epidemiology of vibrio cholerae

Technical support for surveillance, case management including infection, prevention and control (IPC), data management and social mobilization. Later in 2016, a small wave of the disease was experienced in the central region of Ghana accounting for 596 cases [5]. This implies that the inter serotype polymorphism in virulence markers may affect the efficacy of vaccines with limited strain composition in specific geographical areas. Serologic evidence of recent infection. Archived clinical isolates obtained from the 2012, 2014 and 2015 cholera outbreaks in Ghana were revived by culture and subjected to microscopy, biochemical identification, serotyping, antibiotic susceptibility testing, molecular detection of distinct virulence factors and Multi-Locus Variable-Number of Tandem-Repeat Analysis (MLVA). In addition to Sindh province, three districts in Balochistan have reported 31 confirmed cases and nine deaths while two districts in Punjab have reported 25 confirmed cases. Sunlight-induced propagation of the lysogenic phage encoding cholera toxin. FOIA The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Of the 277 bacteria revived, 168 (61%) were both phenotypically and genotypically characterised as V. cholerae and the remaining 109 (39%) isolates were identified as: Aeromonas sobria: 14 (12.8%), Vibrio parahaemolyticus: 2 (1.8%), Pseudomonas aeruginosa: 7 (6.4%), Enterobacter cloacae: 16 (14.8%), Enterococci faecalis: 31 (28.4%), Escherichia coli: 26 (23.9%), Klebsiella pneumonia: 6 (5.5%) and Proteus mirabilis: 7 (6.4%). However, with ongoing transmission in close proximity to border areas and transportation hubs, the risk of international spread cannot be ruled out. It usually takes 2-3 days for symptoms to appear after a person ingests cholera bacteria, but the time can range from a few hours to 5 days. These are difficult to achieve in developing countries including Ghana, where annual cycles of cholera outbreaks continue to occur. Vibrio cholerae is a species of Gram-negative, facultative anaerobe and comma-shaped bacteria. government site. A high rate of V. cholerae resistant to first- and second-line antibiotics occurs. What is the risk for cholera in the United States? 5 more], Since the first reported outbreak in 1970, Ghana has experienced many epidemics [2, 3]. Of the 168: 151 (89.8%), 3 (1.8%) and 14 (8.3%) were of the Ogawa, Inaba and non-O1/non-O139 serotypes respectively. Approximately 1 in 10 people who get sick with cholera will develop severe symptoms such as watery diarrhea, vomiting, and leg cramps. Cholera infection is often mild or without symptoms, but can sometimes be severe and life-threatening. PMC Vibrio cholerae, with strains that cause cholera, is a motile, Gram-negative curved rod belonging to the family Vibrionaceae. Choleragenic V. cholera O1 and O139 are the only causative agents of the disease. Genetic organization of the TCP pathogenicity island of V. cholerae . fluids might be necessary. Advocacy and coordination through multiple high-level meetings. sharing sensitive information, make sure youre on a federal Nevertheless, the current study has provided useful information for disease treatment and control, and hope to build on this in a future study to include WGS. Climate changes, increasing water contamination and coastlines anthropization, favor the global spread of Vibrio spp. The three provincial departments have also officially declared an outbreak in the affected districts. The isolates were concurrently sub-cultured on thiosulphate-citrate-bile salt-sucrose (TCBS) agar, blood agar and in alkaline peptone water and all three media were aerobically incubated overnight at 37 C. Colonies were subjected to Analytical profile index (API 20E) standard biochemical tests. Andrusenko IT, Lomov IuM, Moskvitina EA, Podosinnikova LS, Ivanova SM. Before Vibrio cholerae is the causative agent of cholera, an acutely dehydrating diarrheal disease that can kill its victims within hours if left untreated [ 1 ]. The current licenced cholera vaccine contains limited variants of killed whole cells of the O1 V. cholerae serogroup, at the same time newer variants are emerging with non-O1 types causing disease in some geographical areas [9]. Antibiotics shorten the course and diminish the severity of the illness, but they are not as important as rehydration. 1992 Aug 21;67(34):253-60. 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. People with cholera shed the bacteria in their feces (stool). MeSH Capacity building for district health management teams, health care providers and hospital focal persons on surveillance, rapid response teams and in areas including laboratory testing, IPC, and case management. Unable to load your collection due to an error, Unable to load your delegates due to an error. Support to the affected districts through the distribution of sample collection kits, water purification tablets, ORS as well as information on cholera, education, and communication materials. In Punjab, although response activities are taking place, the province is still recording an increased number of suspected cholera cases, including in Lahore, the provincial capital and large international commercial hub. This highlights the potential confounding due to horizontal gene transfer and the superiority of MLVA for genotyping compared to PCR detection of virulence genes. In August 