Recent Cholera Publications on PubMed

Addressing the shortage of cholera vaccines

November 26, 2022

Lancet Infect Dis. 2022 Dec;22(12):1674-1675. doi: 10.1016/S1473-3099(22)00752-6.


PMID:36435186 | DOI:10.1016/S1473-3099(22)00752-6

Dengue surge in Pakistan amidst the torrential rains: the threat of a potential outbreak

November 24, 2022

J Med Virol. 2022 Nov 24. doi: 10.1002/jmv.28346. Online ahead of print.


With 390 million infections occurring globally and the infection putting half of the world's population at risk, dengue is an illness with potential, life-threatening manifestations such as plasma leakage and fluid retention, severe bleeding, and organ impairment. This disease is already lurking in the various regions of Pakistan, which was recently ravaged by decades' worst flood. With mosquitoes being its eminent transmission source, it is coherent that a country with massive flooding, accumulation of stagnant water, and lack of adequate drainage systems can lead to a dengue outbreak. Pakistan, a low-middle-income country, is still recuperating from the aftershocks of the pandemic, a recent cholera outbreak, and the massive economic destruction they caused, especially in the healthcare sector. Concerningly, the World Health Organization (WHO) has already issued a "second catastrophe" warning for Pakistan in the aftermath of the fatal floods which have caused the destruction of hundreds of health facilities while physicians and medical workers on the ground scramble to combat outbreaks of waterborne and other illnesses. If the spread of dengue isn't contained immediately, it will destroy the healthcare systems across the country and result in massive fatalities. To avoid tragic consequences, the government and concerned authorities must devise plans to launch public health programs aimed at boosting knowledge of the disease, its symptoms, transmission, prevention, and control. In this commentary, we discuss the current spike of dengue virus, epidemiology, transmission patterns, and preventative efforts in the aftermath of Pakistan's disastrous floods. This article is protected by copyright. All rights reserved.

PMID:36424668 | DOI:10.1002/jmv.28346

Haiti's cholera treatment centres are overwhelmed as cases surge

November 23, 2022

BMJ. 2022 Nov 23;379:o2831. doi: 10.1136/bmj.o2831.


PMID:36418029 | DOI:10.1136/bmj.o2831

Clinical and Epidemiologic Characteristics and Therapeutic Management of Patients with Vibrio Infections, Bay of Biscay, France, 2001-2019

November 23, 2022

Emerg Infect Dis. 2022 Dec;28(12). doi: 10.3201/eid2812.220748.


Noncholera vibriosis is a rare, opportunistic bacterial infection caused by Vibrio spp. other than V. cholerae O1/O139 and diagnosed mainly during the hot summer months in patients after seaside activities. Detailed knowledge of circulating pathogenic strains and heterogeneities in infection outcomes and disease dynamics may help in patient management. We conducted a multicenter case-series study documenting Vibrio infections in 67 patients from 8 hospitals in the Bay of Biscay, France, over a 19-year period. Infections were mainly caused by V. alginolyticus (34%), V. parahaemolyticus (30%), non-O1/O139 V. cholerae (15%), and V. vulnificus (10%). Drug-susceptibility testing revealed intermediate and resistant strains to penicillins and first-generation cephalosporins. The acute infections (e.g., those involving digestive disorder, cellulitis, osteitis, pneumonia, and endocarditis) led to a life-threatening event (septic shock), amputation, or death in 36% of patients. Physicians may need to add vibriosis to their list of infections to assess in patients with associated risk factors.

PMID:36418019 | DOI:10.3201/eid2812.220748

Emergence and Evolutionary Response of Vibrio cholerae to Novel Bacteriophage, Democratic Republic of the Congo<sup>1</sup>

November 23, 2022

Emerg Infect Dis. 2022 Dec;28(12):2482-2490. doi: 10.3201/eid2812.220572.


