. Which one of these two mechanisms actually governs the dynamics depends on the network features. In uncorr...

  12. Outbreak-associated Vibrio cholerae genotypes with identical pulsotypes, Malaysia, 2009.

    Science.gov (United States)

    Teh, Cindy Shuan Ju; Suhaili, Zarizal; Lim, King Ting; Khamaruddin, Muhamad Afif; Yahya, Fariha; Sajili, Mohd Hailmi; Yeo, Chew Chieng; Thong, Kwai Lin

    2012-07-01

    A cholera outbreak in Terengganu, Malaysia, in November 2009 was caused by 2 El Tor Vibrio cholerae variants resistant to typical antimicrobial drugs. Evidence of replacement of treatable V. cholerae infection in the region with antimicrobial-resistant strains calls for increased surveillance and prevention measures.

  13. A model to predict when a cholera outbreak might hit the Congo

    Science.gov (United States)

    Schultz, Colin

    2014-09-01

    In 2011, as many as 600,000 people in 58 countries contracted cholera, with thousands succumbing to the disease. In most countries, cholera is rare. In others, like the Democratic Republic of the Congo, cholera is an endemic threat, always lurking in the background waiting for the right set of conditions to spark an outbreak.

  14. How Wars Begin

    Institute of Scientific and Technical Information of China (English)

    2009-01-01

    @@ The Stevenson family was having dinner. The family atewithout talking for several minutes, then Tom said, "Daddy,do you know how wars begin? " Mr. Stevenson thought for a moment, then he said, "Yes,I think so.

  15. Masculinity, War and Violence

    DEFF Research Database (Denmark)

    Christensen, Ann-Dorte; Rasmussen, Palle Damkjær

    Addressing the relationship between masculinity, war and violence, the book covers these themes broadly and across disciplines. The ten contributions encompass four recurring themes: violent masculinities and how contemporary societies and regimes cope with them; popular written and visual fiction...

  16. Epidemic Survivability: Characterizing Networks Under Epidemic-like Failure Propagation Scenarios

    DEFF Research Database (Denmark)

    Manzano, Marc; Calle, Eusebi; Ripoll, Jordi

    2013-01-01

    in telecommunication networks has not been extensively considered, nowadays, with the increasing computation capacity and complexity of operating systems of modern network devices (routers, switches, etc.), the study of possible epidemic-like failure scenarios must be taken into account. When epidemics occur......, such as in other multiple failure scenarios, identifying the level of vulnerability offered by a network is one of the main challenges. In this paper, we present epidemic survivability, a new network measure that describes the vulnerability of each node of a network under a specific epidemic intensity. Moreover......, this metric is able to identify the set of nodes which are more vulnerable under an epidemic attack. In addition, two applications of epidemic survivability are provided. First, we introduce epidemic criticality, a novel robustness metric for epidemic failure scenarios. A case study shows the utility...

  17. Preventing a Currency War

    Institute of Scientific and Technical Information of China (English)

    YU SHUJUN

    2010-01-01

    @@ On the global economic recovery's already unpredictable road, the latest threat comes from the possibility of a currency war. Although worries about the war have recently been alleviated,as G20 financial officials vowed to "refrain from competitive devaluation of currencies" at their meeting in Gyeongju, South Korea, on October 21-23, more than just words and promises are necessary to avert a currency showdown.

  18. The American Home Front: Revolutionary War, Civil War, World War I, World War II

    Science.gov (United States)

    1983-01-01

    customs. War, they have also asserted, draws two related political dangers in its train. An ambitious President (or one of his successful generals ) might... general questions about war’s intluence upon the economy. political institutions, and society’s constituent groups. This book takes a preliminary step... millennial task. As a consequence. political theorists and statesmen re- placed clergymen as the leaders of American thought, and politics supplanted

  19. War, violence and masculinities

    DEFF Research Database (Denmark)

    Christensen, Ann-Dorte; Rasmussen, Palle Damkjær

    2015-01-01

    The evolution and social constitution of masculinities are intimately linked to violence and to warfare as an organised field of violent practices. The mutual influences between violence, war and masculinities have taken different forms these have taken in different social and cultural contexts....... In this introductory article we present four key themes in this field and discuss perspectives and challenges for the study of violence, war and masculinities....

  20. SIS epidemic propagation on hypergraphs

    CERN Document Server

    Bodó, Ágnes; Simon, Péter L

    2015-01-01

    Mathematical modeling of epidemic propagation on networks is extended to hypergraphs in order to account for both the community structure and the nonlinear dependence of the infection pressure on the number of infected neighbours. The exact master equations of the propagation process are derived for an arbitrary hypergraph given by its incidence matrix. Based on these, moment closure approximation and mean-?eld models are introduced and compared to individual-based stochastic simulations. The simulation algorithm, developed for networks, is extended to hypergraphs. The e?ects of hypergraph structure and the model parameters are investigated via individual-based simulation results.

  1. Fractional Derivatives in Dengue Epidemics

    Science.gov (United States)

    Pooseh, Shakoor; Rodrigues, Helena Sofia; Torres, Delfim F. M.

    2011-09-01

    We introduce the use of fractional calculus, i.e., the use of integrals and derivatives of non-integer (arbitrary) order, in epidemiology. The proposed approach is illustrated with an outbreak of dengue disease, which is motivated by the first dengue epidemic ever recorded in the Cape Verde islands off the coast of west Africa, in 2009. Numerical simulations show that in some cases the fractional models fit better the reality when compared with the standard differential models. The classical results are obtained as particular cases by considering the order of the derivatives to take an integer value.

  2. An epidemic outbreak of cryptosporidiosis

    DEFF Research Database (Denmark)

    Mølbak, Kåre; Højlyng, Niels; Ingholt, Liselotte;

    1990-01-01

    significantly associated with diarrhea (OR = 2.79, P = 0.0006). The seasonal distribution was striking, with a peak prevalence in the beginning of the rainy season (May 17.6%) when an epidemic outbreak of diarrhea started. The prevalence was highest in children younger than 18 months, an age at which......In the first year of a prospective community study of childhood diarrhea conducted in a semiurban area in the capital of Guinea Bissau, Cryptosporidium sp. was found in 73 (6.0%) of 1216 episodes of diarrhea. The parasite was the second most prevalent intestinal parasite, and the only one...