2010, Pakistan experienced major floods and a subsequent cholera epidemic. Microbiol Immunol. Although much is known about the evolution and pathogenicity of the O1/O139 serogroups of V. cholerae, information is lacking on the molecular epidemiology of nonO1/O139 strains isolated from patients who have diarrheal illnesses. broad scope, and wide readership a perfect fit for your research every time. You will be subject to the destination website's privacy policy when you follow the link. The pathogenesis of cholera is complex involving several factors that aid V. cholerae bacteria to colonize and release enterotoxin (CT) that disrupts ion transport by intestinal epithelial cells. You can review and change the way we collect information below. Clipboard, Search History, and several other advanced features are temporarily unavailable. 1. The global picture of cholera changes periodically, so travelers should seek updated information on countries of interest. A cholera epidemic can occur in both endemic countries and in non-endemic countries. How soon after exposure do symptoms appear? Isaac Darko Otchere, Although approximately 200 recognized O serogroups have been. They help us to know which pages are the most and least popular and see how visitors move around the site. A map showing geographical distribution and the number of isolates of, A phylogenetic tree depicting clonal distribution of. Environmental determinants of cholera outbreaks in inland Africa: a systematic review of main transmission foci and propagation routes. Cholera is a highly virulent, lethal diarrhoeal disease caused by ingestion of water or food contaminated with the bacterium, Vibrio cholerae (V. cholerae). The https:// ensures that you are connecting to the Cookies used to track the effectiveness of CDC public health campaigns through clickthrough data. Nevertheless, there were few 2014 outbreak genotypes that persisted in 2015 signifying the inefficiency of the control measures put in place or existence of an unknown environmental reservoir. We describe the molecular epidemiology of cholera in South Africa during 2018-2020. All the isolates tested were predominantly Ogawa serotype, confirming as the main circulating serotype in West Africa [33, 4648]. Isolation of toxigenic (i.e., cholera toxin-producing) Vibrio cholerae O1 or O139 from stool or vomitus, OR 2. Where can a traveler get information about cholera? If no water and soap are available, use an alcohol-based hand sanitizer with at least 60% alcohol. Infect Immun. Department of Biochemistry, Cell and Molecular Biology, University of Ghana, Legon, Accra, Ghana, Affiliation: How long after infection do the symptoms appear? National Library of Medicine WHO recommends strengthening of the disease surveillance system. At least five large clones were observed based on the presence or absence of virulence genes. Spatial analysis showed clustering of most isolates at Ablekuma sub-district. Seven cholera pandemics have been experienced globally and it continues to cause outbreaks locally and regionally across the African continent [1, 2]. 8600 Rockville Pike Bookshelf Accessibility Available at:https://www.who.int/emergencies/disease-outbreak-news/item/2022-DON391. Moreover, utilization of discriminating tools such as multi-locus variable number of tandem repeats analysis (MLVA) will aid in tracking disease spread, which is crucial for disease control. With prompt appropriate rehydration, fewer than 1% of cholera patients die. Cholera is an acute diarrheal illness caused by certain strains of the bacterium Vibrio cholerae. PLOS ONE promises fair, rigorous peer review, Dehydration can be rapid so fluid replacement is essential. Patients can be treated with oral rehydration solution (ORS), a prepackaged mixture of sugar and salts that is mixed with 1 liter of water and drunk in large amounts. The bacterial suspension was heated at 95C for 10 minutes to release crude DNA. Community engagement including support for social mobilizers in highly affected districts and health awareness sessions that are being conducted on a daily basis. 2023 Mar 8;23(1):455. doi: 10.1186/s12889-023-15326-2. Rarely, people in the U.S. have contracted cholera after eating raw or undercooked shellfish from the Gulf of Mexico. Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon, Accra, Ghana, We cleaned and analysed the generated sequences using the Staden software package [25]. Cholera can be life-threatening but it is easily prevented and treated. The disease can spread rapidly in areas with inadequate treatment of sewage and drinking water. V. cholerae O1 and O139 serogroup organisms are the causes of epidemic cholera. This solution is used throughout the world to treat diarrhea. Cholera can be endemic or epidemic. Unable to load your collection due to an error, Unable to load your delegates due to an error, Genetic organization of the TCP pathogenicity island of, Model for the ToxR/ToxT regulatory cascade of, Proposed model for the emergence of new strains of toxigenic. We however, found three of our isolates to be Inaba serotype that is mostly found in Asia. Broad Street pump with handle removed. Distribution of risk communication pamphlets and awareness banners with additional materials being printed for future distribution. The first laboratory confirmed case was reported on 15 January 2022 in Sindh province. Dalsgaard A, Serichantalergs O, Forslund