Recent Cholera Publications on PubMed

Subscribe to Recent Cholera Publications on PubMed feed Recent Cholera Publications on PubMed
NCBI: db=pubmed; Term=cholera epidemiology
Updated: 2 hours 56 min ago

Cholera Incidence and Mortality in Sub-Saharan African Sites during Multi-country Surveillance.

March 23, 2017
Related Articles

Cholera Incidence and Mortality in Sub-Saharan African Sites during Multi-country Surveillance.

PLoS Negl Trop Dis. 2016 05;10(5):e0004679

Authors: Sauvageot D, Njanpop-Lafourcade BM, Akilimali L, Anne JC, Bidjada P, Bompangue D, Bwire G, Coulibaly D, Dengo-Baloi L, Dosso M, Orach CG, Inguane D, Kagirita A, Kacou-N'Douba A, Keita S, Kere Banla A, Kouame YJ, Landoh DE, Langa JP, Makumbi I, Miwanda B, Malimbo M, Mutombo G, Mutombo A, NGuetta EN, Saliou M, Sarr V, Senga RK, Sory F, Sema C, Tante OV, Gessner BD, Mengel MA

Abstract
BACKGROUND: Cholera burden in Africa remains unknown, often because of weak national surveillance systems. We analyzed data from the African Cholera Surveillance Network (www.africhol.org).
METHODS/ PRINCIPAL FINDINGS: During June 2011-December 2013, we conducted enhanced surveillance in seven zones and four outbreak sites in Togo, the Democratic Republic of Congo (DRC), Guinea, Uganda, Mozambique and Cote d'Ivoire. All health facilities treating cholera cases were included. Cholera incidences were calculated using culture-confirmed cholera cases and culture-confirmed cholera cases corrected for lack of culture testing usually due to overwhelmed health systems and imperfect test sensitivity. Of 13,377 reported suspected cases, 34% occurred in Conakry, Guinea, 47% in Goma, DRC, and 19% in the remaining sites. From 0-40% of suspected cases were aged under five years and from 0.3-86% had rice water stools. Within surveillance zones, 0-37% of suspected cases had confirmed cholera compared to 27-38% during outbreaks. Annual confirmed incidence per 10,000 population was <0.5 in surveillance zones, except Goma where it was 4.6. Goma and Conakry had corrected incidences of 20.2 and 5.8 respectively, while the other zones a median of 0.3. During outbreaks, corrected incidence varied from 2.6 to 13.0. Case fatality ratios ranged from 0-10% (median, 1%) by country.
CONCLUSIONS/SIGNIFICANCE: Across different African epidemiological contexts, substantial variation occurred in cholera incidence, age distribution, clinical presentation, culture confirmation, and testing frequency. These results can help guide preventive activities, including vaccine use.

PMID: 27186885 [PubMed - indexed for MEDLINE]

Mice with Streptozotocin-Induced Hyperglycemia are Susceptible to Invasive Enteric Bacterial Infection.

March 23, 2017
Related Articles

Mice with Streptozotocin-Induced Hyperglycemia are Susceptible to Invasive Enteric Bacterial Infection.

Jpn J Infect Dis. 2017 Jan 24;70(1):111-114

Authors: Koley H, Ghosh P, Sinha R, Mitra S, Mukherjee P, Howlader DR, Chaki C, Nag D

Abstract
Diabetes mellitus and diarrhea are becoming increasingly burdensome worldwide, particularly in developing countries such as India. Diabetic patients are susceptible to infection with pathogenic bacteria, particularly those causing invasive enteric infections. In this study, we observed changes in the pathophysiological features of mice with streptozotocin-induced hyperglycemia. In our experiments, both hyperglycemic and control mice were infected with pathogenic enteric bacteria-non-typhoidal Salmonella, Shigella flexneri, or Vibrio parahaemolyticus. Morbidity, mortality, and bacterial load were all higher in the diabetic mice than in the control mice, and the phagocytic and bactericidal activities of peritoneal macrophages isolated from hyperglycemic mice were lower than they were in the controls. We hypothesize that hyperglycemia leads to a downregulation of the innate immune response, which in turn increases vulnerability to enteric bacterial infection.

PMID: 27169940 [PubMed - indexed for MEDLINE]

Induction of immunomodulatory miR-146a and miR-155 in small intestinal epithelium of Vibrio cholerae infected patients at acute stage of cholera.

March 21, 2017
Related Articles

Induction of immunomodulatory miR-146a and miR-155 in small intestinal epithelium of Vibrio cholerae infected patients at acute stage of cholera.

