Recent Cholera Publications on PubMed

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Crisis-driven cholera resurgence switches focus to oral vaccine.

December 20, 2018
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Crisis-driven cholera resurgence switches focus to oral vaccine.

Bull World Health Organ. 2018 Jul 01;96(7):446-447

Authors:

Abstract
Oral rehydration was once the mainstay of treatment for cholera, but today's cholera outbreaks fuelled by conflict and instability require a new approach. Sophie Cousins reports.

PMID: 29962546 [PubMed - indexed for MEDLINE]

Forecasting the size and peak of cholera epidemic in Yemen, 2017.

December 19, 2018
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Forecasting the size and peak of cholera epidemic in Yemen, 2017.

Future Microbiol. 2018 03;13:399-402

Authors: Nishiura H, Tsuzuki S, Asai Y

PMID: 29464968 [PubMed - indexed for MEDLINE]

Association between post-diagnostic use of cholera vaccine and risk of death in prostate cancer patients.

December 18, 2018
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Association between post-diagnostic use of cholera vaccine and risk of death in prostate cancer patients.

Nat Commun. 2018 06 18;9(1):2367

Authors: Ji J, Sundquist J, Sundquist K

Abstract
Recent evidence suggests that cholera toxin might have multiple functions regarding the ability to regulate the immune system. However, it is unknown whether subsequent administration of cholera vaccine might affect the mortality rate in patients with prostate cancer. Here we report that patients in Sweden, who were diagnosed with prostate cancer between July 2005 and December 2014 and used cholera vaccine, have a decreased risk of death from prostate cancer (HR, 0.57; 95% CI, 0.40-0.82) as compared to patients with prostate cancer but without cholera vaccine use, adjusted for a range of confounding factors. In addition, patients using cholera vaccine show a decreased risk of death overall (HR, 0.53; 95% CI, 0.41-0.69). The decreased mortality rate is largely consistent, irrespective of patients' age or tumor stage at diagnosis. In this population-based study, we suggest that subsequent administration of cholera vaccine after prostate cancer diagnosis might reduce the mortality rate.

PMID: 29915319 [PubMed - indexed for MEDLINE]

Guidelines for the management of paediatric cholera infection: a systematic review of the evidence.

December 13, 2018
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Guidelines for the management of paediatric cholera infection: a systematic review of the evidence.

Paediatr Int Child Health. 2018 11;38(sup1):S16-S31

Authors: Williams PCM, Berkley JA

Abstract
Background Vibrio cholerae is a highly motile Gram-negative bacterium which is responsible for 3 million cases of diarrhoeal illness and up to 100,000 deaths per year, with an increasing burden documented over the past decade. Current WHO guidelines for the treatment of paediatric cholera infection (tetracycline 12.5 mg/kg four times daily for 3 days) are based on data which are over a decade old. In an era of increasing antimicrobial resistance, updated review of the appropriate empirical therapy for cholera infection in children (taking account of susceptibility patterns, cost and the risk of adverse events) is necessary. Methods A systematic review of the current published literature on the treatment of cholera infection in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) was undertaken. International clinical guidelines and studies pertaining to adverse effects associated with treatments available for cholera infection were also reviewed. Results The initial search produced 256 results, of which eight studies met the inclusion criteria. Quality assessment of the studies was performed as per the Grading of Recommendations Assessment, Development and Evaluation guidelines. Conclusions In view of the changing non-susceptibility rates worldwide, empirical therapy for cholera infection in paediatric patients should be changed to single-dose azithromycin (20 mg/kg), a safe and effective medication with ease of administration. Erythromycin (12.5 mg/kg four times daily for 3 days) exhibits similar bacteriological and clinical success and should be listed as a second-line therapy. Fluid resuscitation remains the cornerstone of management of paediatric cholera infection, and prevention of infection by promoting access to clean water and sanitation is paramount.

PMID: 29790841 [PubMed - indexed for MEDLINE]

Notes from the Field: Outbreak of Vibrio cholerae Associated with Attending a Funeral - Chegutu District, Zimbabwe, 2018.

December 13, 2018
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Notes from the Field: Outbreak of Vibrio cholerae Associated with Attending a Funeral - Chegutu District, Zimbabwe, 2018.