A, Lin W, Mekalanos J, Mintz E, Shimada T, Wells JG. e0236016. MLVA differentiated the isolates into 2 large unique clones A and B, with each predominating in a particular year. Among people who develop symptoms, the majority have mild or moderate symptoms, while a minority develop acute watery diarrhoea with severe dehydration. Vibrio infections are largely classified into 2 distinct groups: Vibrio cholera infections and noncholera Vibrio infections. Please enable it to take advantage of the complete set of features! Thank you for taking the time to confirm your preferences. Cholera outbreaks in Ghana are caused by Vibrio cholerae (mostly of the Ogawa serotype). Cholera caused by Vibrio cholerae O139 was first reported in Bangladesh and India in 1992. The highest number of virulence factors was detected in clone 1 (red) (Fig 3, Table 3). All visitors or residents in areas where cholera is occurring or has occurred should follow recommendations to prevent getting sick: To receive email updates about this topic, enter your email address: We take your privacy seriously. None of our isolates tested positive for serogroup O139 and this finding is concordant with earlier reports of unsuccessful detection of this serogroup from geographical areas outside Asia [44]. Cholera can be life-threatening but it is easily prevented and treated. Keywords: Independent Oversight and Advisory Committee, https://www.who.int/emergencies/disease-outbreak-news/item/2022-DON391. Historically, the noncholera Vibrio species are classified as. If you think you or a member of your family might have cholera, seek medical attention immediately. Alternatively, the Inaba serotype could have been imported. They help us to know which pages are the most and least popular and see how visitors move around the site. 2023 Jan 3;23(1):527. doi: 10.3390/s23010527. in fishery products collected in Sicily and to assess their antibiotic . An average of thirteen isolates was detected annually from the Dhaka Hospital during the last ten years, yielding an estimated 650 cases annually at this hospital. The disease is not likely to spread directly from one person to another. It takes between 12 hours and 5 days for a person to show symptoms after ingesting contaminated food or water (2). As of 27 May, a total of 109 samples have been tested from the public water sources (hydrants) and individual households in Karachi city, Sindh province. Cookies used to track the effectiveness of CDC public health campaigns through clickthrough data. Samuel Yaw Aboagye, CDC is not responsible for Section 508 compliance (accessibility) on other federal or private website. Without treatment, death can occur within hours. The consequences of a humanitarian crisis such as disruption of water and sanitation systems, or the displacement of populations to inadequate and overcrowded camps can increase the risk of cholera transmission, should the bacteria be present or introduced. Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon, Accra, Ghana, While the isolates from the NPHRL (120) were collected across Ghana, the 157 NMIMR isolates were from selected health facilities in the Greater Accra region specifically, Ga West Municipal hospital 100 (63.7%), Achimota hospital 15 (9.6%), Korle-Bu Polyclinic 12 (7.6%), La General Hospital 9 (5.7%), University of Ghana hospital 8 (5.2%), Princess Marie Luis childrens hospital 12 (7.6%), and 37 Military hospital 1(0.6%) (Fig 1). 2002;46(2):59-66. doi: 10.1111/j.1348-0421.2002.tb02659.x. Shellfish eaten raw have been a source of infection. Laboratory support to civil hospitals to conduct water and environmental sampling. Thank you for taking the time to confirm your preferences. Cholera remains a major global public health threat and continuous emergence of new Vibrio cholerae strains is of major concern. The World Health Organization (WHO) estimates that in 2018, there were 1.3 to 4.0 million cases and 21,000 to 143,000 deaths due to cholera globally [1]. Interestingly, the clustering pattern by MLVA was very different from the clonal distribution derived from the presence/absence of specific virulent factors (Figs 3 and 4). In these people, rapid loss of body fluids leads to dehydration and shock. We detected several virulence genes among the V. cholerae isolates. The aim of this study was to evaluate the spread of potentially pathogenic Vibrio spp. Molecular epidemiology of Vibrio cholerae strains has contributed to the understanding of cholera dynamics in Asia 9 - 21, Africa 22 - 27, South America 28, 29 and Haiti. A person can get cholera by drinking water or eating food contaminated with cholera bacteria. Alimuddin Zumla, Cholera caused by toxigenic Vibrio cholerae is a major public health problem confronting developing countries, where outbreaks occur in a regular seasonal pattern and are particularly associated with poverty and poor sanitation. Careers. Currently, there is no evidence of cross-border spread of the disease. However, there is a need to further strengthen surveillance by establishing systematic detection and laboratory confirmation of cholera to properly track the evolution of the outbreak and institute timely and appropriate interventions. Baltazar CS, Pezzoli L, Baloi LD, Luiz N, Chitio JE, Capitine I, Sitoe M, Mala S, Langa JP. Abstract Enterotoxigenic strains of Vibrio cholerae O-1, biotype El Tor, isolated from a case of cholera in Texas in 1973, an outbreak of cholera in Louisiana in 1978, and Louisiana sewage samples in 1980 and 1981 were analyzed for their genetic similarities. Dorothy Yeboah-Manu V. cholerae is a noninvasive intestinal pathogen. 