PLoS One. 2017;12(3):e0173817

Authors: Bitar A, De R, Melgar S, Aung KM, Rahman A, Qadri F, Wai SN, Shirin T, Hammarström ML

Abstract
The potential immunomodulatory role of microRNAs in small intestine of patients with acute watery diarrhea caused by Vibrio cholerae O1 or enterotoxigenic Escherichia coli (ETEC) infection was investigated. Duodenal biopsies were obtained from study-participants at the acute (day 2) and convalescent (day 21) stages of disease, and from healthy individuals. Levels of miR-146a, miR-155 and miR-375 and target gene (IRAK1, TRAF6, CARD10) and 11 cytokine mRNAs were determined by qRT-PCR. The cellular source of microRNAs in biopsies was analyzed by in situ hybridization. The ability of V. cholerae bacteria and their secreted products to cause changes in microRNA- and mRNA levels in polarized tight monolayers of intestinal epithelial cells was investigated. miR-146a and miR-155 were expressed at significantly elevated levels at acute stage of V. cholerae infection and declined to normal at convalescent stage (P<0.009 versus controls; P = 0.03 versus convalescent stage, pairwise). Both microRNAs were mainly expressed in the epithelium. Only marginal down-regulation of target genes IRAK1 and CARD10 was seen and a weak cytokine-profile was identified in the acute infected mucosa. No elevation of microRNA levels was seen in ETEC infection. Challenge of tight monolayers with the wild type V. cholerae O1 strain C6706 and clinical isolates from two study-participants, caused significant increase in miR-155 and miR-146a by the strain C6706 (P<0.01). One clinical isolate caused reduction in IRAK1 levels (P<0.05) and none of the strains induced inflammatory cytokines. In contrast, secreted factors from these strains caused markedly increased levels of IL-8, IL-1β, and CARD10 (P<0.001), without inducing microRNA expression. Thus, miR-146a and miR-155 are expressed in the duodenal epithelium at the acute stage of cholera. The inducer is probably the V. cholerae bacterium. By inducing microRNAs the bacterium can limit the innate immune response of the host, including inflammation evoked by its own secreted factors, thereby decreasing the risk of being eliminated.

PMID: 28319200 [PubMed - in process]

Notes from the Field: Ongoing Cholera Epidemic - Tanzania, 2015-2016.

March 18, 2017
Related Articles

Notes from the Field: Ongoing Cholera Epidemic - Tanzania, 2015-2016.

MMWR Morb Mortal Wkly Rep. 2017 Feb 17;66(6):177-178

Authors: Narra R, Maeda JM, Temba H, Mghamba J, Nyanga A, Greiner AL, Bakari M, Beer KD, Chae SR, Curran KG, Eidex RB, Gibson JJ, Handzel T, Kiberiti SJ, Kishimba RS, Lukupulo H, Malibiche T, Massa K, Massay AE, McCrickard LS, Mchau GJ, Mmbaga V, Mohamed AA, Mwakapeje ER, Nestory E, Newton AE, Oyugi E, Rajasingham A, Roland ME, Rusibamayila N, Sembuche S, Urio LJ, Walker TA, Wang A, Quick RE

PMID: 28207686 [PubMed - indexed for MEDLINE]

Epidemiology of cholera outbreaks and socio-economic characteristics of the communities in the fishing villages of Uganda: 2011-2015.

March 14, 2017

Epidemiology of cholera outbreaks and socio-economic characteristics of the communities in the fishing villages of Uganda: 2011-2015.

PLoS Negl Trop Dis. 2017 Mar 13;11(3):e0005407

Authors: Bwire G, Munier A, Ouedraogo I, Heyerdahl L, Komakech H, Kagirita A, Wood R, Mhlanga R, Njanpop-Lafourcade B, Malimbo M, Makumbi I, Wandawa J, Gessner BD, Orach CG, Mengel MA

Abstract
BACKGROUND: The communities in fishing villages in the Great Lakes Region of Africa and particularly in Uganda experience recurrent cholera outbreaks that lead to considerable mortality and morbidity. We evaluated cholera epidemiology and population characteristics in the fishing villages of Uganda to better target prevention and control interventions on cholera and contribute to its elimination from those communities.
METHODOLOGY/PRINCIPAL FINDINGS: We conducted a prospective study between 2011-15 in fishing villages in Uganda. We collected, reviewed and documented epidemiological and socioeconomic data for 10 cholera outbreaks that occurred in fishing communities located along the African Great Lakes and River Nile in Uganda. These outbreaks caused 1,827 suspected cholera cases and 43 deaths, with a Case-Fatality Ratio (CFR) of 2.4%. Though the communities in the fishing villages make up only 5-10% of the Ugandan population, they bear the biggest burden of cholera contributing 58% and 55% of all reported cases and deaths in Uganda during the study period. The CFR was significantly higher among males than females (3.2% vs. 1.3%, p = 0.02). The outbreaks were seasonal with most cases occurring during the months of April-May. Male children under age of 5 years, and 5-9 years had increased risk. Cholera was endemic in some villages with well-defined "hotspots". Practices predisposing communities to cholera outbreaks included: the use of contaminated lake water, poor sanitation and hygiene. Additional factors were: ignorance, illiteracy, and poverty.
CONCLUSIONS/SIGNIFICANCE: Cholera outbreaks were a major cause of morbidity and mortality among the fishing communities in Uganda. In addition to improvements in water, sanitation, and hygiene, oral cholera vaccines could play an important role in the prevention and control of these outbreaks, particularly when targeted to high-risk areas and populations. Promotion and facilitation of access to social services including education and reduction in poverty should contribute to cholera prevention, control and elimination in these communities.