MMWR Morb Mortal Wkly Rep. 2018 May 18;67(19):560-561

Authors: McAteer JB, Danda S, Nhende T, Manamike P, Parayiwa T, Tarupihwa A, Tapfumanei O, Manangazira P, Mhlanga G, Garone DB, Martinsen A, Aubert RD, Davis W, Narra R, Balachandra S, Tippett Barr BA, Mintz E

PMID: 29771875 [PubMed - indexed for MEDLINE]

Theorizing medical practice for India.

December 13, 2018
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Theorizing medical practice for India.

Natl Med J India. 2017 Jul-Aug;30(4):183-186

Authors: Jacob KS

PMID: 29162748 [PubMed - indexed for MEDLINE]

cholera epidemiology; +12 new citations

December 12, 2018

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cholera epidemiology

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A prospective cohort study comparing household contact and water Vibrio cholerae isolates in households of cholera patients in rural Bangladesh.

November 28, 2018
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A prospective cohort study comparing household contact and water Vibrio cholerae isolates in households of cholera patients in rural Bangladesh.

PLoS Negl Trop Dis. 2018 07;12(7):e0006641

Authors: George CM, Hasan K, Monira S, Rahman Z, Saif-Ur-Rahman KM, Rashid MU, Zohura F, Parvin T, Islam Bhuyian MS, Mahmud MT, Li S, Perin J, Morgan C, Mustafiz M, Sack RB, Sack DA, Stine OC, Alam M

Abstract
BACKGROUND: Household contacts of cholera patients are at a 100 times higher risk of developing cholera than the general population. The objective of this study was to examine the incidence of V. cholerae infections among household contacts of cholera patients in a rural setting in Bangladesh, to identify risk factors for V. cholerae infections among this population, and to investigate transmission pathways of V. cholerae using multilocus variable-number tandem-repeat analysis (MLVA).
METHODOLOGY/PRINCIPAL FINDINGS: Stool from household contacts, source water and stored water samples were collected from cholera patient households on Day 1, 3, 5, and 7 after the presentation of the index patient at a health facility. Two hundred thirty clinical and water V. cholerae isolates were analyzed by MLVA. Thirty seven percent of households had at least one household contact with a V. cholerae infection. Thirteen percent of households had V. cholerae in their water source, and 27% had V. cholerae in stored household drinking water. Household contacts with V. cholerae in their water source had a significantly higher odds of symptomatic cholera (Odds Ratio (OR): 5.49, 95% Confidence Interval (CI): 1.07, 28.08). Contacts consuming street vended food had a significantly higher odds of a V. cholerae infection (OR: 9.45, 95% CI: 2.14, 41.72). Older age was significantly associated with a lower odds of a V. cholerae infection (OR: 0.96, 95% CI: 0.93, 0.99). Households with both water and clinical V. cholerae-positive samples all had isolates that were closely related by MLVA.
CONCLUSIONS/SIGNIFICANCE: These findings emphasize the need for interventions targeting water treatment and food hygiene to reduce V. cholerae infections.

PMID: 30052631 [PubMed - indexed for MEDLINE]

Biofilm formation and avian immune response following experimental acute and chronic avian cholera due to Pasteurella multocida.

November 21, 2018
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Biofilm formation and avian immune response following experimental acute and chronic avian cholera due to Pasteurella multocida.