  3. Fractional derivatives in Dengue epidemics

    CERN Document Server

    Pooseh, Shakoor; Torres, Delfim F M

    2011-01-01

    We introduce the use of fractional calculus, i.e., the use of integrals and derivatives of non-integer (arbitrary) order, in epidemiology. The proposed approach is illustrated with an outbreak of dengue disease, which is motivated by the first dengue epidemic ever recorded in the Cape Verde islands off the coast of west Africa, in 2009. Numerical simulations show that in some cases the fractional models fit better the reality when compared with the standard differential models. The classical results are obtained as particular cases by considering the order of the derivatives to take an integer value.

  4. Ecología de Vibrio cholerae en relación al Fitoplancton y variables fisicoquímicas en ríos de Tucumán (Argentina Ecology of Vibrio cholerae in relation to phytoplankton and physico-chemical variables in rivers of Tucumán (Argentina

    Directory of Open Access Journals (Sweden)

    V. Mirande

    Full Text Available Vibrio cholerae muestra gran diversidad serológica en base a su antígeno somático O, conociéndose al menos 200 serogrupos. De éstos, solamente O1 y O139 son causantes de epidemias o pandemias. En Latinoamérica el serogrupo O1 reapareció en 1991, tras cien años de no presentar brotes en el continente. Esta bacteria sobrevive y se multiplica asociada al plancton, independientemente de la aparición de infecciones humanas. Desde la década del noventa, en Tucumán, se detectaron casos esporádicos de diarrea por Vibrio cholerae no-O1. El objetivo del presente trabajo fue estudiar la posible relación entre la presencia de especímenes de fitoplancton, variables fisicoquímicas y aislamientos de Vibrio cholerae en ríos de Tucumán. Se realizaron 18 campañas en los ríos Lules y Salí entre 2003-2005. Se estudiaron las variables fisicoquímicas del agua (pH, temperatura, conductividad y oxígeno disuelto, el fitoplancton (riqueza y frecuencia relativa y las cepas aisladas de V. cholerae. Los resultados evidenciaron diferencias en la calidad del agua, observándose períodos de anoxia en el río Salí. Las diatomeas sobresalieron en la mayoría de los meses y generalmente estuvieron en porcentajes superiores al 85 %. Sólo se aisló Vibrio cholerae no-O1, no-O139, detectándose más frecuentemente en los meses cálidos, con pH alcalino, aún con baja concentración de oxígeno.Vibrio cholerae shows a great serologic diversity in relation to his O somatic antigen and we know at least 200 serogroups. About these, only O1 and O139 are responsible of epidemics and pandemics. The serogroup O1 reemerged in Latin America in 1991 after being absent from the continent for nearly a century. This bacterium survives and grows up associated to plankton, independently of appearance of human infections. From 90 th decade, there were sporadic cases of diarrhea because of Vibrio cholerae O1 in Tucumán. The aims of this paper were to study the possible

  5. [Disease control in the Red Army during the final stages of the Great Patriotic War].

    Science.gov (United States)

    Butakov, S S; Berskii, O V; Zetkin, A Yu; Zobov, A E

    2015-05-01

    Forms and methods of disease, control in troops were fully developed during the Great Patriotic War 1941-1945 years. An improvement of anti-epidemic organization in the Red Army was based on military medical doctrine, which demanded united views on methods of disease prevention and in accordance with the 'main tasks of medical support of the army, including prevention of epidemic outbreaks in the army. Disease control system in the Red Army during the war was a series of targeted, science-based and proved by military practice measures .aimed at both the prevention and the immediate elimination of epidemic diseases. when they occur. The questions of disease control forces in the final stage of the Great Patriotic War (January 1944 - May 1945). Depending on the progress of the war and the conditions of the fighting, given the period laid down in the principles of disease control of military operations, discussed aspects of the organization of sanitary-epidemiological (preventive) measures in the armed forces.

  6. Antibiotic Resistance of Vibrio cholerae Isolates from Kashan, Iran

    Directory of Open Access Journals (Sweden)

    Afzali H.MD,

    2016-03-01

    Full Text Available Abstract Aims: Cholera is an acute diarrheal disease that can lead to severe dehydration and death. Antibiotic resistance is a big challenge in infective disease like Cholera. The present study aimed to understand the characteristics and trends of antibiotic resistance of V. cholerae isolations in and around Kashan, Iran. Instrument & Methods: In this descriptive cross-sectional study, samples were gathered using census method from 1998 to 2013 in Kashan, Iran. 1132 fecal samples of patients with acute diarrhea and 237 samples of suspected water samples were taken. The serotypes and biotypes were determined by an enzymatic method. Antibiotic susceptibility test was performed by using Disk Diffusion Method. Data were analyzed using SPSS 23 software. Fisher-exact and Chi-square tests were used to compare the statistical parameters. Findings: 96 fecal samples (8.5% and 18 water samples (7.6% were positive for Vibrio cholerae. Non-agglutinating (Nag isolates (75.4% were more common than serotype Inaba (13.2% and Ogawa (11.4%. Nag serotypes were mostly resistant to cefixime (44% and ampicillin (33%. In contaminated water samples also the most frequent cases were Nag serotype (50%. Nag serotype showed 22.2% of resistance to ampicillin and nitrofurantoin. Conclusion: Vibrio cholerae isolates in Kashan, Iran, are highly resistant to antibiotics, especially Nag serotypes.

  7. Nonredundant Roles of Iron Acquisition Systems in Vibrio cholerae.

    Science.gov (United States)

    Peng, Eric D; Wyckoff, Elizabeth E; Mey, Alexandra R; Fisher, Carolyn R; Payne, Shelley M

    2015-12-07

    Vibrio cholerae, the causative agent of the severe diarrheal disease cholera, thrives in both marine environments and the human host. To do so, it must encode the tools necessary to acquire essential nutrients, including iron, under these vastly different conditions. A number of V. cholerae iron acquisition systems have been identified; however, the precise role of each system is not fully understood. To test the roles of individual systems, we generated a series of mutants in which only one of the four systems that support iron acquisition on unsupplemented LB agar, Feo, Fbp, Vct, and Vib, remains functional. Analysis of these mutants under different growth conditions showed that these systems are not redundant. The strain carrying only the ferrous iron transporter Feo grew well at acidic, but not alkaline, pH, whereas the ferric iron transporter Fbp promoted better growth at alkaline than at acidic pH. A strain defective in all four systems (null mutant) had a severe growth defect under aerobic conditions but accumulated iron and grew as well as the wild type in the absence of oxygen, suggesting the presence of an additional, unidentified iron transporter in V. cholerae. In support of this, the null mutant was only moderately attenuated in an infant mouse model of infection. While the null mutant used heme as an iron source in vitro, we demonstrate that heme is not available to V. cholerae in the infant mouse intestine.