Cholera causes substantial illness and death in Africa. We analyzed 24 toxigenic Vibrio cholerae O1 strains isolated in 2015-2017 from patients in the Great Lakes region of the Democratic Republic of the Congo. Strains originating in southern Asia appeared to be part of the T10 introduction event in eastern Africa. We identified 2 main strain lineages, most recently a lineage corresponding to sequence type 515, a V. cholerae cluster previously reported in the Lake Kivu region. In 41% of fecal samples from cholera patients, we also identified a novel ICP1 (Bangladesh cholera phage 1) bacteriophage, genetically distinct from ICP1 isolates previously detected in Asia. Bacteriophage resistance occurred in distinct clades along both internal and external branches of the cholera phylogeny. This bacteriophage appears to have served as a major driver for cholera evolution and spread, and its appearance highlights the complex evolutionary dynamic that occurs between predatory phage and bacterial host.

PMID:36417939 | DOI:10.3201/eid2812.220572

Association between Conflict and Cholera in Nigeria and the Democratic Republic of the Congo

November 23, 2022

Emerg Infect Dis. 2022 Dec;28(12):2472-2481. doi: 10.3201/eid2812.212398.


Cholera outbreaks contribute substantially to illness and death in low- and middle-income countries. Cholera outbreaks are associated with several social and environmental risk factors, and extreme conditions can act as catalysts. A social extreme known to be associated with infectious disease outbreaks is conflict, causing disruption to services, loss of income, and displacement. To determine the extent of this association, we used the self-controlled case-series method and found that conflict increased the risk for cholera in Nigeria by 3.6 times and in the Democratic Republic of the Congo by 2.6 times. We also found that 19.7% of cholera outbreaks in Nigeria and 12.3% of outbreaks in the Democratic Republic of the Congo were attributable to conflict. Our results highlight the value of providing rapid and sufficient assistance during conflict-associated cholera outbreaks and working toward conflict resolution and addressing preexisting vulnerabilities, such as poverty and access to healthcare.

PMID:36417932 | DOI:10.3201/eid2812.212398

Temporal-Spatial Distribution of Vibrio cholerae in Cuba: July 1997-December 2019

November 23, 2022

MEDICC Rev. 2022 Oct 31;24(3-4):24-29. doi: 10.37757/MR2022.V24.N3-4.4.


INTRODUCTION: Vibrio cholerae is a microorganism that causes acute diarrheal diseases and cholera, one of the leading causes of global morbidity and mortality, especially in children under five years old. It is present in many regions and has been isolated from diverse sources such as water, soil and food. Surveillance of this microorganism in Cuba from 1985 through June 1997 showed circulation of non-epidemic non-O1/non-O139 serogroups, but surveillance continued to identify distribution of V. cholerae serotypes and serogroups in the different geographic regions of the country during the following years, due to the risk of introducing cholera-causing serogroups that provoked cholera epidemics in other countries of the region.

OBJECTIVE: Describe the temporal‒spatial distribution of serogroups and serotypes of V. cholerae in Cuba.

METHODS: A cross-sectional study was conducted that included isolates from passive surveillance of V. cholerae in 16 hygiene and epidemiology centers throughout Cuba from July 1997 through December 2019, submitted to the National Reference Laboratory for Acute Diarrheal Diseases of the Pedro Kourí Tropical Medicine Institute in Havana, Cuba. The timeline was subdivided into three five-year periods and one eight-year period. The centers submitting isolates were grouped into three geographical regions: western, central and eastern Cuba. A total of 1060 V. cholerae isolates were studied, from the 1438 samples sent from 15 Provincial Hygiene, Epidemiology and Microbiology Centers and the Municipal Hygiene, Epidemiology and Microbiology Center of the Isle of Youth Special Municipality. Genus, species and serotype of all specimens were studied and reviewed in the context of the outbreaks of acute diarrheal diseases reported in the country.

RESULTS: All 1060 isolates were confirmed as V. cholerae. In the distribution by time period and region, the highest percentage occurred in the 2012‒2019 period, and the eastern region contributed the most isolates in all periods. Approximately 63.9% (677/1060) were from outbreaks, and in the 2012‒2019 period, the most epidemic-causing isolates came from the western region. Approximately 52.8% (560/1060) were identified as non-O1/non-O139 V. cholerae, and 47.2% (500/1060) as O1 V. cholerae; of these, 96.4% (482/500) corresponded to Ogawa serotype and 3.6% (18/500) to Inaba. Circulation of non-O1/non-O139 V. cholerae occurred throughout the entire period. The O1 serogroup began to circulate in 2012 and continued through 2016; however, since 2017, it has not been identified again. In the western region, there were smaller percentages of isolates of non-O1/non-O139 V. cholerae in all periods, except 2012‒2019. In that period, V. cholerae O1 was identified to a lesser degree in the central region.