Vet Microbiol. 2018 Aug;222:114-123

Authors: Petruzzi B, Dalloul RA, LeRoith T, Evans NP, Pierson FW, Inzana TJ

Abstract
Pasteurella multocida is the causative agent of avian cholera, an important economic and ecological disease that can present as a peracute, acute, chronic, or asymptomatic infection. Acute avian cholera is associated with encapsulated P. multocida, while chronic and asymptomatic cases of avian cholera may be associated with capsule-deficient P. multocida isolates. We hypothesize that biofilm formation is also associated with chronic and asymptomatic avian cholera. Experimental infections of chickens with encapsulated, biofilm-deficient P. multocida strain X73, proficient biofilm forming P. multocida strain X73ΔhyaD, and proficient biofilm forming clinical strains 775 and 756 showed that virulence was inversely correlated with biofilm formation. Biofilm-proficient isolates induced chronic avian cholera in the chicken host. Histopathological analysis was used to show that biofilm-proficient isolates induced little inflammation in the lungs, heart, and liver, while biofilm-deficient isolates induced greater inflammation and induced the recruitment of heterophil granulocytes. Putative biofilm matrix material and exopolysaccharide was detected in pulmonary tissue of chickens diagnosed with chronic avian cholera using scanning electron microscopy and a fluorescently-tagged lectin, respectively, supporting a role for biofilm in chronic avian cholera. P. multocida induced Th1 and Th17 immune responses during acute and chronic avian cholera, as determined by quantitative real-time PCR of splenic cytokine genes. Chickens that succumbed to acute avian cholera after experimental challenge with strain X73 had high levels of INF-γ, IL-1β, IL-6, IL-12A, IL-22, IL-17A, and IL-17RA expressed in the spleen compared to all other experimental groups. Birds infected with capsule-deficient strains had chronic infections lasting 7 days or longer, and had increased levels of IL-17RA, CCR6, and IL-16 compared to non-infected control chickens. However, specific antibody titers increased only transiently to capsule-deficient strains and were low, indicating that antibodies are less important in managing and clearing P. multocida infections.

PMID: 30080666 [PubMed - indexed for MEDLINE]

Oral cholera vaccine in cholera prevention and control, Malawi.

November 16, 2018
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Oral cholera vaccine in cholera prevention and control, Malawi.

Bull World Health Organ. 2018 Jun 01;96(6):428-435

Authors: M'bangombe M, Pezzoli L, Reeder B, Kabuluzi S, Msyamboza K, Masuku H, Ngwira B, Cavailler P, Grandesso F, Palomares A, Beck N, Shaffer A, MacDonald E, Senbete M, Lessler J, Moore SM, Azman AS

Abstract
Problem: With limited global supplies of oral cholera vaccine, countries need to identify priority areas for vaccination while longer-term solutions, such as water and sanitation infrastructure, are being developed.
Approach: In 2017, Malawi integrated oral cholera vaccine into its national cholera control plan. The process started with a desk review and analysis of previous surveillance and risk factor data. At a consultative meeting, researchers, national health and water officials and representatives from nongovernmental and international organizations reviewed the data and local epidemiological knowledge to determine priority districts for oral cholera vaccination. The final stage was preparation of an application to the global oral cholera vaccine stockpile for non-emergency use.
Local setting: Malawi collects annual data on cholera and most districts have reported cases at least once since the 1970s.
Relevant changes: The government's application for 3.2 million doses of vaccine to be provided over 20 months in 12 districts was accepted in April 2017. By April 2018, over 1 million doses had been administered in five districts. Continuing surveillance in districts showed that cholera outbreaks were notably absent in vaccinated high-risk areas, despite a national outbreak in 2017-2018.
Lessons learnt: Augmenting advanced mapping techniques with local information helped us extend priority areas beyond those identified as high-risk based on cholera incidence reported at the district level. Involvement of the water, sanitation and hygiene sectors is key to ensuring that short-term gains from cholera vaccine are backed by longer-term progress in reducing cholera transmission.

PMID: 29904226 [PubMed - indexed for MEDLINE]

AlmG, responsible for polymyxin resistance in pandemic Vibrio cholerae, is a glycyltransferase distantly related to lipid A late acyltransferases.

November 15, 2018
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AlmG, responsible for polymyxin resistance in pandemic Vibrio cholerae, is a glycyltransferase distantly related to lipid A late acyltransferases.