  8. Non-01 Vibrio cholerae infections in Cancun, Mexico.

    Science.gov (United States)

    Finch, M J; Valdespino, J L; Wells, J G; Perez-Perez, G; Arjona, F; Sepulveda, A; Bessudo, D; Blake, P A

    1987-03-01

    To determine the role of Vibrio cholerae as a cause of diarrheal illness in Cancun, Mexico, an investigation was conducted in July and August 1983. Although toxigenic V. cholerae 01 were not found, non-01 V. cholerae were isolated from 22 (16%) of 134 stools from persons with diarrheal illness and none of 22 stools from well persons; 58 (92%) of 63 sewage samples; 12 (86%) of 14 untreated well water samples; a home storage tank for treated water; and 5 (21%) of 24 samples of raw seafood. None of the V. cholerae isolates from patients were toxigenic. The illness occurred mainly in small children, and were characterized principally by diarrhea and abdominal pain. No patient was seriously ill, and all recovered without sequelae. Seven different serotypes of non-01 V. cholerae were isolated from the stool specimens, and Smith serotype 12 accounted for 10 (46%) of the 22 isolates. A matched-pair case-control study found that cases were more likely than controls to have eaten home prepared gelatin (P = 0.03, OR = 5/0) and seafood (P = 0.06, OR = 4/0).

  9. Environmental reservoirs and mechanisms of persistence of Vibrio cholerae

    Directory of Open Access Journals (Sweden)

    Carla eLutz

    2013-12-01

    Full Text Available It is now well accepted that Vibrio cholerae, the causative agent of the water-borne disease cholera, is acquired from environmental sources where it persists between outbreaks of the disease. Recent advances in molecular technology have demonstrated that this bacterium could be detected in areas where it had not been isolated from before, indicating a much broader, global distribution of this bacterium rather than specifically within regions where cholera is endemic. The environmental persistence of V. cholerae in the aquatic environment can be attributed to multiple intra- and interspecific strategies such as responsive gene regulation and biofilm formation on biotic and abiotic surfaces, as well as interactions with a multitude of other organisms. This review will discuss some of the mechanisms that enable the persistence of the bacterium in the sometimes hostile environment. In particular, we will discuss how V. cholerae can survive stressors such as starvation, temperature and salinity fluctuations as well as how the organism persists under constant predation by heterotrophic protists.

  10. Cyclo(valine-valine) inhibits Vibrio cholerae virulence gene expression.

    Science.gov (United States)

    Vikram, Amit; Ante, Vanessa M; Bina, X Renee; Zhu, Qin; Liu, Xinyu; Bina, James E

    2014-06-01

    Vibrio cholerae has been shown to produce a cyclic dipeptide, cyclo(phenylalanine-proline) (cFP), that functions to repress virulence factor production. The objective of this study was to determine if heterologous cyclic dipeptides could repress V. cholerae virulence factor production. To that end, three synthetic cyclic dipeptides that differed in their side chains from cFP were assayed for virulence inhibitory activity in V. cholerae. The results revealed that cyclo(valine-valine) (cVV) inhibited virulence factor production by a ToxR-dependent process that resulted in the repression of the virulence regulator aphA. cVV-dependent repression of aphA was found to be independent of known aphA regulatory genes. The results demonstrated that V. cholerae was able to respond to exogenous cyclic dipeptides and implicated the hydrophobic amino acid side chains on both arms of the cyclo dipeptide scaffold as structural requirements for inhibitory activity. The results further suggest that cyclic dipeptides have potential as therapeutics for cholera treatment.

  11. Isolation of isoelectrically pure cholera toxin for crystallization

    Science.gov (United States)

    Spangler, Brenda D.; Westbrook, Edwin M.

    1991-03-01

    We have determined that the failure of cholera toxin to crystallize well results from its isoelectric heterogeneity, which is probably due to a post-translational process such as deamidation of its B subunit. Every sample of cholera toxin we have examined from commercial or academic suppliers has been heterogeneous; heterogeneous cholera toxin does not crystallize satisfactorily. We have overcome this problem by using ion-exchange fast protein liquid chromatography (FPLC) to obtain an isoelectrically homogeneous species of cholera toxin. Homogeneous cholera toxin crystallizes readily, forming single, nonmosaic crystals suitable for X-ray diffraction studies. For this process, protein was applied to a MonoQ ion-exchange column, then eluted with an isocratic low salt buffer followed by a linear salt gradient (0-100 mM NaCl). Column fractions were analyzed on isoelectric focusing gels, and those fractions containing the desired homogeneous species were pooled and concentrated. Crystals formed within 24 to 48 h in a MOPS/PEG buffer, which made use of slow isoelectric precipitation to induce crystallization.

  12. THE TRANSFORMATION OF WAR

    Directory of Open Access Journals (Sweden)

    L.S. Mnyandu

    2012-02-01

    Full Text Available "A ghost is stalking the corridors of general staffs and defence departments all over the 'developed' world - the fear of military impotence, even irrelevance. ...As new forms of armed conflict multiply and spread, they will cause the lines between public and private, government and people, military and civilian to become as blurred as they were before 1648. ...One very important way in which men can attain joy, freedom, happiness is (through war." (Van Creveld, 1991: 1,226,227 These are the words that open and conclude this book whose stated objective is to provide a non-Clausewitzian perspective to 'modern' warfare (p ix. In the first two chapters, Van Creveld perceptively addresses the bankruptcy of nuclear weapons and strategy, the declining utility of conventional armed forces and the resurgence of low intensity conflict as well as the resounding political outcomes accrued through such conflicts. Acknowledging Karl von Clausewitz as an outstanding military theoretician, Van Creveld not only delineates the historical context in which Clausewitz's writings were most relevant, but goes on to evoke the works of Colmar von der Goltz (Das Volk in Waffen, 1883 and Erich Ludendorf (Der Totale Krieg, 1936 in order to clearly distinguish the concept of a trinitarian war in comparison to those of a total war and nontrinitarian war (p 35, 42, 45, 49. "Involving the surgical separation of the state, society and the military, the trinitarian war is compatible with the Clausewitzian prescription and primary notion of war as a continuation of politics" (p 63. While total war appears to be an extreme and perverted form of trinitarian war - it plays a vital role in as far as it nearly obliterated society, facilitated the rise of totalitarian governments and even precipitated the Second World War. This openened the flood gates for the resurgence of nontrinitarian conflict in which individuals and individual societies (not established armies acting on behalf