PMID: 28288154 [PubMed - as supplied by publisher]

Helicobacter pylori Adapts to Chronic Infection and Gastric Disease via pH-Responsive BabA-Mediated Adherence.

March 11, 2017
Related Articles

Helicobacter pylori Adapts to Chronic Infection and Gastric Disease via pH-Responsive BabA-Mediated Adherence.

Cell Host Microbe. 2017 Mar 08;21(3):376-389

Authors: Bugaytsova JA, Björnham O, Chernov YA, Gideonsson P, Henriksson S, Mendez M, Sjöström R, Mahdavi J, Shevtsova A, Ilver D, Moonens K, Quintana-Hayashi MP, Moskalenko R, Aisenbrey C, Bylund G, Schmidt A, Åberg A, Brännström K, Königer V, Vikström S, Rakhimova L, Hofer A, Ögren J, Liu H, Goldman MD, Whitmire JM, Ådén J, Younson J, Kelly CG, Gilman RH, Chowdhury A, Mukhopadhyay AK, Nair GB, Papadakos KS, Martinez-Gonzalez B, Sgouras DN, Engstrand L, Unemo M, Danielsson D, Suerbaum S, Oscarson S, Morozova-Roche LA, Olofsson A, Gröbner G, Holgersson J, Esberg A, Strömberg N, Landström M, Eldridge AM, Chromy BA, Hansen LM, Solnick JV, Lindén SK, Haas R, Dubois A, Merrell DS, Schedin S, Remaut H, Arnqvist A, Berg DE, Borén T

Abstract
The BabA adhesin mediates high-affinity binding of Helicobacter pylori to the ABO blood group antigen-glycosylated gastric mucosa. Here we show that BabA is acid responsive-binding is reduced at low pH and restored by acid neutralization. Acid responsiveness differs among strains; often correlates with different intragastric regions and evolves during chronic infection and disease progression; and depends on pH sensor sequences in BabA and on pH reversible formation of high-affinity binding BabA multimers. We propose that BabA's extraordinary reversible acid responsiveness enables tight mucosal bacterial adherence while also allowing an effective escape from epithelial cells and mucus that are shed into the acidic bactericidal lumen and that bio-selection and changes in BabA binding properties through mutation and recombination with babA-related genes are selected by differences among individuals and by changes in gastric acidity over time. These processes generate diverse H. pylori subpopulations, in which BabA's adaptive evolution contributes to H. pylori persistence and overt gastric disease.

PMID: 28279347 [PubMed - in process]

In silico prediction of drug resistance due to S247R mutation of Influenza H1N1 neuraminidase protein.

March 11, 2017
Related Articles

In silico prediction of drug resistance due to S247R mutation of Influenza H1N1 neuraminidase protein.

J Biomol Struct Dyn. 2017 Mar 09;:1-43

Authors: Mandal RS, Panda S, Das S

Abstract
We present here in silico studies on antiviral drug resistance due to a novel mutation of influenza A/H1N1 neuraminidase (NA) protein. Influenza A/H1N1 virus was responsible for a recent pandemic and is currently circulating among the seasonal influenza strains. M2 and NA are the two major viral proteins related to pathogenesis in humans and have been targeted for drug designing. Among them, NA is preferred because the ligand-binding site of NA is highly conserved between different strains of influenza virus. Different mutations of the NA active site residues leading to drug resistance or susceptibility of the virus were studied earlier. We report here a novel mutation (S247R) in the NA protein that was sequenced earlier from the nasopharyngeal swab from Sri Lanka and Thailand in the year 2009 and 2011, respectively. Another mutation (S247N) was already known to confer resistance to oseltamivir. We did a comparative study of these two mutations vis-s-vis the drug-sensitive wild type NA to understand the mechanism of drug resistance of S247N and to predict the probability of the novel S247R mutation to become resistant to the currently available drugs, oseltamivir and zanamivir. We performed molecular docking- and molecular dynamics-based analysis of both the mutant proteins and showed that mutation of S247R affects drug binding to the protein by positional displacement due to altered active site cavity architecture, which in turn reduces the affinity of the drug molecules to the NA active site. Our analysis shows that S247R may have high probability of being resistant.