J Biol Chem. 2017 12 22;292(51):21205-21215

Authors: Henderson JC, Herrera CM, Trent MS

Abstract
Cationic antimicrobial peptides (CAMPs), such as polymyxins, are used as a last-line defense in treatment of many bacterial infections. However, some bacteria have developed resistance mechanisms to survive these compounds. Current pandemic O1 Vibrio cholerae biotype El Tor is resistant to polymyxins, whereas a previous pandemic strain of the biotype Classical is polymyxin-sensitive. The almEFG operon found in El Tor V. cholerae confers >100-fold resistance to antimicrobial peptides through aminoacylation of lipopolysaccharide (LPS), expected to decrease the negatively charged surface of the V. cholerae outer membrane. This Gram-negative system bears striking resemblance to a related Gram-positive cell-wall remodeling strategy that also promotes CAMP resistance. Mutants defective in AlmEF-dependent LPS modification exhibit reduced fitness in vivo Here, we present investigation of AlmG, the hitherto uncharacterized member of the AlmEFG pathway. Evidence for AlmG glycyl to lipid substrate transferase activity is demonstrated in vivo by heterologous expression of V. cholerae pathway enzymes in a specially engineered Escherichia coli strain. Development of a minimal keto-deoxyoctulosonate (Kdo)-lipid A domain in E. coli was necessary to facilitate chemical structure analysis and to produce a mimetic Kdo-lipid A domain AlmG substrate to that synthesized by V. cholerae. Our biochemical studies support a uniquely nuanced pathway of Gram-negative CAMPs resistance and provide a more detailed description of an enzyme of the pharmacologically relevant lysophosphospholipid acyltransferase (LPLAT) superfamily.

PMID: 29101229 [PubMed - indexed for MEDLINE]

Untangling the causes of the 2016-18 Cholera epidemic in Yemen.

November 8, 2018
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Untangling the causes of the 2016-18 Cholera epidemic in Yemen.

Lancet Glob Health. 2018 06;6(6):e600-e601

Authors: Gormley M

PMID: 29731399 [PubMed - indexed for MEDLINE]

Reviving Phage Therapy for the Treatment of Cholera.

November 6, 2018
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Reviving Phage Therapy for the Treatment of Cholera.

J Infect Dis. 2018 Nov 03;:

Authors: Bhandare S, Colom J, Baig A, Ritchie JM, Bukhari H, Shah MA, Sarkar BL, Su J, Wren B, Barrow P, Atterbury RJ

Abstract
Cholera remains a major risk in developing countries, particularly after natural or man-made disasters. Vibrio cholerae El Tor is the most important cause of these outbreaks, and is becoming increasingly resistant to antibiotics, so alternative therapies are urgently needed. In this study, a single bacteriophage, Phi_1, was used to control cholera prophylactically and therapeutically in an infant rabbit model. In both cases, phage-treated animals showed no clinical signs of disease, compared with 69% of untreated control animals. Bacterial counts in the intestines of phage-treated animals were reduced by up to 4 log10 colony-forming units/g. There was evidence of phage multiplication only in animals that received a V. cholerae challenge. No phage-resistant bacterial mutants were isolated from the animals, despite extensive searching. This is the first evidence that a single phage could be effective in the treatment of cholera, without detectable levels of resistance. Clinical trials in human patients should be considered.

PMID: 30395214 [PubMed - as supplied by publisher]

Detection of Uncommon Enteric Bacterial Pathogens from Acute Diarrheal Specimens using SYBR-Green Real Time PCR.

November 2, 2018
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Detection of Uncommon Enteric Bacterial Pathogens from Acute Diarrheal Specimens using SYBR-Green Real Time PCR.

Jpn J Infect Dis. 2018 Oct 31;:

Authors: Chowdhury G, Stine OC, Rajendran K, Mukhopadhyay AK, Okamoto K, Ramamurthy T

Abstract
Acute diarrheal disease is a major health problem and second most common cause of death in children under five years of age. Conventional diagnostic methods are laborious, time consuming and occasionally inaccurate. We examined SYBR-Green real-time PCR for the detection of ten uncommon bacterial pathogens using fecal specimens from acute diarrheal patients. In SYBR-Green real-time PCR, the products formed were identified based on melting point temperature (Tm) curve analysis and was validated with the respective reference strain. In a retrospective study, 1184 tested stool specimens by conventional culture methods were included. Enterotoxigenic Bacteriodes fragilis was detected more (6.7%) followed by enterotoxigenic Bacillus cereus (5.1%), Clostridium perfringens (3.9%) and Aeromonas hydrophila (3.8%). In the prospective study, A. hydrophila, S. aureus, and C. perfringens, were predominantly detected in >5 years age group by the real-time PCR. The real-time PCR assay is comprehensive, rapid, accurate and well suited for surveillance or diagnostic purpose for detection of uncommon bacterial pathogens and also helpful in initiating appropriate care and thereby reducing the risk of the patients.

PMID: 30381678 [PubMed - as supplied by publisher]

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