  13. The hows and whys of constructing a native recombinant cholera vaccine

    Science.gov (United States)

    Boustanshenas, Mina; Bakhshi, Bita

    2014-01-01

    Emergence of different ctxB genotypes within virulent Vibrio cholerae populations accentuates the need to develop a vaccine that has the potential to protect against all cholera toxin genotypes. Oral administration of rCTB—alone and in combination with 2 dominant domestic killed whole cells of V. cholerae (O1 Ogawa El Tor and O1 Inaba El Tor) plus one standard V. cholerae (O1 Ogawa classic ATCC 14035)—has shown satisfactory protection as a potent vaccine candidate against toxigenic V. cholerae. PMID:24165439

  14. Mobile phone data highlights the role of mass gatherings in the spreading of cholera outbreaks.

    Science.gov (United States)

    Finger, Flavio; Genolet, Tina; Mari, Lorenzo; de Magny, Guillaume Constantin; Manga, Noël Magloire; Rinaldo, Andrea; Bertuzzo, Enrico

    2016-06-07

    The spatiotemporal evolution of human mobility and the related fluctuations of population density are known to be key drivers of the dynamics of infectious disease outbreaks. These factors are particularly relevant in the case of mass gatherings, which may act as hotspots of disease transmission and spread. Understanding these dynamics, however, is usually limited by the lack of accurate data, especially in developing countries. Mobile phone call data provide a new, first-order source of information that allows the tracking of the evolution of mobility fluxes with high resolution in space and time. Here, we analyze a dataset of mobile phone records of ∼150,000 users in Senegal to extract human mobility fluxes and directly incorporate them into a spatially explicit, dynamic epidemiological framework. Our model, which also takes into account other drivers of disease transmission such as rainfall, is applied to the 2005 cholera outbreak in Senegal, which totaled more than 30,000 reported cases. Our findings highlight the major influence that a mass gathering, which took place during the initial phase of the outbreak, had on the course of the epidemic. Such an effect could not be explained by classic, static approaches describing human mobility. Model results also show how concentrated efforts toward disease control in a transmission hotspot could have an important effect on the large-scale progression of an outbreak.

  15. Changing genotypes of cholera toxin (CT) of Vibrio cholerae O139 in Bangladesh and description of three new CT genotypes.

    Science.gov (United States)

    Bhuiyan, Nurul A; Nusrin, Suraia; Alam, Munirul; Morita, Masatomo; Watanabe, Haruo; Ramamurthy, Thandavarayan; Cravioto, Alejandro; Nair, Gopinath Balakrish

    2009-11-01

    We determined the genotype of cholera toxin by amplifying and sequencing the B-subunit in a sequential collection of 90 strains of Vibrio cholerae O139 isolated over the past 13 years since its first description in 1992. Representative strains isolated during 1993-1997 harboured ctxB of El Tor type (genotype 3). Twenty-six strains isolated during 1999, 2001, 2005 and three strains isolated in 1998, 2000 and 2002 were identified to belong to new ctxB genotypes 4 and 5, respectively. Genotype 5 was similar to genotype 1 except at position 28 (D-->A). The genotype 6 was similar to genotype 4 except at position 34 (H-->P). The implication of switch in terms of function of the toxin and its impact on human disease is unclear. How this change has influenced their prevalence relative to that of V. cholerae O1 in human infection is also not clear. The other common virulence gene clusters including the Vibrio pathogenicity island-1, Vibrio seventh pandemic island (VSP)-I and VSP-II of V. cholerae O139 did not show any remarkable difference from that of the O1 El Tor strains. Overall, the majority of the O139 strains tested in this study were similar to the El Tor strains but had altered ctxB genotype. This change and the impact that it causes to the epidemiology of cholera caused by O139 should be closely monitored.

  16. Conjugated Linoleic Acid Reduces Cholera Toxin Production In Vitro and In Vivo by Inhibiting Vibrio cholerae ToxT Activity.

    Science.gov (United States)

    Withey, Jeffrey H; Nag, Drubhajyoti; Plecha, Sarah C; Sinha, Ritam; Koley, Hemanta

    2015-12-01

    The severe diarrheal disease cholera is endemic in over 50 countries. Current therapies for cholera patients involve oral and/or intravenous rehydration, often combined with the use of antibiotics to shorten the duration and intensity of the disease. However, as antibiotic resistance increases, treatment options will become limited. Linoleic acid has been shown to be a potent negative effector of V. cholerae virulence that acts on the major virulence transcription regulator protein, ToxT, to inhibit virulence gene expression. ToxT activates transcription of the two major virulence factors required for disease, cholera toxin (CT) and toxin-coregulated pilus (TCP). A conjugated form of linoleic acid (CLA) is currently sold over the counter as a dietary supplement and is generally recognized as safe by the U.S. Food and Drug Administration. This study examined whether CLA could be used as a new therapy to reduce CT production, which, in turn, would decrease disease duration and intensity in cholera patients. CLA could be used in place of traditional antibiotics and would be very unlikely to generate resistance, as it affects only virulence factor production and not bacterial growth or survival.

