Cholera in Lima, Peru, Correlates with Prior Isolation of Vibrio cholerae from the Environment

Aa, Franco; Ad, Fix; Prada, Ana; Paredes, Eduar Bravo; Jc, Palomino; Wright, AC; Johnson, J. A.; McCarter, Robert; Guerra, Humberto; Jg, Morris

doi:10.1093/oxfordjournals.aje.a009235

Cited by 67 publications

(38 citation statements)

References 16 publications

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“…The same probe but with a nonradioactive label was used in a study conducted in Lima, Peru, where all ctx probe-positive colonies were V. cholerae, confirmed by standard microbiological methods (13). Based on these results, and the exclusion from analysis of any filters lacking clear positive and negative control results, the probe data provide a reasonable estimate of total ctx-positive V. cholerae present in the samples examined.…”

Section: Resultsmentioning

confidence: 86%

“…Cholera toxin oligonucleotide labeling. For these studies we utilized a DNA oligonucleotide probe that has been shown to have essentially 100% sensitivity and specificity for the cholera toxin gene (ctx) in prior laboratory and field studies (13). Of particular note, the probe is drawn from a portion of ctx that is divergent from the Escherichia coli heat-labile toxin (LT) gene, permitting differentiation between strains carrying cholera toxin and heat-labile toxin genes (13).…”

Section: Methodsmentioning

confidence: 99%

“…Notably, it has been established by remote sensing, employing satellites, that sea surface temperature and sea surface height are correlated with cholera epidemics (9,24). Studies in Lima, Peru, have also suggested that increasing water temperature can serve as a trigger for the occurrence of epidemic disease (13,14).…”

mentioning

confidence: 99%

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Critical Factors Influencing the Occurrence of Vibrio cholerae in the Environment of Bangladesh

Huq

Sack

Nizam

et al. 2005

Appl Environ Microbiol

288

291

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Cholera has historically occurred in periodic epidemics, with the most severe epidemics limited to a few countries, namely Bangladesh, India, and countries in Africa and South America. During the past three decades, however, this disease has occurred in geographical areas from which it had seemingly disappeared almost a century ago (35). Including these new appearances, epidemics have been reported in over 75 countries in South America, Africa, and Asia during the past decade (38). In addition, each year sporadic cases are reported in other countries around the world (38).Interestingly, cholera is one of the few bacterial diseases known for its pandemicity, and until 1992, all epidemics of cholera were caused by Vibrio cholerae serogroup O1. In the latter part of 1992, a newly recognized O139 serogroup was isolated in areas surrounding the Bay of Bengal and was linked to major epidemics, first in Madras on the eastern coast of India and then in the southern part of Bangladesh. Later it was detected in neighboring countries and has continued to persist in that geographic region (6, 28).In 1992 in Bangladesh during a 12-week period, there were approximately 220,000 cases of cholera caused by serotype O139, with over 8,000 deaths, more deaths than in all of Latin America that same year (31,35). Cholera is known to be a disease with a high mortality (Ϸ60% if untreated); with adequate treatment (intravenous and oral rehydration therapy, supplemented with appropriate antibiotics) the mortality drops to Ͻ1.0% (5, 26). The large numbers of deaths indicate that adequate therapy was not available to the many persons who died (6,35).In the recent history of cholera, most major epidemics originated in coastal regions, including both the South American epidemic that began in the coastal regions of Peru, spreading to 21 countries, including Mexico, and the new O139 outbreak in India and Bangladesh. In Dhaka City and a rural area of Bangladesh, Matlab, cholera occurs year-round, with a distinct pattern of two peaks of disease, one in the spring and the other in the fall (16,30).The presence of V. cholerae O1 year-round via its commensal association with plankton was established by Colwell and coworkers using direct detection methods (17). It is still not certain what triggers the continuing seasonal epidemics of cholera in Bangladesh and what determines the persistence and multiplication of V. cholerae O1 and O139 in the choleraendemic regions of the world. However, coexistence of V. cholerae O1 and O139 serogroups in association with plankton has

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Section: Resultsmentioning

confidence: 86%

Section: Methodsmentioning

confidence: 99%

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Critical Factors Influencing the Occurrence of Vibrio cholerae in the Environment of Bangladesh

Huq

Sack

Nizam

et al. 2005

Appl Environ Microbiol

288

291

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“…Yet, it has been demonstrated that V. cholerae can be transmitted to humans via the environment, in drinking and cooking water, irrigation water, and shellfish. With active environmental monitoring systems using epifluorescence microscopy and molecular methods for direct detection, the presence of V. cholerae, ctxAB-carrying bacteria, and vibriophages in sewage and surface waters has been shown to precede the onset of cholera outbreaks by 1 to 4 months (52,104,106,154). Furthermore, cholera is dose dependent, with at least 10 4 cells required for infection (69).…”