CONCLUSIONS: Vibrio cholerae circulated in all three Cuban regions during the years studied, with a higher percentage of isolates of the non-O1/non-O139 serogroup, which caused outbreaks or sporadic cases of diarrhea in the eastern region, with the exception of the 2012‒2019 period, when epidemic outbreaks of the O1 serogroup (which causes cholera) occurred in all three regions, with higher percentages in the western region.

PMID:36417331 | DOI:10.37757/MR2022.V24.N3-4.4

Yellow Fever: A Perennial Threat

November 21, 2022

Arch Med Res. 2022 Nov;53(7):649-657. doi: 10.1016/j.arcmed.2022.10.005. Epub 2022 Oct 28.


Despite the availability of a safe and effective vaccine, yellow fever remains a major vaccine-preventable disease in endemic regions. Additionally, travelers risk acquiring yellow fever when visiting areas of endemic transmission or locations with ongoing outbreaks. Yellow fever is a viral hemorrhagic fever that has inflicted stigma, illness, and death among human societies. From the 17th to the 19th centuries, yellow fever remained a mysterious illness that predominantly affected tropical regions in Africa, the Caribbean and the Americas. The disease was as feared as cholera or smallpox, and played a significant geopolitical role in shaping modern societies. Epidemics of yellow fever brought out the best and the worst of human nature: the disease spread to new regions during the Atlantic slave trade; while the identification of its causative viral agent and mode of transmission, as well as the development of a vaccine, were made possible by the sacrifice of selfless scientists. Confirmation of the vector transmission of YF paved the way for the development of an effective vaccine in the first half of the 20th century. Encroachment of human settlements into locations with sylvatic transmission has blurred the distinction between the urban and sylvatic cycles. Introduction or expansion of routine immunization activities and reaching hard-to-reach populations consitute public health priorities toward ensuring vaccine equity in endemic areas. It is also critical to ensure the timely immunization of at-risk populations during outbreaks and to promote vaccination of international travelers. We conclude that the threat of YF will linger far into the 21st century as a leading public health emergency of global concern under the International Health Regulations.

PMID:36404585 | DOI:10.1016/j.arcmed.2022.10.005

Conditions to eliminate cholera in Mozambique - the pathway for the development of the national cholera plan

November 21, 2022

Pan Afr Med J. 2022 Aug 15;42:279. doi: 10.11604/pamj.2022.42.279.36368. eCollection 2022.


Cholera disproportionately affects the most vulnerable segments of the population, particularly those who have low or no access to basic water, sanitation, and hygiene (WASH). Despite some improvements in WASH conditions, cholera still represents a persistent challenge in Mozambique, where outbreaks occur almost every year, with high case fatality rates, posing a threat to the country's economic development. The Government of Mozambique has started developing a revised National Cholera Plan (NCP), which aligns with "ending cholera-a global roadmap to 2030" launched by the Global Task Force on Cholera Control (GTFCC) in 2017. Ending cholera represents a critical step towards achieving the sustainable development goals and requires effective prevention and control interventions, ensuring that no one is left behind. The NCP must use a multi-sector approach and broad stakeholder collaboration with well-coordinated roles and functions of different partners to address major areas for cholera elimination - water and sanitation, health care services and management, epidemiology and surveillance, and health and hygiene promotion. Every cholera death is preventable. In this review, we reiterate the need for effective coordinated actions to control and eliminate cholera in Mozambique and decrease the cholera burden, enabling a healthy population over the generations.

PMID:36405663 | PMC:PMC9636724 | DOI:10.11604/pamj.2022.42.279.36368

Remembering India's pioneer in life-saving cholera treatment

November 15, 2022

Nature. 2022 Nov;611(7936):449. doi: 10.1038/d41586-022-03678-5.


