Recent Cholera Publications on PubMed

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The challenges of cholera at the 2017 Hajj pilgrimage.

October 12, 2018
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The challenges of cholera at the 2017 Hajj pilgrimage.

Lancet Infect Dis. 2017 09;17(9):895-897

Authors: Zumla A, McCloskey B, Endericks T, Azhar EI, Petersen E

PMID: 28803813 [PubMed - indexed for MEDLINE]

A self-quenching-resistant carbon nanodot powder with multicolored solid-state fluorescence for ultra-fast staining of various representative bacterial species within one minute.

October 6, 2018
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A self-quenching-resistant carbon nanodot powder with multicolored solid-state fluorescence for ultra-fast staining of various representative bacterial species within one minute.

Nanoscale. 2016 Dec 01;8(47):19744-19753

Authors: Zhang Y, Li C, Fan Y, Wang C, Yang R, Liu X, Zhou L

Abstract
In this study, we prepared self-quenching-resistant solid-state fluorescent carbon nanodots (SFCDs) without any other solid matrices. The SFCDs were prepared using a one-step microwave synthesis method through precise control of the heating power and time. The resulting SFCD powder showed excitation-dependent emission behavior with a maximum fluorescence quantum yield of 40%. The multicolored SFCDs were successfully used as fluorescent agents for rapid staining of 14 representative bacterial species, including Gram-negative, Gram-positive, and acid-fast bacteria. Moreover, some pathogenic bacteria, including Bacillus anthracis (vegetative cells and endospores), Yersinia pestis, Vibrio cholera O1, Listeria monocytogenes, Neisseria meningitidis, and Klebsiella pneumoniae, could all be stained within just 1 min by the smear staining method without any incubation, which was also applicable by using the liquid incubation method. Moreover, excellent staining quality, superior resistance to photobleaching, high stability in solutions of different pH values, and low toxicity were also demonstrated.

PMID: 27874136 [PubMed - indexed for MEDLINE]

UNstoppable: How Advocates Persevered in the Fight for Justice for Haitian Cholera Victims.

October 4, 2018
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UNstoppable: How Advocates Persevered in the Fight for Justice for Haitian Cholera Victims.

Health Hum Rights. 2017 Jun;19(1):299-304

Authors: Houston A

PMID: 28630562 [PubMed - indexed for MEDLINE]

Cyclical cholera outbreaks in Ghana: filth, not myth.

October 3, 2018
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Cyclical cholera outbreaks in Ghana: filth, not myth.

Infect Dis Poverty. 2018 Jun 15;7(1):51

Authors: Mireku-Gyimah N, Apanga PA, Awoonor-Williams JK

Abstract
BACKGROUND: Ranked among the world's dirtiest countries, Ghana has poor environmental sanitation and hygiene, and a lack of potable water, all of which combined have been largely blamed as the underscoring reasons for cholera outbreaks. The country has concomitantly suffered seasonal cholera outbreaks that have impacted negatively on the population's health, as well as on the nation's economy. To prevent cyclical cholera outbreaks in Ghana, this commentary discusses the associated problems and makes recommendations to solve them.
MAIN BODY: This commentary aims to throw light on the menace of cholera in Ghana and the need to curb the recurrence of outbreaks and bouts of this epidemic. Response measures, challenges, and lessons learnt from the most recent cholera outbreak are critically assessed to determine how best this public health issue could be resolved. General and specific policy recommendations are identified in this regard.
CONCLUSION: To resolve this problem, there is a need for an oral cholera vaccine to be introduced. There is also a need to develop strategies and interventions relating to water, sanitation, and hygiene, to be initiated by the Ministry of Health, with component activities that are culturally tailored to Ghanaian communities. Policy change towards the prevention of outbreaks in Ghana is identified as another requisite.

PMID: 29903037 [PubMed - indexed for MEDLINE]

Treating cholera in severely malnourished children in the Horn of Africa and Yemen.

October 2, 2018
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Treating cholera in severely malnourished children in the Horn of Africa and Yemen.

Lancet. 2017 Oct 28;390(10106):1945-1946

Authors: Ververs M, Narra R

PMID: 28988791 [PubMed - indexed for MEDLINE]

Feasibility, coverage and cost of oral cholera vaccination conducted by icddr,b using the existing national immunization service delivery mechanism in rural setting Keraniganj, Bangladesh.

September 28, 2018
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Feasibility, coverage and cost of oral cholera vaccination conducted by icddr,b using the existing national immunization service delivery mechanism in rural setting Keraniganj, Bangladesh.