PMID: 28279127 [PubMed - as supplied by publisher]

Pandemics, pathogenicity and changing molecular epidemiology of cholera in the era of global warming.

March 9, 2017
Related Articles

Pandemics, pathogenicity and changing molecular epidemiology of cholera in the era of global warming.

Ann Clin Microbiol Antimicrob. 2017 Mar 07;16(1):10

Authors: Chowdhury FR, Nur Z, Hassan N, von Seidlein L, Dunachie S

Abstract
BACKGROUND: Vibrio cholerae, a Gram-negative, non-spore forming curved rod is found in diverse aquatic ecosystems around the planet. It is classified according to its major surface antigen into around 206 serogroups, of which O1 and O139 cause epidemic cholera. A recent spatial modelling technique estimated that around 2.86 million cholera cases occur globally every year, and of them approximately 95,000 die. About 1.3 billion people are currently at risk of infection from cholera. Meta-analysis and mathematical modelling have demonstrated that due to global warming the burden of vector-borne diseases like malaria, leishmaniasis, meningococcal meningitis, viral encephalitis, dengue and chikungunya will increase in the coming years in the tropics and beyond.
CHOLERA AND CLIMATE: This review offers an overview of the interplay between global warming and the pathogenicity and epidemiology of V. cholerae. Several distinctive features of cholera survival (optimal thriving at 15% salinity, 30 °C water temperature, and pH 8.5) indicate a possible role of climate change in triggering the epidemic process. Genetic exchange (ctxAB, zot, ace, cep, and orfU) between strains and transduction process allows potential emergence of new toxigenic clones. These processes are probably controlled by precise environmental signals such as optimum temperature, sunlight and osmotic conditions. Environmental influences on phytoplankton growth and chitin remineralization will be discussed alongside the interplay of poor sanitary conditions, overcrowding, improper sewage disposal and global warming in promoting the growth and transmission of this deadly disease.
CONCLUSION: The development of an effective early warning system based on climate data could help to prevent and control future outbreaks. It may become possible to integrate real-time monitoring of oceanic regions, climate variability and epidemiological and demographic population dynamics to predict cholera outbreaks and support the design of cost-effective public health strategies.

PMID: 28270154 [PubMed - in process]

Rugose atypical Vibrio cholerae O1 El Tor responsible for 2009 cholera outbreak in India.

March 8, 2017
Related Articles

Rugose atypical Vibrio cholerae O1 El Tor responsible for 2009 cholera outbreak in India.

J Med Microbiol. 2016 Oct;65(10):1130-1136

Authors: Chowdhury G, Bhadra RK, Bag S, Pazhani GP, Das B, Basu P, Nagamani K, Nandy RK, Mukhopadhyay AK, Ramamurthy T

Abstract
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).

PMID: 27561681 [PubMed - indexed for MEDLINE]

Cholera forecast for Dhaka, Bangladesh, with the 2015-2016 El Niño: Lessons learned.

March 3, 2017
Related Articles

Cholera forecast for Dhaka, Bangladesh, with the 2015-2016 El Niño: Lessons learned.

PLoS One. 2017;12(3):e0172355

Authors: Martinez PP, Reiner RC, Cash BA, Rodó X, Shahjahan Mondal M, Roy M, Yunus M, Faruque AS, Huq S, King AA, Pascual M

Abstract
A substantial body of work supports a teleconnection between the El Niño-Southern Oscillation (ENSO) and cholera incidence in Bangladesh. In particular, high positive anomalies during the winter (Dec-Feb) in sea surface temperatures (SST) in the tropical Pacific have been shown to exacerbate the seasonal outbreak of cholera following the monsoons from August to November. Climate studies have indicated a role of regional precipitation over Bangladesh in mediating this long-distance effect. Motivated by this previous evidence, we took advantage of the strong 2015-2016 El Niño event to evaluate the predictability of cholera dynamics for the city in recent times based on two transmission models that incorporate SST anomalies and are fitted to the earlier surveillance records starting in 1995. We implemented a mechanistic temporal model that incorporates both epidemiological processes and the effect of ENSO, as well as a previously published statistical model that resolves space at the level of districts (thanas). Prediction accuracy was evaluated with "out-of-fit" data from the same surveillance efforts (post 2008 and 2010 for the two models respectively), by comparing the total number of cholera cases observed for the season to those predicted by model simulations eight to twelve months ahead, starting in January each year. Although forecasts were accurate for the low cholera risk observed for the years preceding the 2015-2016 El Niño, the models also predicted a high probability of observing a large outbreak in fall 2016. Observed cholera cases up to Oct 2016 did not show evidence of an anomalous season. We discuss these predictions in the context of regional and local climate conditions, which show that despite positive regional rainfall anomalies, rainfall and inundation in Dhaka remained low. Possible explanations for these patterns are given together with future implications for cholera dynamics and directions to improve their prediction for the city.