2022 Aug 15;42:279. doi: 10.11604/pamj.2022.42.279.36368. Published by Elsevier Ltd.. All rights reserved. [35]. No proper study has been carried out in order to find out the environmental burden of toxigenic V. cholerae as well as how temporal and environmental factors associated in driving cholera across the country. The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website. Copyright 2019 The Authors. However, U.S. travelers to areas with epidemic cholera (for example, parts of Africa, Asia, and Latin America) can be exposed to cholera bacteria, and might develop illness after arriving home. Francine Ntoumi, Epub 2012 Oct 17. A single-dose live oral cholera vaccine, called, For more information, visit the Visit CDCs global immunization website to learn more about. Authors Thandavarayan Ramamurthy 1 , Ankur Mutreja 1 2 , Franois-Xavier Weill 3 , Bhabatosh Das 1 , Amit Ghosh 4 , Gopinath Balakrish Nair 5 Affiliations Assaying for the presence or absence of 10 known virulence genes, we detected 7 virulence genes among the four 2012 isolates and 9 genes among both the 2014 and 2015 isolates (Table 2). Serotyping the V. cholerae isolates identified 151 (89.9%) as Ogawa, 3 (1.8%) as Inaba and 14 (8.3%) as non-O1/O139 serogroup. The Centers for Disease Control and Prevention (CDC) investigates epidemic cholera wherever it occurs at the invitation of the affected country and trains laboratory workers in proper techniques for identification of, The World Health Organization (WHO) and the Global Task Force on Cholera Control (GTFCC) along with partners and various stakeholders launched. The .gov means its official. The MLVA was achieved using five previously described loci by Danin Poleg et al. Cholera is an ancient disease that remains a public health problem in many impoverished locations around the world. Non-O1 and non-O139 V. cholerae can cause isolated cases of usually mild gastroenteritis. Travelers, public health, medical professionals, and outbreak responders should be aware of areas with high rates of cholera, know how the disease spreads, and what to do to prevent it. In the United States, cholera occurs in persons who travel to foreign countries where outbreaks of cholera are occurring and who drink contaminated water and food there, or those who eat raw or undercooked seafood, including seafood from the Gulf of Mexico. Sensors (Basel). Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. A total of 277 archived isolates were used of which 43.3% (120) were received from the National Public Health and Reference laboratory, Korle-Bu and the remaining 157 (56.7%) were isolated from human stool samples at the Bacteriology Department of Noguchi Memorial Institute for Medical Research (NMIMR). How can I avoid getting sick with cholera? Hasan MM, Islam MU, Sadeq MJ, Fung WK, Uddin J. Non-O1 and non-O139 V. cholerae can cause isolated cases of usually mild gastroenteritis. The isolates were obtained from 152 (54.9%) males and 119 (43.0%) females and 6 (2.1%) with gender not specified. The resulting dendrogram was annotated with patient demographic information using the ggtree package implemented in R [26]. Material support has also been provided to ensure the availability of supplies including ORS, zinc, selected antibiotics and intra venous fluids for case management. Overcrowding, poverty, insufficient water and sanitation facilities increase the risk for cholera outbreaks. In severe illness, intravenous (I.V.) Trolle H, Forsberg B, King C, Akande O, Ayres S, Alfvn T, Elimian K. BMC Public Health. WHO has provided support to health authorities in Pakistan through: The risk of potential international spread from Sindh province exists given that the most affected districts are located in Karachi city which is an industrial center as well as transport hub with airport and seaport; it is also the largest city in Pakistan and capital of Sindh province. ST75 isolates were found across large spatial and temporal distances, suggesting local ST75 spread. For full functionality of this site, please enable JavaScript. Antibiotics are also sometimes used. Food can also be contaminated if it is washed with unclean water or fertilized with sewage or contaminated soil. 2013 Nov 1;208 Suppl 1:S46-54. Conducting field visits to various hospitals to support surveillance, laboratory testing for cholera confirmation, water quality monitoring, improving IPC measures and case management. Furthermore, our findings support the current WHO licensed cholera vaccines which include both O1 Inaba and Ogawa serotypes. In 2022, Sindh province is facing a significant increase in cholera cases with 234 laboratory confirmed cases reported between 15 January to 27 May. Health threat and continuous emergence of new Vibrio cholerae strains is of major concern in are. Or without symptoms, while a minority develop acute watery diarrhoea with severe.!, there is no evidence of cross-border spread of Vibrio spp see how visitors move the... Broad scope, and leg cramps 23 ( 1 ):527. doi: 10.1111/j.1348-0421.2002.tb02659.x to an error officially! 26 ] most and least popular and see how visitors move around the world to crude. 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