Hum Vaccin Immunother. 2018 Sep 27;:

Authors: Khan AI, Khan IA, Siddique SA, Rahman A, Islam MT, Bhuiya MAI, Saha NC, Biswas PK, Saha A, Chowdhury F, Qadri F

Abstract
BACKGROUND: Cholera is a considerable health burden in developing country settings including Bangladesh. The oral cholera vaccine (OCV) is a preventative tool to control the disease. The objective of this study was to describe whether the International Centre for Diarrheal Disease Research, Bangladesh (icddr,b), could provide the OCV to rural communities using existing government infrastructure.
METHODS: The study was conducted in rural sub-district Keraniganj, 20 km from the capital city Dhaka. All listed participants one year and above in age (excluding pregnant women) were offered two doses of OCV at a 14 day interval. Existing government facilities were used to deliver and also maintain the cold chain required for the vaccine. All events related to vaccination were recorded at the 17 vaccination sites to evaluate the coverage and feasibility of OCV program.
RESULTS: A total of 29,029 individuals received the 1st dose (90% of target) and 26,611 individuals received the 2nd dose (83% of target and 92% of 1st dose individuals) of OCV. The highest vaccination coverage was in younger children (1-9 years) and the lowest was amongst 18-29-year age group. Somewhat better coverage was seen amongst the female participants than males (92% vs. 88% for the 1st dose and 93% vs. 90% for the 2nd dose). The cost of vaccine cost was calculated as US$1.00 per dose plus freight, insurance, and transportation and the total vaccine delivery cost was US$70,957.
CONCLUSION: This was a project undertaken using existing public health program resources to collect empirical evidence on the use of a mass OCV campaign in the rural setting. Mass vaccination with the OCV is feasible in the rural setting using existing governmental vaccine delivery systems in Bangladesh.

PMID: 30261152 [PubMed - as supplied by publisher]

Cholera.

September 28, 2018
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Cholera.

Lancet. 2017 Sep 23;390(10101):1539-1549

Authors: Clemens JD, Nair GB, Ahmed T, Qadri F, Holmgren J

Abstract
Cholera is an acute, watery diarrhoeal disease caused by Vibrio cholerae of the O1 or O139 serogroups. In the past two centuries, cholera has emerged and spread from the Ganges Delta six times and from Indonesia once to cause global pandemics. Rational approaches to the case management of cholera with oral and intravenous rehydration therapy have reduced the case fatality of cholera from more than 50% to much less than 1%. Despite improvements in water quality, sanitation, and hygiene, as well as in the clinical treatment of cholera, the disease is still estimated to cause about 100 000 deaths every year. Most deaths occur in cholera-endemic settings, and virtually all deaths occur in developing countries. Contemporary understanding of immune protection against cholera, which results from local intestinal immunity, has yielded safe and protective orally administered cholera vaccines that are now globally stockpiled for use in the control of both epidemic and endemic cholera.

PMID: 28302312 [PubMed - indexed for MEDLINE]

Cholera outbreak in the horn of Africa.

September 25, 2018
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Cholera outbreak in the horn of Africa.

Lancet. 2017 Jun 03;389(10085):2179

Authors: Green A

PMID: 28589885 [PubMed - indexed for MEDLINE]

Progress and Challenges in Using Oral Cholera Vaccines to Control Outbreaks: The Médecins Sans Frontières Experience.

September 22, 2018
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Progress and Challenges in Using Oral Cholera Vaccines to Control Outbreaks: The Médecins Sans Frontières Experience.

J Infect Dis. 2018 Sep 14;:

Authors: Ciglenecki I, Azman AS, Jamet C, Serafini M, Luquero FJ, Cabrol JC

Abstract
The use of oral cholera vaccine (OCV) has increased since 2011, when Shanchol, the first OCV suitable for large-scale use, became available. Médecins Sans Frontières considers OCVs an essential cholera outbreak control tool and has contributed to generating new evidence on OCV use in outbreaks. We showed that large-scale mass campaigns are feasible during outbreaks, documented high short-term effectiveness and showed that vaccines are likely safe in pregnancy. We found that a single-dose regimen has high short-term effectiveness, making rapid delivery of vaccine during outbreaks easier, especially given the on-going global vaccine shortage. Despite progress, OCV has still not been used widely in some of the largest recent outbreaks and thousands of cholera deaths are reported every year. While working towards improving our tools to protect those most at-risk of cholera, we must strive to use all available effective interventions in efficient ways, including OCV, to prevent avoidable deaths today.