PMID: 28253325 [PubMed - in process]

Public health round-up.

March 1, 2017
Related Articles

Public health round-up.

Bull World Health Organ. 2016 Feb 01;94(2):80-1

Authors:

PMID: 26908955 [PubMed - indexed for MEDLINE]

A cholera outbreak in Alborz Province, Iran: a matched case-control study.

February 28, 2017
Related Articles

A cholera outbreak in Alborz Province, Iran: a matched case-control study.

Epidemiol Health. 2016;38:e2016018

Authors: Moradi G, Rasouli MA, Mohammadi P, Elahi E, Barati H

Abstract
OBJECTIVES: A total of 229 confirmed cholera cases were reported in Alborz Province during an outbreak that lasted from June 2011 to August 2011. This study aimed to identify potential sources of transmission in order to determine suitable interventions in similar outbreaks. In other words, the lessons learned from this retrospective study can be utilized to manage future similar outbreaks.
METHODS: An age-matched and sex-matched case-control study was conducted during the outbreak. For each case, two control subjects were selected from the neighborhood. A case of cholera was defined as a bacteriologically confirmed case with signs and symptoms of cholera. This study was conducted from June 14, 2011 through August 23, 2011. The data were analyzed by calculating odds ratios (ORs) using the logistic regression method.
RESULTS: In this outbreak, 229 confirmed cholera cases were diagnosed. The following risk factors were found to be associated with cholera: consumption of unrefrigerated leftover food (OR, 3.05; 95% confidence interval [CI], 1.72 to 5.41), consumption of vegetables and fruits in the previous three days (OR, 2.75; 95% CI, 1.95 to 3.89), and a history of traveling in the previous five days (OR, 5.31; 95% CI, 2.21 to 9.72).
CONCLUSIONS: Consumption of vegetables and fruits has remained an unresolved risk factor in cholera outbreaks in Iran in recent years. In order to reduce the risk of cholera, sanitary standards for fruits and vegetables should be observed at all points from production to consumption, the population should be educated regarding hygienic food storage during outbreaks, and sanitary standards should be maintained when traveling during cholera outbreaks.

PMID: 27188308 [PubMed - indexed for MEDLINE]

Genetic Characterization of Vibrio cholerae O1 isolates from outbreaks between 2011 and 2015 in Tanzania.

February 22, 2017
Related Articles

Genetic Characterization of Vibrio cholerae O1 isolates from outbreaks between 2011 and 2015 in Tanzania.

BMC Infect Dis. 2017 Feb 20;17(1):157

Authors: Kachwamba Y, Mohammed AA, Lukupulo H, Urio L, Majigo M, Mosha F, Matonya M, Kishimba R, Mghamba J, Lusekelo J, Nyanga S, Almeida M, Li S, Domman D, Massele SY, Stine OC

Abstract
BACKGROUND: Cholera outbreaks have occurred in Tanzania since 1974. To date, the genetic epidemiology of these outbreaks has not been assessed.
METHODS: 96 Vibrio cholerae O1 isolates from five regions were characterized, and their genetic relatedness assessed using multi-locus variable-number tandem-repeat analysis (MLVA) and whole genome sequencing (WGS).
RESULTS: Of the 48 MLVA genotypes observed, 3 were genetically unrelated to any others, while the remaining 45 genotypes separated into three MLVA clonal complexes (CCs) - each comprised of genotypes differing by a single allelic change. In Kigoma, two separate outbreaks, 4 months apart (January and May, 2015), were each caused by genetically distinct strains by MLVA and WGS. Remarkably, one MLVA CC contained isolates from both the May outbreak and ones from the 2011/2012 outbreak in Dar-es-Salaam. However, WGS revealed the isolates from the two outbreaks to be distinct clades. The outbreak that started in August 2015 in Dar-es-Salaam and spread to Morogoro, Singida and Mara was comprised of a single MLVA CC and WGS clade. Isolates from within an outbreak were closely related differing at fewer than 5 nucleotides. All isolates were part of the 3(rd) wave of the 7(th) pandemic and were found in four clades related to isolates from Kenya and Asia.
CONCLUSIONS: We conclude that genetically related V. cholerae cluster in outbreaks, and distinct strains circulate simultaneously.

