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

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 climateThis 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.ConclusionThe 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.

Epidemiological Distribution of Different Vibrio cholerae Strains Causing Cholera Disease in Endemic Countries: A Review

“…This is same with the global estimates of the disease made public annually, since epidemiological surveillance and other public health facilities do not reach most interior parts of the less developed and most affected countries [8]. The World Health Organization reports that only an estimated 5-10% of the actual case number are reported officially annually worldwide [9]. This review attempts to describe the characteristics and epidemiological distribution of the various strains of Vibrio cholerae causing epidemics all over the globe.…”

Evaluation of Whole-Genome Sequencing for Identification and Typing of Vibrio cholerae

“…The World Health Organization recommends that cholera surveillance should be part of an integrated disease surveillance system that includes feedback at the local level and information sharing at the global level. WGS linked to cases of travelers' diarrhea caused by V. cholerae have the potential to be a useful public health resource for global surveillance, enabling us to track the emergence and dissemination of specific lineages on a global scale (5,8,35). At the local level, sharing of WGS data linked to these cases could result in the timely reinforcement of direct public health messaging to travelers in order to reduce the number of imported infections and mitigate the impact of imported infections and associated risks to public health (36).…”

Position of human blood group O(H) and phenotype‐determining enzymes in growth and infectious disease

“…Nevertheless, the evolutionary‐selective pressure that is exerted by the eukaryote P. falciparum and malaria tropica infections on blood group A populations is obviously much stronger. Consequently, blood group O(H), which offers the widest flexibility in adaptive and germline‐encoded immunity, has survived as the most frequently occurring blood group worldwide despite extensive historical cholera pandemics …”

“…Consequently, blood group O(H), which offers the widest flexibility in adaptive and germline-encoded immunity, has survived as the most frequently occurring blood group worldwide 118 despite extensive historical cholera pandemics. [119][120][121]…”