Active surveillance for Vibrio cholerae O1 and vibriophages in sewage water as a potential tool to predict cholera outbreaks

Abstract

The 1991 Peruvian cholera epidemic has thus far been responsible for 600,000 cholera cases in Peru. In an attempt to design a cholera surveillance program in the capital city of Lima, weekly sewage samples were collected between August 1993 and May 1996 and examined for the presence of Vibrio cholerae O1 bacteria and V. cholerae O1 bacteriophages (i.e., vibriophages). During the 144 weeks of surveillance, 6,323 cases of clinically defined cholera were recorded in Lima. We arbitrarily defined an outbreak as five or more reported cases of cholera in a week. The odds of having an outbreak were 7.6 times greater when V. cholerae O1 was present in sewage water during the four previous weeks compared with when it was not (P < 0.001). Furthermore, the odds of having an outbreak increased as the number of V. cholerae O1 isolations during the previous 4 weeks increased (P < 0.001). The odds of having an outbreak were 2.4 times greater when vibriophages were present in sewage water during the four previous weeks compared with when they were not, but this increase was not statistically significant (P ‫؍‬ 0.15). The odds of having an outbreak increased as the number of vibriophage isolations during the previous 4 weeks increased (P < 0.05). The signaling of a potential cholera outbreak 1 month in advance may be a valuable tool for the implementation of preventive measures. In Peru, active surveillance for V. cholerae O1 and possibly vibriophages in sewage water appears to be a feasible and effective means of predicting an outbreak of cholera.

An Analytical Method for Trifluoroacetic Acid in Water and Air Samples Using Headspace Gas Chromatographic Determination of the Methyl Ester

“…V. cholerae strain 0139 was the causative agent of a waterborne epidemic of cholera in south India (Ramakrishna et al, 1996). Routine monitoring of wastewater samples for V. eholerae 01 and vibriophages was useful in predicting and controlling the outbreak of cholera in Peru, where the disease has been epidemic since 1991 (Madico et al, 1996). Dalsgaard et al (1996) compared a commercial biochemical kit (API 20E) with an oligonucleotide probe for the identification of V. vulnificus from environmental samples.…”

Surveillance of vibriophages reveals their role as biomonitoring agents in Kolkata

“…Although no comprehensive studies have been carried out to look for V. cholerae O1‐ and O139‐specific phages in freshwater environments in Kolkata, to our knowledge, this is the first study to prove that the surveillance of vibriophages reveals the presence of V. cholerae O1 and O139, in particular, in the water bodies in and around Kolkata even if there is no clinical cholera cases caused by V. cholerae O139. It should be mentioned here that several earlier works have been reported on the relationship between environmental cholera phages and seasonal epidemics of cholera (Madico et al , 1996; Faruque et al , 2005a, b; Jensen et al , 2006).…”

Isolation of Laribacter hongkongensis, a novel bacterium associated with gastroenteritis, from drinking water reservoirs in Hong Kong

“…In particular, epidemics of Vibrio cholerae are most well known to be associated with contaminated water sources (Acosta et al 2001;Beatty et al 2004). Moreover, active surveillance for V. cholerae O1 and vibriophages in sewage water has been shown to be a potentially useful tool to predict cholera outbreaks (Madico et al 1996). Although the significance of Aeromonas in drinking water with respect to the occurrence of acute gastroenteritis remains debatable (Leclerc et al 2002), cases of water-related infections have been reported (Filler et al 2000).…”