PMID: 28219321 [PubMed - in process]

Emergence and serovar profiling of non-typhoidal Salmonellae (NTS) isolated from gastroenteritis cases-A study from South India.

February 22, 2017
Related Articles

Emergence and serovar profiling of non-typhoidal Salmonellae (NTS) isolated from gastroenteritis cases-A study from South India.

Infect Dis (Lond). 2016 Nov-Dec;48(11-12):847-51

Authors: Ballal M, Devadas SM, Shetty V, Bangera SR, Ramamurthy T, Sarkar A

Abstract
Human infection with non-typhoidal Salmonella (NTS) serovars is often a neglected and undiagnosed infection in the developing world. Invasive NTS is now being established as having a new and emerging pathogenic role. There is not sufficient data on the prevalence of NTS serovars and their antibiotic susceptibility pattern from India. Faecal specimens collected from patients with acute gastroenteritis were processed to isolate Salmonella according to the standard protocol for a period from January 2011-December 2014. Salmonella isolates were serotyped and tested for antibiotic susceptibility. Of the total 320 (10.04%) bacterial enteric pathogens isolated, 64 (20%) were non-typhoidal Salmonella. Among the serogroup, O:4 (B) (n = 26; 40.6%) was found to be the commonest followed by O:7 (C1) (n = 11; 17.1%) and O:3,10 (E1) (n = 11; 17.1%). NTS infection in cancer patients could also be termed as nosocomial NTS diarrhoea due to primary community infection with prolonged incubation periods, consumption of contaminated food during hospital stay or Nosocomially acquired infection. Serovar Oslo has been predominant (9/17) in NTS isolates from cancer patients, whereas serovars Bovismorbificans, Wangata and Schleissheim have been reported for the first time in the country. The isolates were mostly susceptible to antibiotics except Salmonella ser Kentucky, which showed resistance to ciprofloxacin is reported for the first time in the country. Continuous surveillance is required to monitor resistance of NTS isolates.

PMID: 27300440 [PubMed - indexed for MEDLINE]

The epidemiology and antimicrobial resistance of cholera cases in Iran during 2013.

February 18, 2017
Related Articles

The epidemiology and antimicrobial resistance of cholera cases in Iran during 2013.

Iran J Microbiol. 2016 Aug;8(4):232-237

Authors: Masoumi-Asl H, Gouya MM, Rahbar M, Sabourian R

Abstract
BACKGROUND AND OBJECTIVES: Cholera is an endemic diarrheal disease in Iran, caused by Vibrio Cholerae. The epidemiology, transmission route, environmental determinants and antimicrobial resistant pattern of cholera have been changed during recent years. In this study the epidemiology and antimicrobial resistance of cholera in Iran during 2013 outbreak was investigated.
MATERIALS AND METHODS: A retrospective, cross-sectional study was carried out using cholera national surveillance system collected data in 2013. Bacterial identification and antimicrobial susceptibility testing were done on 60 Vibrio cholerae isolates, serotype Inaba.
RESULTS: During July to November 2013, 256 confirmed cholera cases were diagnosed by stool culture. Two hundred and eleven out of 256 (83%) cases were imported from Afghanistan and Pakistan. The prevalent age group was 16-30 years old, 90% were male, 98.8% affected by Inaba serotype and case fatality rate was 2.7%. The results of antimicrobial susceptibility testing on 60 V. cholerae, serotype Inaba showed that all isolates were resistant to nalidixic acid, tetracyclin and trimethoprim-sulfamethoxazole and intermediate resistance to erythromycin but sensitive to ciprofloxacin, cefixime and ampicillin.
CONCLUSION: Migrants from neighboring countries played a key role in cholera outbreak in Iran during 2013. The results of antimicrobial susceptibility testing on 60 V. cholerae, serotype Inaba showed an increasing resistance rate in comparison with previous years.

PMID: 28210461 [PubMed - in process]

Cholera outbreak following a marriage ceremony in Medinya, Western Ghana.

February 18, 2017
Related Articles

Cholera outbreak following a marriage ceremony in Medinya, Western Ghana.