  17. Conjugated Linoleic Acid Reduces Cholera Toxin Production In Vitro and In Vivo by Inhibiting Vibrio cholerae ToxT Activity

    Science.gov (United States)

    Nag, Drubhajyoti; Plecha, Sarah C.; Sinha, Ritam; Koley, Hemanta

    2015-01-01

    The severe diarrheal disease cholera is endemic in over 50 countries. Current therapies for cholera patients involve oral and/or intravenous rehydration, often combined with the use of antibiotics to shorten the duration and intensity of the disease. However, as antibiotic resistance increases, treatment options will become limited. Linoleic acid has been shown to be a potent negative effector of V. cholerae virulence that acts on the major virulence transcription regulator protein, ToxT, to inhibit virulence gene expression. ToxT activates transcription of the two major virulence factors required for disease, cholera toxin (CT) and toxin-coregulated pilus (TCP). A conjugated form of linoleic acid (CLA) is currently sold over the counter as a dietary supplement and is generally recognized as safe by the U.S. Food and Drug Administration. This study examined whether CLA could be used as a new therapy to reduce CT production, which, in turn, would decrease disease duration and intensity in cholera patients. CLA could be used in place of traditional antibiotics and would be very unlikely to generate resistance, as it affects only virulence factor production and not bacterial growth or survival. PMID:26392502

  18. Stepwise changes in viable but nonculturable Vibrio cholerae cells.

    Science.gov (United States)

    Imamura, Daisuke; Mizuno, Tamaki; Miyoshi, Shin-ichi; Shinoda, Sumio

    2015-05-01

    Many bacterial species are known to become viable but nonculturable (VBNC) under conditions that are unsuitable for growth. In this study, the requirements for resuscitation of VBNC-state Vibrio cholerae cells were found to change over time. Although VBNC cells could initially be converted to culturable by treatment with catalase or HT-29 cell extract, they subsequently entered a state that was not convertible to culturable by these factors. However, fluorescence microscopy revealed the presence of live cells in this state, from which VBNC cells were resuscitated by co-cultivation with HT-29 human colon adenocarcinoma cells. Ultimately, all cells entered a state from which they could not be resuscitated, even by co-cultivation with HT-29. These characteristic changes in VBNC-state cells were a common feature of strains in both V. cholerae O1 and O139 serogroups. Thus, the VBNC state of V. cholerae is not a single property but continues to change over time.

  19. Epidemics in interconnected small-world networks

    NARCIS (Netherlands)

    Liu, M.; Li, D.; Qin, P.; Liu, C.; Wang, H.; Wang, F.

    2015-01-01

    Networks can be used to describe the interconnections among individuals, which play an important role in the spread of disease. Although the small-world effect has been found to have a significant impact on epidemics in single networks, the small-world effect on epidemics in interconnected networks

  20. Modeling and simulation of epidemic spread

    DEFF Research Database (Denmark)

    Shatnawi, Maad; Lazarova-Molnar, Sanja; Zaki, Nazar

    2013-01-01

    and control such epidemics. This paper presents an overview of the epidemic spread modeling and simulation, and summarizes the main technical challenges in this field. It further investigates the most relevant recent approaches carried out towards this perspective and provides a comparison and classification...

  1. Malaria Epidemic and Drug Resistance, Djibouti

    OpenAIRE

    Rogier, Christophe; Pradines, Bruno; Bogreau, H.; Koeck, Jean-Louis; Kamil, Mohamed-Ali; Mercereau-Puijalon, Odile

    2005-01-01

    Analysis of Plasmodium falciparum isolates collected before, during, and after a 1999 malaria epidemic in Djibouti shows that, despite a high prevalence of resistance to chloroquine, the epidemic cannot be attributed to a sudden increase in drug resistance of local parasite populations.

  2. Nitrosative Stress Response in Vibrio cholerae: Role of S-Nitrosoglutathione Reductase.

    Science.gov (United States)

    Patra, Sourav Kumar; Bag, Prasanta Kumar; Ghosh, Sanjay

    2016-12-20

    Vibrio cholerae, the causative agent of cholera, poses serious threats to humans worldwide. V. cholerae faces host inflammatory response and encounters nitrosative stress before establishing successful colonization. It is not clear how V. cholerae combats nitric oxide and reactive nitrogen species. In the present study, we used three clinical strains of V. cholerae and tested their nitrosative stress response pattern towards sodium nitroprusside (SNP) and S-Nitrosoglutathione (GSNO). Among them, V. cholerae, belonging to both O1 and O139 serotypes, showed moderate resistance to SNP and GSNO. However, a V. cholerae strain belonging to non O1 and non O139 showed sensitivity to SNP but resistance towards GSNO. Reduced glutathione and glutathione reductase play a significant role to combat nitrosative stress in V. cholerae. This is the first report where we show the presence of GSNO reductase activity in V. cholerae and that it plays an important role to detoxify S-Nitrosoglutathione. GSNO reductase activity of V. cholerae was regulated by posttranslational modification through S-nitrosylation under in vitro conditions which could be reversed by dithiothreitol (DTT). In addition, we show that biofilm formation remained unaffected under nitrosative stress in V. cholerae.

  3. Influence of climate factors on Vibrio cholerae dynamics in the Pearl River estuary, South China.

    Science.gov (United States)

    Yue, Yujuan; Gong, Jianhua; Wang, Duochun; Kan, Biao; Li, Baisheng; Ke, Changwen

    2014-06-01

    Current research has seldom focused on the quantitative relationships between Vibrio cholerae (V. cholerae) and climate factors owing to the complexities and high cost of field observation in the aquatic environment. This study has focused on the relationships between V. cholerae and climate factors based on linear regression method and data partition method. Data gathered from 2008 to 2009 in the Pearl River estuary, South China, were adopted. Positive rate of V. cholerae was correlated closely with monthly climate factors of water temperature and air temperature, respectively in 2009. Quarterly data analysis from 2008 to 2009 showed that there existed seasonal characteristic for V. cholerae. Positive rate of V. cholerae was correlated positively with quarterly climate factors of land surface temperature, pH, water temperature, air temperature and rainfall, respectively and negatively with quarterly air pressure. Partition data analysis in 2009 showed that there existed geography region characteristic for V. cholerae. V. cholerae dynamics was closely correlated to climate factors in the downstream area. However, it was more greatly affected by human geography factors in the urban area. Positive annual rate of V. cholerae was higher in the downstream area than in the urban area both in 2008 and 2009. At last, a cellular automaton model was used to simulate V. cholerae diffusion downstream, and the distribution of V. cholerae obtained from this model was similar to that obtained from the field observations.

