Widespread epidemic cholera caused by a restricted subset of Vibrio cholerae clones. (29th March 2014)

• Record Type: Journal Article
• Authors: Moore, S.; Thomson, N.; Mutreja, A.; Piarroux, R.
• Is Part Of: Clinical microbiology and infection. Volume 20:Number 5(2014:May)
• Page Start: 373
• Page End: 379
• Publication Date: 2014-03-29
• Subjects: Medical microbiology -- Periodicals; Diagnostic microbiology -- Periodicals; Communicable diseases -- Periodicals; Infection -- Periodicals; 616.01
• DOI: 10.1111/1469-0691.12610
• Languages: English
• ISSNs: 1198-743X

Abstract

<abstract abstract-type="main" id="clm12610-abs-0001"> <title>Abstract</title> <p>Since 1817, seven cholera pandemics have plagued humankind. As the causative agent, <italic>Vibrio cholerae</italic>, is autochthonous in the aquatic ecosystem and some studies have revealed links between outbreaks and fluctuations in climatic and aquatic conditions, it has been widely assumed that cholera epidemics are triggered by environmental factors that promote the growth of local bacterial reservoirs. However, mounting epidemiological findings and genome sequence analysis of clinical isolates have indicated that epidemics are largely unassociated with most of the <italic>V. cholerae</italic> strains in aquatic ecosystems. Instead, only a specific subset of <italic>V. cholerae </italic>El Tor 'types' appears to be responsible for current epidemics. A recent report examining the evolution of a variety of <italic>V. cholerae</italic> strains indicates that the current pandemic is monophyletic and originated from a single ancestral clone that has spread globally in successive waves. In this review, we examine the clonal nature of the disease, with the example of the recent history of cholera in the Americas. Epidemiological data and genome sequence‐based analysis of <italic>V. cholerae</italic> isolates demonstrate that the cholera epidemics of the 1990s in South America were triggered by the importation of a pathogenic <italic>V. cholerae</italic> strain that gradually spread throughout the region until local outbreaks ceased in 2001. Latin America remained almost unaffected by the disease until a new toxigenic <italic>V. cholerae</italic> clone was imported into Haiti in 2010. Overall, cholera appears to be largely caused by a subset of specific <italic>V. cholerae</italic> clones rather than by the vast diversity of <italic>V. cholerae</italic> strains in the environment.</p> </abstract>