PMID: 30239901 [PubMed - as supplied by publisher]

The Epidemiology of Cholera in Zanzibar: Implications for the Zanzibar Comprehensive Cholera Elimination Plan.

September 22, 2018
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The Epidemiology of Cholera in Zanzibar: Implications for the Zanzibar Comprehensive Cholera Elimination Plan.

J Infect Dis. 2018 Sep 19;:

Authors: Bi Q, Abdalla FM, Masauni S, Reyburn R, Msambazi M, Deglise C, von Seidlein L, Deen J, Jiddawi MS, Olson D, Nemes I, Taib JA, Lessler J, Andemichael GR, Azman AS

Abstract
Background: Cholera poses a public health and economic threat to Zanzibar. Detailed epidemiologic analyses are needed to inform a multisectoral cholera elimination plan currently under development.
Methods: We collated passive surveillance data from 1997 to 2017 and calculated the outbreak-specific and cumulative incidence of suspected cholera per shehia (neighborhood). We explored the variability in shehia-specific relative cholera risk and explored the predictive power of targeting intervention at shehias based on historical incidence. Using flexible regression models, we estimated cholera's seasonality and the relationship between rainfall and cholera transmission.
Results: From 1997 and 2017, 11921 suspected cholera cases were reported across 87% of Zanzibar's shehias, representing an average incidence rate of 4.4 per 10000/year. The geographic distribution of cases across outbreaks was variable, although a number of high-burden areas were identified. Outbreaks were highly seasonal with 2 high-risk periods corresponding to the annual rainy seasons.
Conclusions: Shehia-targeted interventions should be complemented with island-wide cholera prevention activities given the spatial variability in cholera risk from outbreak to outbreak. In-depth risk factor analyses should be conducted in the high-burden shehias. The seasonal nature of cholera provides annual windows of opportunity for cholera preparedness activities.

PMID: 30239836 [PubMed - as supplied by publisher]

Cholera in Yemen: war, hunger, disease…and heroics.

September 21, 2018
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Cholera in Yemen: war, hunger, disease…and heroics.

Lancet Infect Dis. 2017 08;17(8):781

Authors: The Lancet Infectious Diseases

PMID: 28741538 [PubMed - indexed for MEDLINE]

Cholera in Yemen.

September 21, 2018
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Cholera in Yemen.

Lancet Infect Dis. 2017 07;17(7):700-701

Authors: Balakrishnan VS

PMID: 28737493 [PubMed - indexed for MEDLINE]

What information and the extent of information research participants need in informed consent forms: a multi-country survey.

September 17, 2018
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What information and the extent of information research participants need in informed consent forms: a multi-country survey.

BMC Med Ethics. 2018 Sep 15;19(1):79

Authors: Karbwang J, Koonrungsesomboon N, Torres CE, Jimenez EB, Kaur G, Mathur R, Sholikhah EN, Wanigatunge C, Wong CS, Yimtae K, Abdul Malek M, Ahamad Fouzi L, Ali A, Chan BZ, Chandratilake M, Chiew SC, Chin MYC, Gamage M, Gitek I, Hakimi M, Hussin N, Jamil MFA, Janarsan P, Julia M, Kanungo S, Karunanayake P, Kollanthavelu S, Kong KK, Kueh BL, Kulkarni R, Kumaran PP, Kumarasiri R, Lim WH, Lim XJ, Mahmud F, Mantaring JBV, Md Ali SM, Mohd Noor N, Muhunthan K, Nagandran E, Noor M, Ooi KH, Pradeepan JA, Sadewa AH, Samaranayake N, Sri Ranganathan S, Subasingha W, Subramaniam S, Sulaiman N, Tay JF, Teng LH, Tew MM, Tharavanij T, Tok PSK, Weeratna J, Wibawa T, Wickremasinghe R, Wongwai P, Yadav S, FERCAP Multi-Country Research Team