PMID:36380040 | DOI:10.1038/d41586-022-03678-5

Metagenomic analysis of diarrheal stools in Kolkata, India, indicates the possibility of subclinical infection of Vibrio cholerae O1

November 14, 2022

Sci Rep. 2022 Nov 14;12(1):19473. doi: 10.1038/s41598-022-24167-9.


We examined the stools of 23 patients in Kolkata, who were diagnosed as cholera patients because Vibrio cholerae O1 was detected from their stools by culturing methods, and further explored by metagenomic sequencing analysis. Subsequently, the presence of the gene encoding A subunit of cholera toxin (ctxA) and the cholera toxin (CT) level in these stool samples were examined. ctxA was examined by both metagenomic sequencing analysis and polymerase chain reaction. In these examinations, two samples did not show positive in any of these tests. The metagenomic analysis showed that the genes for Streptococcus pneumoniae and Salmonella enterica were present in the stools of these two patients, respectively. Therefore, these two patients were not considered to have diarrhea due to V. cholerae infection. From these results, we predicted that some Kolkata residents harbor a small number of V. cholerae in their intestines as a form of subclinical infection with V. cholerae. Next, we analyzed the stool samples of 22 diarrhea patients from which V. cholerae was not isolated. The results showed that 3 of the patients seemed to have subclinical infection of V. cholerae based on the amount of the genes. These results indicated that subclinical infections with V. cholerae O1 occur in Kolkata.

PMID:36376441 | DOI:10.1038/s41598-022-24167-9

Effectiveness of two doses of Euvichol-plus oral cholera vaccine in response to the 2017/2018 outbreak: a matched case-control study in Lusaka, Zambia

November 11, 2022

BMJ Open. 2022 Nov 11;12(11):e066945. doi: 10.1136/bmjopen-2022-066945.


INTRODUCTION: Zambia experienced a major cholera outbreak in 2017-2018, with more than 5905 cases reported countrywide, predominantly from the peri-urban slums of Lusaka city. The WHO recommends the use of oral cholera vaccines (OCVs) together with traditional control measures, including health promotion, provision of safe water and improving sanitation, in cholera endemic areas and during cholera outbreaks. In response to this outbreak, the Zambian government implemented the OVC campaign and administered the Euvichol-plus vaccine in the high-risk subdistricts of Lusaka. Although OCVs have been shown to be effective in preventing cholera infection in cholera endemic and outbreak settings, the effectiveness of the Euvichol-plus vaccine has not yet been evaluated in Zambia. This study aimed to determine the effectiveness of two doses of OCV administered during the 2017/2018 vaccination campaign.

METHODS: We conducted a matched case-control study involving 79 cases and 316 controls following the mass vaccination campaign in the four subdistricts of Lusaka (Chawama, Chipata, Kanyama and Matero). Matching of controls was based on the place of residence, age and sex. Conditional logistic regression was used for analysis. Adjusted OR (AOR), 95% CI and vaccine effectiveness (1-AOR) for two doses of Euvichol-plus vaccine and any dose were estimated (p<0.05).

RESULTS: The AOR vaccine effectiveness for two doses of Euvichol-plus OCV was 81.0% (95% CI 66.0% to 78.0%; p<0.01). Secondary analysis showed that vaccine effectiveness for any dose was 74.0% (95% CI 50.0% to 86.0%; p<0.01).

CONCLUSION: These findings show that two doses of Euvichol-plus OCV are effective in a cholera outbreak setting in Lusaka, Zambia. The findings also indicate that two doses are more effective than a single dose and thus support the use of two doses of the vaccine as part of an integrated intervention to cholera control during outbreaks.

PMID:36368745 | DOI:10.1136/bmjopen-2022-066945

MGTdb: a web service and database for studying the global and local genomic epidemiology of bacterial pathogens

November 11, 2022

Database (Oxford). 2022 Nov 11;2022:baac094. doi: 10.1093/database/baac094.


