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Background Despite the advancement in our understanding of cholera and its etiological agent, Vibrio cholerae, the prevention and treatment of the disease are often hindered due to rapid changes in drug response pattern, serotype, and the major genomic islands namely, the CTX-prophage, and related genetic characteristics. In the present study, V. cholerae (n = 172) associated with endemic cholera in Dhaka during the years 2015-2021 were analyzed for major phenotypic and genetic characteristics, including drug resistance patterns. Results Results revealed that the V. cholerae strains belonged to serogroup O1 biotype El Tor carrying El Tor -specific genes rtxC, tcpA El Tor, and hlyA El Tor, but possessed classical-biotype cholera toxin. Serotypes of V. cholerae strains differed temporally in predominance with Inaba during 2015-2017, and again in 2020-2021, while Ogawa was the predominant serotype in 2018-2019. Also, ctxB1 was predominant in V. cholerae associated with cholera during 2015-2017, while ctxB7 was predominant in 2018, and in the subsequent years, as observed until 2021. V. cholerae strains differed in their antibiotic resistance pattern with a majority (97%) being multi-drug resistant (MDR) and belonging to six sub-groups. Notably, one of these MDR strains was resistant to eleven of the eighteen antibiotics tested, with resistance to fourth-generation cephalosporin (cefepime), and aztreonam. This extreme drug resistant (XDR) strain carried resistance-related genes namely, extended-spectrum [beta]-lactamases (ESBL), blaOXA-1 and blaPER-3. Conclusion The observed temporal switching of serotypes, as well as the ctxB genotype, and the emergence of MDR/XDR V. cholerae and their association with endemic cholera in Dhaka underscore the need for routine monitoring of the pathogen for proper patient management. Keywords: Vibrio cholerae, Temporal transition, Multi-drug resistant, Author(s): Fatema Tuz Jubyda[sup.1,2], Kazi Sumaita Nahar[sup.1], Indrajeet Barman[sup.1], Fatema-Tuz Johura[sup.1], Mohammad Tarequl Islam[sup.1], Marzia Sultana[sup.1], Wali Ullah[sup.1], Jarin Tasnim[sup.1], Sahitya Ranjan Biswas[sup.1], Md Mamun Monir[sup.1], Christine Marie George[sup.3], Andrew [...]

Background Kenya introduced Rotarix.sup.[R] (GlaxoSmithKline Biologicals, Rixensart, Belgium) vaccination into its national immunization programme beginning July 2014. The impact of this vaccination program on the local epidemiology of various known enteropathogens is not fully understood. Methods We used a custom TaqMan Array Card (TAC) to screen for 28 different enteropathogens in 718 stools from children aged less than 13 years admitted to Kilifi County Hospital, coastal Kenya, following presentation with diarrhea in 2013 (before vaccine introduction) and in 2016-2018 (after vaccine introduction). Pathogen positivity rate differences between pre- and post-Rotarix.sup.[R] vaccination introduction were examined using both univariate and multivariable logistic regression models. Results In 665 specimens (92.6%), one or more enteropathogen was detected, while in 323 specimens (48.6%) three or more enteropathogens were detected. The top six detected enteropathogens were: enteroaggregative Escherichia coli (EAggEC; 42.1%), enteropathogenic Escherichia coli (EPEC; 30.2%), enterovirus (26.9%), rotavirus group A (RVA; 24.8%), parechovirus (16.6%) and norovirus GI/GII (14.4%). Post-rotavirus vaccine introduction, there was a significant increase in the proportion of samples testing positive for EAggEC (35.7% vs. 45.3%, p = 0.014), cytomegalovirus (4.2% vs. 9.9%, p = 0.008), Vibrio cholerae (0.0% vs. 2.3%, p = 0.019), Strongyloides species (0.8% vs. 3.6%, p = 0.048) and Dientamoeba fragilis (2.1% vs. 7.8%, p = 0.004). Although not reaching statistical significance, the positivity rate of adenovirus 40/41 (5.8% vs. 7.3%, p = 0.444), norovirus GI/GII (11.2% vs. 15.9%, p = 0.089), Shigella species (8.7% vs. 13.0%, p = 0.092) and Cryptosporidium spp. (11.6% vs. 14.7%, p = 0.261) appeared to increase post-vaccine introduction. Conversely, the positivity rate of sapovirus decreased significantly post-vaccine introduction (7.8% vs. 4.0%, p = 0.030) while that of RVA appeared not to change (27.4% vs. 23.5%, p = 0.253). More enteropathogen coinfections were detected per child post-vaccine introduction compared to before (mean: 2.7 vs. 2.3; p = 0.0025). Conclusions In this rural Coastal Kenya setting, childhood enteropathogen infection burden was high both pre- and post-rotavirus vaccination introduction. Children who had diarrheal admissions post-vaccination showed an increase in coinfections and changes in specific enteropathogen positivity rates. This study highlights the utility of multipathogen detection platforms such as TAC in understanding etiology of childhood acute gastroenteritis in resource-limited regions. Keywords: Enteropathogens, RVA, Taqman array card, Co-infections, Vaccination, Children, Epidemiology, Kenya, Author(s): Charles N. Agoti[sup.1,2], Martin D. Curran[sup.3,4], Nickson Murunga[sup.1], Moses Ngari[sup.1], Esther Muthumbi[sup.1], Arnold W. Lambisia[sup.1], Simon D. W. Frost[sup.5,6], Barbara A. Blacklaws[sup.7], D. James Nokes[sup.1,8] and Lydia N. Drumright[sup.9,10] [...]