Abstract
BACKGROUND: The use of lengthy, detailed, and complex informed consent forms (ICFs) is of paramount concern in biomedical research as it may not truly promote the rights and interests of research participants. The extent of information in ICFs has been the subject of debates for decades; however, no clear guidance is given. Thus, the objective of this study was to determine the perspectives of research participants about the type and extent of information they need when they are invited to participate in biomedical research.
METHODS: This multi-center, cross-sectional, descriptive survey was conducted at 54 study sites in seven Asia-Pacific countries. A modified Likert-scale questionnaire was used to determine the importance of each element in the ICF among research participants of a biomedical study, with an anchored rating scale from 1 (not important) to 5 (very important).
RESULTS: Of the 2484 questionnaires distributed, 2113 (85.1%) were returned. The majority of respondents considered most elements required in the ICF to be 'moderately important' to 'very important' for their decision making (mean score, ranging from 3.58 to 4.47). Major foreseeable risk, direct benefit, and common adverse effects of the intervention were considered to be of most concerned elements in the ICF (mean score = 4.47, 4.47, and 4.45, respectively).
CONCLUSIONS: Research participants would like to be informed of the ICF elements required by ethical guidelines and regulations; however, the importance of each element varied, e.g., risk and benefit associated with research participants were considered to be more important than the general nature or technical details of research. Using a participant-oriented approach by providing more details of the participant-interested elements while avoiding unnecessarily lengthy details of other less important elements would enhance the quality of the ICF.

PMID: 30219106 [PubMed - in process]

A Multisectoral Emergency Response Approach to a Cholera Outbreak in Zambia: October 2017-February 2018.

September 15, 2018
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A Multisectoral Emergency Response Approach to a Cholera Outbreak in Zambia: October 2017-February 2018.

J Infect Dis. 2018 Sep 11;:

Authors: Kapata N, Sinyange N, Mazaba ML, Musonda K, Hamoonga R, Kapina M, Zyambo K, Malambo W, Yard E, Riggs M, Narra R, Murphy J, Brunkard J, Azman AS, Monze N, Malama K, Mulwanda J, Mukonka VM

PMID: 30215738 [PubMed - as supplied by publisher]

Vaccination against cholera in Juba - Authors' reply.

September 15, 2018
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Vaccination against cholera in Juba - Authors' reply.

Lancet Infect Dis. 2017 05;17(5):480-481

Authors: Ciglenecki I, Azman AS, Rumunu J, Cabrol JC, Luquero FJ

PMID: 28447952 [PubMed - indexed for MEDLINE]

Vaccination against cholera in Juba.

September 15, 2018
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Vaccination against cholera in Juba.

Lancet Infect Dis. 2017 05;17(5):479-480

Authors: Rebaudet S, Gaudart J, Piarroux R

PMID: 28447951 [PubMed - indexed for MEDLINE]

A MOOC as an immediate strategy to train health personnel in the cholera outbreak in Mexico.

September 13, 2018
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A MOOC as an immediate strategy to train health personnel in the cholera outbreak in Mexico.

BMC Med Educ. 2018 May 16;18(1):111

Authors: Magaña-Valladares L, Rosas-Magallanes C, Montoya-Rodríguez A, Calvillo-Jacobo G, Alpuche-Arande CM, García-Saisó S

Abstract
BACKGROUND: In September 2013, two cases of cholera were reported in Mexico; 1 week later, a new outbreak was reported in the Huasteca region of Hidalgo. Upon the determination that the diagnostic and therapeutic interventions implemented by health personnel overlooked predefined procedures, the National Institute of Public Health, in coordination with the Ministry of Health, immediately designed the massive open online course "Proper cholera containment and management measures" to strengthen and standardize basic prevention and control practices.
METHODS: During the first 5 months, 35,968 participants from across the country finished the course: medical and nursing personnel, health promoters, and hospital staff. To understand the magnitude of the data, an analysis was performed to calculate the MOOC coverage, and multiple linear regression models were generated to relate the score earned in the course to the characteristics of the participants. In addition, a qualitative analysis was performed to identify the dissemination of information, technological barriers, and feedback on course design. A total of 17% of participants were from the state where the outbreak originated, and 33.5% were from its neighboring states.
RESULTS: This study shows that the need for information is greater when an emergency occurs, and the involvement of the authorities increased the extent of the training response.
CONCLUSION: A MOOC can be a useful training strategy to prepare personnel for emergency situations.

PMID: 29769059 [PubMed - indexed for MEDLINE]

Vibrio cholerae O1 with ctxB7 variant genotype acquired qnrVC mediated ciprofloxacin resistance in Yavatmal, India.

September 13, 2018
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Vibrio cholerae O1 with ctxB7 variant genotype acquired qnrVC mediated ciprofloxacin resistance in Yavatmal, India.