  4. A global map of suitability for coastal Vibrio cholerae under current and future climate conditions.

    Science.gov (United States)

    Escobar, Luis E; Ryan, Sadie J; Stewart-Ibarra, Anna M; Finkelstein, Julia L; King, Christine A; Qiao, Huijie; Polhemus, Mark E

    2015-09-01

    Vibrio cholerae is a globally distributed water-borne pathogen that causes severe diarrheal disease and mortality, with current outbreaks as part of the seventh pandemic. Further understanding of the role of environmental factors in potential pathogen distribution and corresponding V. cholerae disease transmission over time and space is urgently needed to target surveillance of cholera and other climate and water-sensitive diseases. We used an ecological niche model (ENM) to identify environmental variables associated with V. cholerae presence in marine environments, to project a global model of V. cholerae distribution in ocean waters under current and future climate scenarios. We generated an ENM using published reports of V. cholerae in seawater and freely available remotely sensed imagery. Models indicated that factors associated with V. cholerae presence included chlorophyll-a, pH, and sea surface temperature (SST), with chlorophyll-a demonstrating the greatest explanatory power from variables selected for model calibration. We identified specific geographic areas for potential V. cholerae distribution. Coastal Bangladesh, where cholera is endemic, was found to be environmentally similar to coastal areas in Latin America. In a conservative climate change scenario, we observed a predicted increase in areas with environmental conditions suitable for V. cholerae. Findings highlight the potential for vulnerability maps to inform cholera surveillance, early warning systems, and disease prevention and control.

  5. Cholera and household water treatment why communities do not treat water after a cholera outbreak: a case study in Limpopo Province

    OpenAIRE

    Mudau, Lutendo Sylvia; Mukhola, Murembiwa Stanley; Hunter, Paul Raymond

    2016-01-01

    Background: Cholera is one of the common diseases in developing countries caused by consumption of contaminated and untreated drinking water. A study was conducted 7 months after a cholera outbreak in Vhembe district, Limpopo, South Africa. The aim of the study was to assess if the communities were still conforming to safe water practices after an outbreak of cholera. Methodology: One hundred and fifty-two (152) participants from 11 villages were recruited to form 21 focus groups, with a mean...

  6. Priming immunization against cholera toxin and E. coli heat-labile toxin by a cholera toxin short peptide-beta-galactosidase hybrid synthesized in E. coli.

    OpenAIRE

    Jacob, C O; Leitner, M.; Zamir, A.; Salomon, D.; Arnon, R

    1985-01-01

    A synthetic oligodeoxynucleotide encoding for a small peptide was employed for the expression of this peptide in a form suitable for immunization. The encoded peptide, namely, the region 50-64 of the B subunit of cholera toxin (CTP3), had previously been identified as a relevant epitope of cholera toxin. Thus, multiple immunizations with its conjugate to a protein carrier led to an efficient neutralizing response against native cholera toxin. Immunization with the resulting fusion protein of ...

  7. Spatial and environmental connectivity analysis in a cholera vaccine trial.

    Science.gov (United States)

    Emch, Michael; Ali, Mohammad; Root, Elisabeth D; Yunus, Mohammad

    2009-02-01

    This paper develops theory and methods for vaccine trials that utilize spatial and environmental information. Satellite imagery is used to identify whether households are connected to one another via water bodies in a study area in rural Bangladesh. Then relationships between neighborhood-level cholera vaccine coverage and placebo incidence and neighborhood-level spatial variables are measured. The study hypothesis is that unvaccinated people who are environmentally connected to people who have been vaccinated will be at lower risk compared to unvaccinated people who are environmentally connected to people who have not been vaccinated. We use four datasets including: a cholera vaccine trial database, a longitudinal demographic database of the rural population from which the vaccine trial participants were selected, a household-level geographic information system (GIS) database of the same study area, and high resolution Quickbird satellite imagery. An environmental connectivity metric was constructed by integrating the satellite imagery with the vaccine and demographic databases linked with GIS. The results show that there is a relationship between neighborhood rates of cholera vaccination and placebo incidence. Thus, people are indirectly protected when more people in their environmentally connected neighborhood are vaccinated. This result is similar to our previous work that used a simpler Euclidean distance neighborhood to measure neighborhood vaccine coverage [Ali, M., Emch, M., von Seidlein, L., Yunus, M., Sack, D. A., Holmgren, J., et al. (2005). Herd immunity conferred by killed oral cholera vaccines in Bangladesh. Lancet, 366(9479), 44-49]. Our new method of measuring environmental connectivity is more precise since it takes into account the transmission mode of cholera and therefore this study validates our assertion that the oral cholera vaccine provides indirect protection in addition to direct protection.

  8. Whole-genome sequence comparisons reveal the evolution of Vibrio cholerae O1.

    Science.gov (United States)

    Kim, Eun Jin; Lee, Chan Hee; Nair, G Balakrish; Kim, Dong Wook

    2015-08-01

    The analysis of the whole-genome sequences of Vibrio cholerae strains from previous and current cholera pandemics has demonstrated that genomic changes and alterations in phage CTX (particularly in the gene encoding the B subunit of cholera toxin) were major features in the evolution of V. cholerae. Recent studies have revealed the genetic mechanisms in these bacteria by which new variants of V. cholerae are generated from type-specific strains; these mechanisms suggest that certain strains are selected by environmental or human factors over time. By understanding the mechanisms and driving forces of historical and current changes in the V. cholerae population, it would be possible to predict the direction of such changes and the evolution of new variants; this has implications for the battle against cholera.

  9. An intracellular replication niche for Vibrio cholerae in the amoeba Acanthamoeba castellanii.

    Science.gov (United States)

    Van der Henst, Charles; Scrignari, Tiziana; Maclachlan, Catherine; Blokesch, Melanie

    2016-04-01

    Vibrio cholerae is a human pathogen and the causative agent of cholera. The persistence of this bacterium in aquatic environments is a key epidemiological concern, as cholera is transmitted through contaminated water. Predatory protists, such as amoebae, are major regulators of bacterial populations in such environments. Therefore, we investigated the interaction between V. cholerae and the amoeba Acanthamoeba castellanii at the single-cell level. We observed that V. cholerae can resist intracellular killing. The non-digested bacteria were either released or, alternatively, established a replication niche within the contractile vacuole of A. castellanii. V. cholerae was maintained within this compartment even upon encystment. The pathogen ultimately returned to its aquatic habitat through lysis of A. castellanii, a process that was dependent on the production of extracellular polysaccharide by the pathogen. This study reinforces the concept that V. cholerae is a facultative intracellular bacterium and describes a new host-pathogen interaction.