Section: Seasonalitymentioning

confidence: 99%

Effects of Global Climate on Infectious Disease: the Cholera Model

2002

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Recently, the role of the environment and climate in disease dynamics has become a subject of increasing interest to microbiologists, clinicians, epidemiologists, and ecologists. Much of the interest has been stimulated by the growing problems of antibiotic resistance among pathogens, emergence and/or reemergence of infectious diseases worldwide, the potential of bioterrorism, and the debate concerning climate change. Cholera, caused by Vibrio cholerae, lends itself to analyses of the role of climate in infectious disease, coupled to population dynamics of pathogenic microorganisms, for several reasons. First, the disease has a historical context linking it to specific seasons and biogeographical zones. In addition, the population dynamics of V. cholerae in the environment are strongly controlled by environmental factors, such as water temperature, salinity, and the presence of copepods, which are, in turn, controlled by larger-scale climate variability. In this review, the association between plankton and V. cholerae that has been documented over the last 20 years is discussed in support of the hypothesis that cholera shares properties of a vector-borne disease. In addition, a model for environmental transmission of cholera to humans in the context of climate variability is presented. The cholera model provides a template for future research on climate-sensitive diseases, allowing definition of critical parameters and offering a means of developing more sophisticated methods for prediction of disease outbreaks

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“…There has been much speculation as to the cause of this reemergence and whether there has always been an environmental reservoir for Vibrio cholerae in Latin America. Since 1991, seasonal patterns of cholera outbreaks have been well documented in Central and South America, with the largest numbers of cases occurring during the warm, summer months (January to March) (7,21).…”

mentioning

confidence: 99%

Direct Detection of Vibrio cholerae and ctxA in Peruvian Coastal Water and Plankton by PCR

Lipp

Rivera

Gil

et al. 2003

Appl Environ Microbiol

103

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Seawater and plankton samples were collected over a period of 17 months from November 1998 to March 2000 along the coast of Peru. Total DNA was extracted from water and from plankton grouped by size into two fractions (64 m to 202 m and >202 m). All samples were assayed for Vibrio cholerae, V. cholerae O1, V. cholerae O139, and ctxA by PCR. Of 50 samples collected and tested, 33 (66.0%) were positive for V. cholerae in at least one of the three fractions. Of these, 62.5% (n ‫؍‬ 32) contained V. cholerae O1; ctxA was detected in 25% (n ‫؍‬ 20) of the V. cholerae O1-positive samples. None were positive for V. cholerae O139. Thus, PCR was successfully employed in detecting toxigenic V. cholerae directly in seawater and plankton samples and provides evidence for an environmental reservoir for this pathogen in Peruvian coastal waters.Cholera continues to be an important and devastating disease, especially in those regions of the world where it is endemic. Before its reemergence in Peru and throughout Latin America in 1991, the disease had been absent from the Americas for nearly 100 years. There has been much speculation as to the cause of this reemergence and whether there has always been an environmental reservoir for Vibrio cholerae in Latin America. Since 1991, seasonal patterns of cholera outbreaks have been well documented in Central and South America, with the largest numbers of cases occurring during the warm, summer months (January to March) (7, 21).In 1977, Colwell et al. (3) first hypothesized that coastal waters were an important reservoir of V. cholerae. V. cholerae has since been detected in seawater and other environmental sources around the world, both in areas where cholera is endemic and in cholera-free areas (4,12,13,14,16). Despite its ubiquity, the ability to determine the presence of this bacterial species in the environment with a degree of efficiency has been hindered by the culture techniques relied upon for detection. Under certain environmental conditions, V. cholerae has been shown to enter a viable but nonculturable state that can result in significant underestimation of the total V. cholerae population (23). Techniques employing microscopy, with either direct or indirect fluorescent-antibody staining, have been developed and provide important data on the occurrence of viable but nonculturable V. cholerae O1 and O139. However, it is obvious that the labeled antibody approach to detect all ϳ200 serogroups of V. cholerae is not feasible (24). Furthermore, V. cholerae non-O1 and non-O139 strains can acquire genes for toxin production by transduction and, therefore, have been hypothesized to be the source of new epidemic and pandemic clones, the toxigenic O139 serogroup having arisen from recombination with a toxigenic O1 strain(s) (5). Currently, neither traditional culture methods nor the direct fluorescentantibody assay (DFA) can detect the presence of the cholera toxin directly in the field. While most environmental V. cholerae strains lack the genes required to produce cholera toxin (19)...

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Cholera in Lima, Peru, Correlates with Prior Isolation of Vibrio cholerae from the Environment

Cited by 67 publications

References 16 publications

Critical Factors Influencing the Occurrence of Vibrio cholerae in the Environment of Bangladesh

Critical Factors Influencing the Occurrence of Vibrio cholerae in the Environment of Bangladesh

Effects of Global Climate on Infectious Disease: the Cholera Model

Direct Detection of Vibrio cholerae and ctxA in Peruvian Coastal Water and Plankton by PCR

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