Clin Microbiol Infect. 2017 12;23(12):1005-1006

Authors: Kumar P, Yadav P, Deshmukh DG, Bulle PA, Singh D, Singh N, Sharma KK, Jain M, Ingole KV, Goel AK, Yadava PK

PMID: 28648857 [PubMed - indexed for MEDLINE]

Dissemination of newly emerged polymyxin B sensitive Vibrio cholerae O1 containing Haitian-like genetic traits in different parts of India.

September 12, 2018
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Dissemination of newly emerged polymyxin B sensitive Vibrio cholerae O1 containing Haitian-like genetic traits in different parts of India.

J Med Microbiol. 2018 Sep;67(9):1326-1333

Authors: Samanta P, Saha RN, Chowdhury G, Naha A, Sarkar S, Dutta S, Nandy RK, Okamoto K, Mukhopadhyay AK

Abstract
PURPOSE: Two natural epidemic biotypes of Vibrio cholerae O1, classical and El Tor, exhibit different patterns of sensitivity against the antimicrobial peptide polymyxin B. This difference in sensitivity has been one of the major markers in biotype classification system for several decades. A recent report regarding the emergence of polymyxin B-sensitive El Tor V. cholerae O1 in Kolkata has motivated us to track the spread of the strains containing this important trait, along with Haitian-like genetic content, in different parts of India.
METHODOLOGY: We have collected 260 clinical V. cholerae O1 strains from 12 states in India and screened them for polymyxin B susceptibility. Genetic characterization was also performed to study the tcpA, ctxB and rtxA genotypes by allele-specific polymerase chain reaction (PCR) and nucleotide sequencing.
RESULTS: Interestingly, 88.85 % of the isolates were found to be sensitive to polymyxin B. All of the states, with the exception of Assam, had polymyxin B-sensitive V. cholerae strains and complete replacement with this strain was found in eight of the states. However, from 2016 onwards, all the strains tested showed sensitivity to polymyxin B. Allele-specific PCR and sequencing confirmed that all strains possessed Haitian-like genetic traits.
CONCLUSION: Polymyxin B-sensitive strains have begun to spread throughout India and may lead to the revision of the biotype classification. The dissemination of these new variant strains needs to be carefully monitored in different endemic populations through active holistic surveillance to understand their clinical and epidemiological consequences.

PMID: 29927375 [PubMed - indexed for MEDLINE]

Safety and immunogenicity of single-dose live oral cholera vaccine strain CVD 103-HgR in healthy adults age 18-45.

September 12, 2018
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Safety and immunogenicity of single-dose live oral cholera vaccine strain CVD 103-HgR in healthy adults age 18-45.

Vaccine. 2018 02 01;36(6):833-840

Authors: McCarty JM, Lock MD, Hunt KM, Simon JK, Gurwith M

Abstract
The attenuated recombinant Vibrio cholerae O1 vaccine strain CVD 103-HgR, re-developed as PXVX0200, elicits a rapid serum vibriocidal antibody (SVA) response and protects against cholera diarrhea in volunteer challenge studies. We performed a phase 3, placebo controlled, double blind, multi-center study to further assess the safety, immunogenicity, and lot-to-lot consistency of PXVX0200. Adult volunteers 18-45 years of age were randomized 8:1 to receive a single dose of 1 × 109 CFU of PXVX0200 from three production lots or saline placebo. Immunogenicity endpoints included SVA and anti-cholera toxin (CT) antibody levels on days 1, 11, 29, 91 and 181. Safety was assessed by comparing solicited signs and symptoms on days 1-8, unsolicited adverse events through day 29 and serious adverse events through day 181. A total of 3146 participants were enrolled, including 2795 vaccine and 351 placebo recipients. The SVA seroconversion rates at day 11 were 94% and 4% in the PXVX0200 and placebo recipients, respectively (P < .0001). Cumulative SVA seroconversion occurred among 96% of vaccine recipients. PXVX0200 SVA GMTs peaked on day 11 and remained significantly higher than placebo through day 181 while the fold-rise over baseline in PXVX0200 anti-CT antibody was significantly greater than placebo at every post-vaccination time point. Most reactogenicity was mild and resolved within 1-3 days with headache and diarrhea more frequently reported in PXVX0200 recipients. There were no differences in unsolicited adverse events and no study-related serious adverse events. Immunogenicity and safety endpoints were equivalent between the three production lots. PXVX0200 is immunogenic and well tolerated across multiple production lots.
CLINICAL TRIALS REGISTRATION: Clinicaltrials.gov NCT02094586.

PMID: 29317118 [PubMed - indexed for MEDLINE]

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