Most countries in sub-Saharan Africa are affected by cholera epidemics ranging from annually to every 3-5 years or more (1,2). Cholera tends to be reported at the national or subnational [...]

The 2010-2011 Haiti cholera epidemic was one of the largest worldwide in recent history. Before the initial outbreak, cholera had not been reported in Haiti for at least 100 years [...]

In many areas of the world, cholera remains a major public health problem; it affects millions of persons each year and causes a substantial number of deaths (1,2). In Bangladesh, [...]

In 2010, a surge in cholera cases seriously threatened public health across Pakistan, where previously sporadic cases of cholera had been reported (1-3). In late July and August 2010, record [...]

Cholera, caused by the bacterium Vibrio cholerae and characterized by a profuse watery diarrhea, has been a serious public health problem since the first recorded pandemic in 1817. In 2009, [...]

The current (seventh) cholera pandemic was caused by serogroup O1 El Tor biotypes of Vibrio cholerae. This biotype first emerged on the Indonesian island of Sulawesi in 1961, then subsequently [...]

Epidemic cholera remains a public health problem in developing countries. In 2009, a total of 45 countries reported 221,226 cases and 4,946 deaths; for both, >98% occurred in sub-Saharan Africa [...]

Objective To more accurately define the annual incidence of cholera in India, believed to be higher than reported to the World Health Organization (WHO). Methods We searched the biomedical literature to extract data on the cases of cholera reported in India from 1997 to 2006 and compared the numbers found to those reported annually to WHO over the same period. The latter were obtained from WHO's annual summaries of reported cholera cases and National health profile 2006, published by India's Central Bureau of Health Intelligence. Findings Of India's 35 states or union territories, 21 reported cholera cases during at least one year between 1997 and 2006. The state of West Bengal reported cases during all 10 years, while the state of Maharashtra and the union territory of Delhi reported cases during nine, and Orissa during seven. There were 68 outbreaks in 18 states, and 222 038 cases were detected overall. This figure is about six times higher than the number reported to WHO (37 783) over the same period. The states of Orissa, West Bengal, Andaman and Nicobar Islands, Assam and Chhattisgarh accounted for 91% of all outbreak-related cases. Conclusion The reporting of cholera cases in India is incomplete and the methods used to keep statistics on cholera incidence are inadequate. Although the data are sparse and heterogeneous, cholera notification in India is highly deficient. Objectif Determiner plus precisement l'incidence annuelle du cholera en Inde, que l'on soupconne d'etre plus elevee que le chiffre notifie a l'Organisation mondiale de la Sante (OMS). Methodes Nous avons analyse la litterature biomedicale pour en extraire des donnees sur les cas de cholera signales en Inde de 1997 a 2006 et compare les chiffres trouves a ceux notifies chaque annee a l'OMS sur la meme periode. Ces derniers ont ete tires des recapitulatifs annuels de l'OMS des cas de cholera et du document National Heath profile 2006, publie par le Bureau central indien de l'intelligence sanitaire. Resultats Parmi les 35 Etats et territoires de l'Union indienne, 21 ont notifie des cas de cholera pendant au moins une des annees de la periode 1997-2006. L'Etat du Bengale occidental a notifie des cas sur l'ensemble de ces dix annees, tandis que l'Etat du Maharastra et le territoire de New Delhi ont rapporte des cas pendant neuf d'entre elles et l'Etat de l'Orissa pendant sept d'entre elles. Il s'est produit 68 flambees epidemiques de cholera dans 18 Etats et 222 038 cas ont ete detectes globalement. Ce chiffre est environ six fois plus eleve que le nombre de cas notifie l'OMS sur la meme periode (soit 37 783). Les Etats de l'Orissa et du Bengale occidental, les lles Andaman et Nicobar, l'Assam et le Chhattisgarh ont totalise 91% des cas lies a des flambees. Conclusion La notification des cas de cholera en Inde est incomplete et les methodes servant a la tenue des statistiques sur l'incidence de cette maladie sont inadequates. Malgre la rarete et l'heterogeneite des donnees, on peut affirmer que la notification du cholera est fortement deficiente en Inde. Objetivo Definir con mas precision la incidencia anual de colera en la India, considerada superior a la que se notifica a la Organizacion 'Mundial de la Salud (OMS). Metodos Hicimos busquedas en las publicaciones medicas para extraer datos sobre los casos de colera notificados en la India entre 1997 y 2006 y comparamos las cifras obtenidas con las notificadas anualmente a la OMS en el mismo periodo. Estas ultimas se obtuvieron a partir de los resumenes anuales de la OMS sobre los casos de colera notificados y del National Health Profile 2006, publicado por la Oficina Central de Informacion Sanitaria de la India. Resultados De 35 estados o territorios de la union de la India, 21 notificaron casos de colera durante un ano al menos entre 1997 y 2006. El estado de Bengala Occidental notifico casos cada uno de esos diez anos, mientras que el estado de Maharashtra y el territorio de la union de Delhi notificaron casos nueve anos, y Orissa siete. Hubo 68 brotes en 18 estados, y en total se detectaron 222 038 casos. Esta cifra es unas seis veces mayor que la notificada a la OMS (37 783) en el mismo periodo. Los estados de Orissa, Bengala Occidental, Islas Andaman y Nicobar, Assam y Chhattisgarh concentraron el 91% de todos los casos asociados a brotes. Conclusion La notificacion de los casos de colera en la India es incompleta, y los metodos empleados para mantener las estadisticas sobre la incidencia de la enfermedad son insuficientes. Aunque los datos son escasos y heterogeneos, puede afirmarse que la notificacion de los casos de colera en la India es claramente insatisfactoria., Introduction Cholera is an acute diarrhoeal illness caused by toxigenic strains of Vibrio cholerae serogroups O1 and O 139. Presently, V cholerae O1 belonging to the El Tor biotype is [...]