Multilevel genome typing (MGT) enables the genomic characterization of bacterial isolates and the relationships among them. The MGT system describes an isolate using multiple multilocus sequence typing (MLST) schemes, referred to as levels. Thus, for a new isolate, sequence types (STs) assigned at multiple precisely defined levels can be used to type isolates at multiple resolutions. The MGT designation for isolates is stable, and the assignment is faster than the existing approaches. MGT's utility has been demonstrated in multiple species. This paper presents a publicly accessible web service called MGTdb, which enables the assignment of MGT STs to isolates, along with their storage, retrieval and analysis. The MGTdb web service enables upload of genome data as sequence reads or alleles, which are processed and assigned MGT identifiers. Additionally, any newly sequenced isolates deposited in the National Center for Biotechnology Information's Sequence Read Archive are also regularly retrieved (currently daily), processed, assigned MGT identifiers and made publicly available in MGTdb. Interactive visualization tools are presented to assist analysis, along with capabilities to download publicly available isolates and assignments for use with external software. MGTdb is currently available for Salmonella enterica serovars Typhimurium and Enteritidis and Vibrio cholerae. We demonstrate the usability of MGTdb through three case studies - to study the long-term national surveillance of S. Typhimurium, the local epidemiology and outbreaks of S. Typhimurium, and the global epidemiology of V. cholerae. Thus, MGTdb enables epidemiological and microbiological investigations at multiple levels of resolution for all publicly available isolates of these pathogens. Database URL:

PMID:36367311 | DOI:10.1093/database/baac094

Analysis of the Number and Type of Vaccinations Performed among Polish Soldiers in 2018-2021

November 11, 2022

Int J Environ Res Public Health. 2022 Oct 22;19(21):13724. doi: 10.3390/ijerph192113724.


Vaccination is a very common topic, but it is rarely raised or discussed with respect to military members. Soldiers are one of the main professional groups to be immunized on a regular basis. The military actively participates in research on new vaccine preparations. This paper presents data from 2018-2021 on vaccination among Polish soldiers. The material obtained from the Central Register of Vaccination for Professional Soldiers was analyzed using descriptive statistical methods. The number of injections performed in a given period depends on the location of the ongoing missions and the vaccination schedule specific to a given Polish Military Contingent. In Poland, soldiers undergo preventive vaccinations in accordance with the scheme developed by the Armed Forces Operational Command, taking into account the specific nature of the service, epidemiological risks and the calendar of current preventive vaccinations. Soldiers serving abroad are immunized against typhoid, hepatitis A, hepatitis B, rabies, measles, tick-borne encephalitis, Japanese encephalitis, polio, diphtheria, meningococcal disease, chickenpox, cholera and yellow fever. Regular vaccinations for soldiers are necessary to minimize the spread of infectious diseases, and they have a beneficial effect upon the effectiveness of military operations.

PMID:36360604 | DOI:10.3390/ijerph192113724

Formative Research for the Development of the CHoBI7 Cholera Rapid Response Program for Cholera Hotspots in Bangladesh

October 27, 2022

Int J Environ Res Public Health. 2022 Oct 16;19(20):13352. doi: 10.3390/ijerph192013352.


Cholera is a severe form of acute watery diarrhea that if left untreated can result in death. Globally, there are 2.9 million cholera cases annually. Individuals living in close proximity to cholera cases are at a higher risk for developing cholera compared to the general population. Targeted water, sanitation, and hygiene (WASH) interventions have the potential to reduce cholera transmission in cholera hotspots around cholera cases. The objective of this study was to expand the scope of the Cholera-Hospital-Based-Intervention-for-7-Days (CHoBI7) program, focused on cholera patient households, for delivery in cholera hotspots in urban slums in Dhaka, Bangladesh. Thirty-one semi-structured interviews were conducted in cholera hotspots around cholera patients, and three intervention planning workshops were conducted to inform modifications needed to the CHoBI7 program. After exploratory interviews, a two-phase, iterative pilot study was conducted for 9 months to test the developed CHoBI7 Cholera Rapid Response program among 180 participants to further inform modifications to intervention content and delivery. Findings from pilot participant interviews highlighted the need to adapt intervention content for delivery at the compound-rather than household-level, given an environment with multiple households sharing a water source, toilets, and kitchen facilities. This was addressed by conducting a "ring session" for intervention delivery in cholera hotspots for households to discuss how to improve their shared facilities together and encourage a compound-level commitment to promoted WASH behaviors and placement of soapy water bottles in shared spaces. Based on the low number of soapy water bottles observed in communal spaces during the first iteration of the pilot, we also added context-specific examples using the narratives of families in mobile messages to encourage WASH behavioral recommendations. Formative research identified important considerations for the modifications needed to tailor the CHoBI7 program for delivery in cholera hotspots in urban Bangladesh.