  10. A cocktail of three virulent bacteriophages prevents Vibrio cholerae infection in animal models

    Science.gov (United States)

    Yen, Minmin; Cairns, Lynne S.; Camilli, Andrew

    2017-01-01

    Effective prevention strategies will be essential in reducing disease burden due to bacterial infections. Here we harness the specificity and rapid-acting properties of bacteriophages as a potential prophylaxis therapy for cholera, a severely dehydrating disease caused by Vibrio cholerae. To this end, we test a cocktail of three virulent phages in two animal models of cholera pathogenesis (infant mouse and rabbit models). Oral administration of the phages up to 24 h before V. cholerae challenge reduces colonization of the intestinal tract and prevents cholera-like diarrhea. None of the surviving V. cholerae colonies are resistant to all three phages. Genome sequencing and variant analysis of the surviving colonies indicate that resistance to the phages is largely conferred by mutations in genes required for the production of the phage receptors. For acute infections, such as cholera, phage prophylaxis could provide a strategy to limit the impact of bacterial disease on human health. PMID:28146150

  11. Inferring epidemic contact structure from phylogenetic trees.

    Directory of Open Access Journals (Sweden)

    Gabriel E Leventhal

    Full Text Available Contact structure is believed to have a large impact on epidemic spreading and consequently using networks to model such contact structure continues to gain interest in epidemiology. However, detailed knowledge of the exact contact structure underlying real epidemics is limited. Here we address the question whether the structure of the contact network leaves a detectable genetic fingerprint in the pathogen population. To this end we compare phylogenies generated by disease outbreaks in simulated populations with different types of contact networks. We find that the shape of these phylogenies strongly depends on contact structure. In particular, measures of tree imbalance allow us to quantify to what extent the contact structure underlying an epidemic deviates from a null model contact network and illustrate this in the case of random mixing. Using a phylogeny from the Swiss HIV epidemic, we show that this epidemic has a significantly more unbalanced tree than would be expected from random mixing.

  12. Epidemic centrality and the underestimated epidemic impact on network peripheral nodes

    CERN Document Server

    Sikic, Mile; Antulov-Fantulin, Nino; Stefancic, Hrvoje

    2011-01-01

    Studies of disease spreading on complex networks have provided a deep insight into the conditions of onset, dynamics and prevention of epidemics in human populations and malicious software propagation in computer networks. Identifying nodes which, when initially infected, infect the largest part of the network and ranking them according to their epidemic impact is a priority for public health policies. In simulations of the disease spreading in SIR model on studied empirical complex networks, it is shown that the ranking depends on the dynamical regime of the disease spreading. A possible mechanism leading to this dynamical dependence is illustrated in an analytically tractable example. A measure called epidemic centrality, averaging the epidemic impact over all possible disease spreading regimes, is introduced as a basis of epidemic ranking. Contrary to standard notion, the epidemic centrality of nodes with high degree, k-cores value or betweenness, which are structurally central, is comparable to epidemic c...

  13. Clinical manifestations of non-O1 Vibrio cholerae infections.

    Directory of Open Access Journals (Sweden)

    Yen-Ting Chen

    Full Text Available BACKGROUND: Infections caused by non-O1 Vibrio cholera are uncommon. The aim of our study was to investigate the clinical and microbiological characteristics of patients with non-O1 V. cholera infections. METHODS: The clinical charts of all patients with non-O1 V. cholera infections and who were treated in two hospitals in Taiwan were retrospectively reviewed. RESULTS: From July 2009 to June 2014, a total of 83 patients with non-O1 V. cholera infections were identified based on the databank of the bacteriology laboratories of two hospitals. The overall mean age was 53.3 years, and men comprised 53 (63.9% of the patients. Liver cirrhosis and diabetes mellitus were the two most common underlying diseases, followed by malignancy. The most common type of infection was acute gastroenteritis (n = 45, 54.2%, followed by biliary tract infection (n = 12, 14.5% and primary bacteremia (n = 11, 13.3%. Other types of infection, such as peritonitis (n = 5, 6.0%, skin and soft tissue infection (SSTI (n = 5, 6.0%, urinary tract infection (n = 3, 3.6% and pneumonia (2, 2.4%, were rare. July and June were the most common months of occurrence of V. cholera infections. The overall in-hospital mortality of 83 patients with V. cholera infections was 7.2%, but it was significantly higher for patients with primary bacteremia, hemorrhage bullae, acute kidney injury, acute respiratory failure, or admission to an ICU. Furthermore, multivariate analysis showed that in-hospital mortality was significantly associated with acute respiratory failure (odds ratio, 60.47; 95% CI, 4.79-763.90, P = 0.002. CONCLUSIONS: Non-O1 V. cholera infections can cause protean disease, especially in patients with risk factors and during warm-weather months. The overall mortality of 83 patients with non-O1 V. cholera infections was only 7.2%; however, this value varied among different types of infection.

  14. Cholera at the crossroads: the association between endemic cholera and national access to improved water sources and sanitation.

    Science.gov (United States)

    Nygren, Benjamin L; Blackstock, Anna J; Mintz, Eric D

    2014-11-01

    We evaluated World Health Organization (WHO) national water and sanitation coverage levels and the infant mortality rate as predictors of endemic cholera in the 5-year period following water and sanitation coverage estimates using logistic regression, receiver operator characteristic curves, and different definitions of endemicity. Each was a significant predictors of endemic cholera at P sanitation access level of 39% has 63% sensitivity and 62% specificity, and an infant mortality rate of 65/1,000 has 67% sensitivity and 69% specificity. Our findings reveal the tradeoff between sensitivity and specificity for these predictors of endemic cholera and highlight the substantial uncertainty in the data. More accurate global surveillance data will enable more precise characterization of the benefits of improved water and sanitation.

  15. Cooperative epidemics on multiplex networks

    CERN Document Server

    Azimi-Tafreshi, N

    2015-01-01

    The spread of one disease, in some cases, can stimulate the spreading of another infectious disease. Here, we treat analytically a symmetric co-infection model for spreading of two diseases on a 2-layer multiplex network. We allow layer overlapping, but we assume that each layer is random and locally loop-less. Infection with one of the diseases increases the probability to get infected by the other. Using generating function method, we calculate exactly the fraction of individuals infected with both diseases (so-called co-infected clusters) in the stationary state, as well as the epidemic spreading thresholds and the phase diagram of the model. With increasing cooperation, we observe a tricritical point and the type of transition changes from continuous to hybrid. Finally we compare the co-infected clusters in the case of co-operating diseases with the so-called viable clusters in networks with dependencies.