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.socscimed.2009.07.046 Byline: Tom Koch, Kenneth Denike Abstract: Few cases in the history of epidemiology and public health are more famous than John Snow's investigation of a neighborhood cholera outbreak in the St. James, Westminster, area of London in 1854. In this study Snow is assumed to have proven that cholera was water rather than airborne through a methodology that became, and to a great extent remains, central to the science and social science of disease studies. And yet, Snow's work did not satisfy most of his contemporaries who considered his proof of a solely waterborne cholera interesting but unconvincing. Uniquely, this paper asks whether the caution of Snow's contemporaries was reasonable, and secondly, whether Snow might have been more convincing within the science of the day. The answers significantly alter our understanding of this paradigmatic case. It does so in a manner offering insights both into the origins of nineteenth century disease analysis and more generally, the relation of mapping in the investigation of an outbreak of uncertain origin. The result has general relevance -- pedagogically and practically -- in epidemiology, medical geography, and public health. Author Affiliation: University British Columbia, Vancouver, BC, Canada

Author(s): Andrés Fuentes Flores[sup.1] , Ignacio Sepúlveda Cisternas[sup.1,2] , José Ignacio Vásquez Solis de Ovando[sup.1] , Alexia Torres[sup.1] and Víctor Antonio García-Angulo[sup.1,3] Introduction Riboflavin, also named vitamin B2, is an [...]

The toxic effect of cholera toxin (CT) on target cells is caused by its A1 chain. This polypeptide is released from the holotoxin and unfolded in the lumen of the ER by the action of protein disulfide isomerase (PDI), before being retrotranslocated into the cytosol. The polypeptide is initially unfolded by binding to the reduced form of PDI. We show that upon oxidation of the COOH-terminal disulfide bond in PDI by the enzyme Ero1, the A1 chain is released. Both yeast Ero1 and the mammalian Ero1[alpha] isoform are active in this reaction. Ero1 has a preference for the PDI-toxin complex. We further show that the complex is transferred to a protein at the lumenal side of the ER membrane, where the unfolded toxin is released from PDI by the action of Ero1. Taken together, our results identify Ero1 as the enzyme mediating the release of unfolded CT from PDI and characterize an additional step in retrotranslocation of the toxin.

A newly identified g protein, XL-alpha-s, containing the 51K XL-portion connected to a G-alpha-s trimmed at the amino terminus, specifically targets cholera toxin. A specific relationship exists between the XL-alpha-s and the trans-golgi network and this protein is localized to cells having the regulated and constitutive protein secretion pathway. XL-alpha-s is involved in the cholera toxin-mediated secretory vesicle formation from the trans-golgi network.

A novel qnr determinant emerged in ciprofloxacin-resistant Vibrio cholerae O1 from the Amazon region of Brazil. This qnrVC1 was in a typical class 1 integron. Its attC showed 89% identity [...]