PMID:36293930 | DOI:10.3390/ijerph192013352

Basement-Membrane-Related Gene Signature Predicts Prognosis in WHO Grade II/III Gliomas

October 27, 2022

Genes (Basel). 2022 Oct 7;13(10):1810. doi: 10.3390/genes13101810.


Gliomas that are classified as grade II or grade III lesions by the World Health Organization (WHO) are highly aggressive, and some may develop into glioblastomas within a short period, thus portending the conferral of a poor prognosis for patients. Previous studies have implicated basement membrane (BM)-related genes in glioma development. In this study, we constructed a prognostic model for WHO grade II/III gliomas in accordance with the risk scores of BM-related genes. Differentially expressed genes (DEGs) in the glioma samples relative to normal samples were screened from the GEO database, and five prognostically relevant BM-related genes, including NELL2, UNC5A, TNC, CSPG4, and SMOC1, were selected using Cox regression analyses for the risk score model. The median risk score was calculated, based on which high- and low-risk groups of patients were generated. The clinical information, pathological information, and risk group were combined to establish a prognostic nomogram. Both the nomogram and risk score model performed well in the independent CGGA cohort. Gene set enrichment analysis (GSEA) and immune profile, drug sensitivity, and tumor mutation burden (TMB) analyses were performed in the two risk groups. A significant enrichment of 'Autophagy-other', 'Collecting duct acid secretion', 'Glycosphingolipid biosynthesis-lacto and neolacto series', 'Valine, leucine, and isoleucine degradation', 'Vibrio cholerae infection', and other pathways were observed for patients with high risk. In addition, higher proportions of monocytes and resting CD4 memory T cells were observed in the low- and high-risk groups, respectively. In conclusion, the BM-related gene risk score model can guide the clinical management of WHO grade II and III gliomas.

PMID:36292695 | DOI:10.3390/genes13101810

Detection of Tropical Diseases Caused by Mosquitoes Using CRISPR-Based Biosensors

October 26, 2022

Trop Med Infect Dis. 2022 Oct 17;7(10):309. doi: 10.3390/tropicalmed7100309.


Tropical diseases (TDs) are among the leading cause of mortality and fatality globally. The emergence and reemergence of TDs continue to challenge healthcare system. Several tropical diseases such as yellow fever, tuberculosis, cholera, Ebola, HIV, rotavirus, dengue, and malaria outbreaks have led to endemics and epidemics around the world, resulting in millions of deaths. The increase in climate change, migration and urbanization, overcrowding, and other factors continue to increase the spread of TDs. More cases of TDs are recorded as a result of substandard health care systems and lack of access to clean water and food. Early diagnosis of these diseases is crucial for treatment and control. Despite the advancement and development of numerous diagnosis assays, the healthcare system is still hindered by many challenges which include low sensitivity, specificity, the need of trained pathologists, the use of chemicals and a lack of point of care (POC) diagnostic. In order to address these issues, scientists have adopted the use of CRISPR/Cas systems which are gene editing technologies that mimic bacterial immune pathways. Recent advances in CRISPR-based biotechnology have significantly expanded the development of biomolecular sensors for diagnosing diseases and understanding cellular signaling pathways. The CRISPR/Cas strategy plays an excellent role in the field of biosensors. The latest developments are evolving with the specific use of CRISPR, which aims for a fast and accurate sensor system. Thus, the aim of this review is to provide concise knowledge on TDs associated with mosquitoes in terms of pathology and epidemiology as well as background knowledge on CRISPR in prokaryotes and eukaryotes. Moreover, the study overviews the application of the CRISPR/Cas system for detection of TDs associated with mosquitoes.

PMID:36288050 | DOI:10.3390/tropicalmed7100309

Identifying Recent Cholera Infections Using a Multiplex Bead Serological Assay

October 26, 2022

mBio. 2022 Oct 26:e0190022. doi: 10.1128/mbio.01900-22. Online ahead of print.