  16. Familial epidemic of meningococcal disease.

    Science.gov (United States)

    Smilović, V; Vrbanec-Megla, L; Payerl-Pal, M; Puntarić, D; Baklaić, Z

    1998-03-01

    Two closely related boys from the same house hold (Home 1), aged two and three, were affected with fulminant meningococcal sepsis known as Waterhouse-Friderichsen syndrome. Neisseria meningitidis serogorup B was isolated from their blood and cerebrospinal fluid. The two-year-old boy died one day after the onset of the disease. Epidemiological examination of contacts and pharyngeal swabs were performed in 14 persons from the household, all of them relatives of the affected children, as well as in a number of other contacts. Chemoprophylaxis with cotrimoxazole was simultaneously administered to all contacts. Family histories revealed that two contacts from the household where the patients did not live (Home 2) were inadvertently omitted. Subsequent examinations, following a report of another contagious disease (salmonelosis), revealed that these two persons were Neisseria meningitidis carriers, together with another one in the same household. The carriers most probably caused the infection of a third, five-year-old boy, the deceased boy's brother (Home 1) who also developed fulminant meningococcal sepsis. The failure to take the appropriate prophylaxis led to a prolonged carrier state in the carrier from the second household. Repeated pharyngeal swab sampling revealed two more carriers from both households that had previously been negative. Control of the epidemic was achieved after 5 weeks by repeated and controlled chemoprophylaxis with ciprofloxacin, and by repeated epidemiological examinations, disinfection, and daily health surveillance by the Sanitary Inspectorate. This extremely rare instance of a familial epidemic with three infected persons emphasizes the need for consistent chemoprophylaxis in meningococcal disease contacts.

  17. Heterogeneous edge weights promote epidemic diffusion in weighted evolving networks

    Science.gov (United States)

    Duan, Wei; Song, Zhichao; Qiu, Xiaogang

    2016-08-01

    The impact that the heterogeneities of links’ weights have on epidemic diffusion in weighted networks has received much attention. Investigating how heterogeneous edge weights affect epidemic spread is helpful for disease control. In this paper, we study a Reed-Frost epidemic model in weighted evolving networks. Our results indicate that a higher heterogeneity of edge weights leads to higher epidemic prevalence and epidemic incidence at earlier stage of epidemic diffusion in weighted evolving networks. In addition, weighted evolving scale-free networks come with a higher epidemic prevalence and epidemic incidence than unweighted scale-free networks.

  18. Cultural War of Values

    DEFF Research Database (Denmark)

    Hervik, Peter

    2014-01-01

    Cultural War of Values: The Proliferation of Moral Identities In the Danish Public Sphere Peter Hervik (Aalborg University) This chapter looks at the drastic shift in the construction of minority others that came with the emergence of neo-nationalism, neo-racism and radical right populism...... in the post-1989 world. Through an analysis of a political philosophy launched in Denmark in the 1990s called the “Cultural War of Values”, I show that the moral identities proliferating in the Danish public sphere are fundamentally anti-political correct, anti-multiculturalist, and anti......-Marxist as confrontation is also directed at political adversaries. Thus, the chapter’s key argument is that the social construction of thick minority identities can only be understood in relation to the cultural war of value strategy aimed at domestic political opponents....

  19. Malaria's contribution to World War One - the unexpected adversary.

    Science.gov (United States)

    Brabin, Bernard J

    2014-12-16

    Malaria in the First World War was an unexpected adversary. In 1914, the scientific community had access to new knowledge on transmission of malaria parasites and their control, but the military were unprepared, and underestimated the nature, magnitude and dispersion of this enemy. In summarizing available information for allied and axis military forces, this review contextualizes the challenge posed by malaria, because although data exist across historical, medical and military documents, descriptions are fragmented, often addressing context specific issues. Military malaria surveillance statistics have, therefore, been summarized for all theatres of the War, where available. These indicated that at least 1.5 million solders were infected, with case fatality ranging from 0.2 -5.0%. As more countries became engaged in the War, the problem grew in size, leading to major epidemics in Macedonia, Palestine, Mesopotamia and Italy. Trans-continental passages of parasites and human reservoirs of infection created ideal circumstances for parasite evolution. Details of these epidemics are reviewed, including major epidemics in England and Italy, which developed following home troop evacuations, and disruption of malaria control activities in Italy. Elsewhere, in sub-Saharan Africa many casualties resulted from high malaria exposure combined with minimal control efforts for soldiers considered semi-immune. Prevention activities eventually started but were initially poorly organized and dependent on local enthusiasm and initiative. Nets had to be designed for field use and were fundamental for personal protection. Multiple prevention approaches adopted in different settings and their relative utility are described. Clinical treatment primarily depended on quinine, although efficacy was poor as relapsing Plasmodium vivax and recrudescent Plasmodium falciparum infections were not distinguished and managed appropriately. Reasons for this are discussed and the clinical trial data

  20. Injecting epidemiology into population viability analysis: avian cholera transmission dynamics at an arctic seabird colony.

    Science.gov (United States)

    Iverson, Samuel A; Gilchrist, H Grant; Soos, Catherine; Buttler, Isabel I; Harms, N Jane; Forbes, Mark R

    2016-11-01

    Infectious diseases have the potential to spread rapidly and cause high mortality within populations of immunologically naïve hosts. The recent appearance of avian cholera, a highly virulent disease of birds caused by the bacterium Pasteurella multocida, at remote Arctic seabird colonies is an emerging conservation concern. Determining disease risk to population viability requires a quantitative understanding of transmission potential and the factors that regulate epidemic persistence. Estimates of the basic (R0 ) and real-time (Rt ) reproductive number are critical in this regard - enumerating the number of secondary infections caused by each primary infection in a newly invaded host population and the decline in transmission rate as susceptible individuals are removed via mortality or immunized recovery. Here, we use data collected at a closely monitored common eider (Somateria mollissima) breeding colony located in the Canadian Arctic to examine transmission and host population dynamics. Specifically, we infer epidemic curves from daily mortality observations and use a likelihood-based procedure to estimate changes in the reproductive number over a series of annual outbreaks. These data are interpreted in relation to concurrent changes in host numbers to assess local extinction risk. Consistent with expectations for a novel pathogen invasion, case incidence increased exponentially during the initial wave of exposure (R0  = 2·5; generation time = 6·5 days ± 1·1 SD). Disease conditions gradually abated, but only after several years of smouldering infection (Rt  ≈ 1). In total, 6194 eider deaths were recorded during outbreaks spanning eight consecutive breeding seasons. Breeding pair abundance