Pan Afr Med J. 2016;25(Suppl 1):3

Authors: Acquah H, Malm K, Der J, Kye-Duodu G, Mensah EK, Sackey SO, Nyarko KM, Afari E

Abstract
INTRODUCTION: Cholera is a diarrhoea disease caused by the bacterium e. On 13th June 2011, there was a reported outbreak of acute watery diarrhoea at Medinya among people who eat at a mass traditional wedding ceremony in the Western Region of Ghana. We investigated to characterize the outbreak, and implement control and preventive measures.
METHODS: We conducted a retrospective cohort study. We interviewed health workers, reviewed medical records, conducted environmental assessment and obtained water and stool samples for laboratory investigation. A suspected cholera-case defined as a person with acute watery diarrhoea, with or without vomiting, who ate food prepared at the mass traditional wedding in Medinya on 10th June 2011. We performed univariate and bivariate analysis.
RESULTS: Of the 17 case-patients, 9 (52.9%) were males. The overall attack rate was 11.18% and case fatality rate was 5.9%. The most affected age group was 6-10 years (23.53%) with median age of 20 and ranged 6 to 38 years. Time of onset of symptoms was 2.00am and peaked at 10.am on 13th June. Compared to other food served, fufu with groundnut soup was more likely to have been contaminated (RR=7.3, 95%CI: 1.8-29.3). We isolated e serotype ogawa from stool samples. We observed open defaecation and poor personal hygiene.
CONCLUSION: e serotype ogawa caused a high case-fatality outbreak in Medinya. Contaminated fufu and groundnut soup were the sources. Hand washing with soap was initiated and a make shift latrine constructed following our health education and recommendations.

PMID: 28210372 [PubMed - in process]

Genomic profile of antibiotic resistant, classical ctxB positive Vibrio cholerae O1 biotype El Tor isolated in 2003 and 2005 from Puri, India: A retrospective study.

February 18, 2017
Related Articles

Genomic profile of antibiotic resistant, classical ctxB positive Vibrio cholerae O1 biotype El Tor isolated in 2003 and 2005 from Puri, India: A retrospective study.

Indian J Med Microbiol. 2016 Oct-Dec;34(4):462-470

Authors: Bhotra T, Das MM, Pal BB, Singh DV

Abstract
OBJECTIVES: To examine eight strains of Vibrio cholerae O1 isolated in 2003 and 2005 from Puri, India, for antibiotic susceptibility, presence of virulence and regulatory genes, cholera toxin (CT) production, CTX arrangement and genomic profiles.
MATERIALS AND METHODS: Bacterial strains were tested for antibiotic susceptibility using disc diffusion assay. Polymerase chain reaction determined the presence of antibiotic resistance, virulence and regulatory genes. To determine the type of cholera toxin subunit B (ctxB), nucleotide sequencing was performed. Southern hybridisation determined the number and arrangement of CTXΦ. Ribotyping and pulsed-field gel electrophoresis (PFGE) were used to determine the genomic profile of isolates.
RESULTS: All the eight strains, except one strain, showed resistant to nalidixic acid, sulphamethoxazole, streptomycin and trimethoprim and possessed the sullI, strB, dfrA1 and int SXT genes. All the strains carried the toxin-co-regulated pilus pathogenicity island, the CTX genetic element, the repeat in toxin and produced CT. Restriction fragment length polymorphism (RFLP) analysis showed that V. cholerae O1 possess a single copy of the CTX element flanked by tandemly arranged RS element. Nucleotide sequencing of the ctxB gene showed the presence of classical ctxB. RFLP analysis of conserved rRNA gene showed two ribotype patterns. PFGE analysis also showed at least three PFGE patterns, irrespective of year of isolations, indicating the genomic relatedness among them.
CONCLUSION: Overall, these data suggest that classical ctxB-positive V. cholerae O1 El Tor strains that appeared in 2003 continue to cause infection in 2005 in Puri, India, and belong to identical ribotype(s) and/or pulsotype(s). There is need to continuous monitor the emergence of variant of El Tor because it will improve our understanding of the evolution of new clones of variant of V. cholerae.

PMID: 27934824 [PubMed - indexed for MEDLINE]

Vibrio alginolyticus infections in the USA, 1988-2012.

February 17, 2017
Related Articles

Vibrio alginolyticus infections in the USA, 1988-2012.

Epidemiol Infect. 2017 Feb 16;:1-9

Authors: Jacobs Slifka KM, Newton AE, Mahon BE

Abstract
Vibrio alginolyticus causes soft tissue and bloodstream infection; little systematically collected clinical and epidemiological information is available. In the USA, V. alginolyticus infections are reported to the Cholera and Other Vibrio Illness Surveillance system. Using data from 1988 to 2012, we categorised infections using specimen source and exposure history, analysed case characteristics, and calculated incidence rates using US Census Bureau data. Most (96%) of the 1331 V. alginolyticus infections were from coastal states. Infections of the skin and ear were most frequent (87%); ear infections occurred more commonly in children, lower extremity infections more commonly in older adults. Most (86%) infections involved water activity. Reported incidence of infections increased 12-fold over the study period, although the extent of diagnostic or surveillance bias is unclear. Prevention efforts should target waterborne transmission in coastal areas and provider education to promote more rapid diagnosis and prevent complications.

PMID: 28202099 [PubMed - as supplied by publisher]

Feasibility and acceptability of oral cholera vaccine mass vaccination campaign in response to an outbreak and floods in Malawi.