Estimates of incidence based on medically attended cholera can be severely biased. Vibrio cholerae O1 leaves a lasting antibody signal and recent advances showed that these can be used to estimate infection incidence rates from cross-sectional serologic data. Current laboratory methods are resource intensive and challenging to standardize across laboratories. A multiplex bead assay (MBA) could efficiently expand the breadth of measured antibody responses and improve seroincidence accuracy. We tested 305 serum samples from confirmed cholera cases (4 to 1083 d postinfection) and uninfected contacts in Bangladesh using an MBA (IgG/IgA/IgM for 7 Vibrio cholerae O1-specific antigens) as well as traditional vibriocidal and enzyme-linked immunosorbent assays (2 antigens, IgG, and IgA). While postinfection vibriocidal responses were larger than other markers, several MBA-measured antibodies demonstrated robust responses with similar half-lives. Random forest models combining all MBA antibody measures allowed for accurate identification of recent cholera infections (e.g., past 200 days) including a cross-validated area under the curve (cvAUC200) of 92%, with simpler 3 IgG antibody models having similar accuracy. Across infection windows between 45 and 300 days, the accuracy of models trained on MBA measurements was non-inferior to models based on traditional assays. Our results illustrated a scalable cholera serosurveillance tool that can be incorporated into multipathogen serosurveillance platforms. IMPORTANCE Reliable estimates of cholera incidence are challenged by poor clinical surveillance and health-seeking behavior biases. We showed that cross-sectional serologic profiles measured with a high-throughput multiplex bead assay can lead to accurate identification of those infected with pandemic Vibrio cholerae O1, thus allowing for estimates of seroincidence. This provides a new avenue for understanding the epidemiology of cholera, identifying priority areas for cholera prevention/control investments, and tracking progress in the global fight against this ancient disease.

PMID:36286520 | DOI:10.1128/mbio.01900-22

Genomic Epidemiology of Vibrio cholerae O139, Zhejiang Province, China, 1994-2018

October 26, 2022

Emerg Infect Dis. 2022 Nov;28(11):2253-2260. doi: 10.3201/eid2811.212066.


Cholera caused by Vibrio cholerae O139 was first reported in Bangladesh and India in 1992. To determine the genomic epidemiology and origins of O139 in China, we sequenced 104 O139 isolates collected from Zhejiang Province, China, during 1994-2018 and compared them with 57 O139 genomes from other countries in Asia. Most Zhejiang isolates fell into 3 clusters (C1-C3), which probably originated in India (C1) and Thailand (C2 and C3) during the early 1990s. Different clusters harbored different antimicrobial resistance genes and IncA/C plasmids. The integrative and conjugative elements carried by Zhejiang isolates were of a new type, differing from ICEVchInd4 and SXTMO10 by single-nucleotide polymorphisms and presence of genes. Quinolone resistance-conferring mutations S85L in parC and S83I in gyrA occurred in 71.2% of the Zhejiang isolates. The ctxB copy number differed among the 3 clusters. Our findings provided new insights for prevention and control of O139 cholera .

PMID:36285907 | DOI:10.3201/eid2811.212066

Cholera outbreak in Funpur, Winland

October 26, 2022

Pan Afr Med J. 2021 Dec 16;40(Suppl 2):4. doi: 10.11604/pamj.supp.2021.40.2.30989. eCollection 2021.


Vibrio Cholerae is a category B agent which has moderate to high potential to be used in bioterrorist events. This fictitious case study is based on man-made outbreak investigation and response carried out by disease surveillance and response unit of country Winland. The numbers of acute watery diarrhoea cases (AWDs) were concentrated in city Funpur of country Winland which share international border with Robiland, another country with poor health infrastructure. Regular movement of nomadic population between two countries has additional risk of international spread. This case study is designed for the training of public health students and workers on steps of outbreak investigation, packaging of biological samples, understanding IHR reporting algorithm, understanding difference between biosafety and biosecurity, different categories of bioterrorism organisms and PPE & its zones. This case study can be used as supporting training tool for application of learned concepts to a real situation and can be carried out in 2-3 hours.

PMID:36285255 | PMC:PMC9532274 | DOI:10.11604/pamj.supp.2021.40.2.30989