February 12, 2017
Related Articles

Feasibility and acceptability of oral cholera vaccine mass vaccination campaign in response to an outbreak and floods in Malawi.

Pan Afr Med J. 2016;23:203

Authors: Msyamboza KP, M'bang'ombe M, Hausi H, Chijuwa A, Nkukumila V, Kubwalo HW, Desai S, Pezzoli L, Legros D

Abstract
INTRODUCTION: Despite some improvement in provision of safe drinking water, proper sanitation and hygiene promotion, cholera still remains a major public health problem in Malawi with outbreaks occurring almost every year since 1998. In response to 2014/2015 cholera outbreak, ministry of health and partners made a decision to assess the feasibility and acceptability of conducting a mass oral cholera vaccine (OCV) as an additional public health measure. This paper highlights the burden of the 2014/15 cholera outbreak, successes and challenges of OCV campaign conducted in March and April 2015.
METHODS: This was a documentation of the first OCV campaign conducted in Malawi. The campaign targeted over 160,000 people aged one year or more living in 19 camps of people internally displaced by floods and their surrounding communities in Nsanje district. It was a reactive campaign as additional measure to improved water, sanitation and hygiene in response to the laboratory confirmed cholera outbreak.
RESULTS: During the first round of the OCV campaign conducted from 30 March to 4 April 2015, a total of 156,592 (97.6%) people out of 160,482 target population received OCV. During the second round (20 to 25 April 2015), a total of 137,629 (85.8%) people received OCV. Of these, 108,247 (67.6%) people received their second dose while 29,382 (18.3%) were their first dose. Of the 134,836 people with known gender and sex who received 1 or 2 doses, 54.4% were females and over half (55.4%) were children under the age of 15 years. Among 108,237 people who received 2 doses (fully immunized), 54.4% were females and 51.9% were children under 15 years of age. No severe adverse event following immunization was reported. The main reason for non-vaccination or failure to take the 2 doses was absence during the period of the campaign.
CONCLUSION: This documentation has demonstrated that it was feasible, acceptable by the community to conduct a large-scale mass OCV campaign in Malawi within five weeks. Of 320,000 OCV doses received, Malawi managed to administer at least 294,221 (91.9%) of the doses. OCV could therefore be considered to be introduced as additional measure in cholera hot spot areas in Malawi.

PMID: 27347292 [PubMed - indexed for MEDLINE]

Assessment of the response to cholera outbreaks in two districts in Ghana.

February 9, 2017
Related Articles

Assessment of the response to cholera outbreaks in two districts in Ghana.

Infect Dis Poverty. 2016 Nov 02;5(1):99

Authors: Ohene SA, Klenyuie W, Sarpeh M

Abstract
BACKGROUND: Despite recurring outbreaks of cholera in Ghana, very little has been reported on assessments of outbreak response activities undertaken in affected areas. This study assessed the response activities undertaken in two districts, Akatsi District in Volta Region and Komenda-Edina-Eguafo-Abirem (KEEA) Municipal in Central Region during the 2012 cholera epidemic in Ghana.
METHODS: We conducted a retrospective assessment of the events, strengths and weaknesses of the cholera outbreak response activities in the two districts making use of the WHO cholera evaluation tool. Information sources included surveillance and facility records, reports and interviews with relevant health personnel involved in the outbreak response from both district health directorates and health facilities. We collected data on age, sex, area of residence, date of reporting to health facility of cholera cases, district population data and information on the outbreak response activities and performed descriptive analyses of the outbreak data by person, time and place.
RESULTS: The cholera outbreak in Akatsi was explosive with a high attack rate (AR) of 374/100,000 and case fatality rate (CFR) of 1.2 % while that in KEEA was on a relatively smaller scale AR of 23/100,000 but with a high case fatality rate of 18.8 %. For both districts, we identified multiple strengths in the response to the outbreak including timely notification of the district health officials which triggered prompt investigation of the suspected outbreak facilitating confirmation of cholera and initiation of public health response activities. Others were coordination of the activities by multi-sectoral committees, instituting water, sanitation and hygiene measures and appropriate case management at health facilities. We also found areas that needed improvement in both districts including incomplete surveillance data, sub-optimal community based surveillance considering the late reporting and the deaths in the community and the inadequate community knowledge about cholera preventive measures.
CONCLUSION: The assessment of the cholera outbreak response in the two districts highlighted strengths in the epidemic control activities. There was however need to strengthen preparedness especially in the area of improving community surveillance and awareness about cholera prevention and the importance of seeking prompt treatment in health facilities in the event of an outbreak.

PMID: 27802834 [PubMed - indexed for MEDLINE]

Pages