Clinical profile of acute diarrhoea cases infected with the new epidemic strain of Vibrio cholerae O139: designation of the disease as cholera

Sk, Bhattacharya; Mk, Bhattacharya; Nair, G. Balakrish; Dutta, Dipanjan; Ramamurthy, T.; Garg, Surabhi; Saha, Pradip Kumar; Dutta, P; Moitra, A; Mandal, B K; Shimada, Toshio; Takeda, Yoshifumi; Bc, Deb

doi:10.1016/0163-4453(93)93488-p

Cited by 80 publications

(39 citation statements)

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“…The only other serogroup known to cause epidemic cholera (O139) emerged in 1992 in the Bay of Bengal region and has remained endemic to this region (1,41). The O139 Bengal strains cause disease with severity comparable to the severity of the disease caused by O1 strains, and prior exposure to O1 strains does not provide protection against O139 infections (7,37). Molecular epidemiological studies (ribotyping, fingerprinting, multilocus enzyme electrophoresis, etc.)…”

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Evidence for the Emergence of Non-O1 and Non-O139 Vibrio cholerae Strains with Pathogenic Potential by Exchange of O-Antigen Biosynthesis Regions

Shimada

Morris

et al. 2002

Infect Immun

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The novel epidemic strain Vibrio cholerae O139 Bengal originated from a seventh-pandemic O1 El Tor strain by antigenic shift resulting from homologous recombination-mediated exchange of O-antigen biosynthesis (wb*) clusters. Conservation of the genetic organization of wb* regions seen in other serogroups raised the possibility of the existence of pathogenic non-O1 and non-O139 V. cholerae strains that emerged by similar events. To test this hypothesis, 300 V. cholerae isolates of non-O1 and non-O139 serogroups were screened for the presence of virulence genes and an epidemic genetic background by DNA dot blotting, IS1004 fingerprinting, and restriction fragment length polymorphism (RFLP) analysis. We found four non-O1 strains (serogroups O27, O37, O53, and O65) with an O1 genetic backbone suggesting exchange of wb* clusters. DNA sequence analysis of the O37 wb* region revealed that a novel ϳ23.4-kb gene cluster had replaced all but the ϳ4.2-kb right junction of the 22-kb O1 wbe region. In sharp contrast to the backbones, the virulence regions of the four strains were quite heterogeneous; the O53 and O65 strains had the El Tor vibrio pathogenicity island (VPI) cluster, the O37 strain had the classical VPI cluster, and the O27 strain had a novel VPI cluster. Two of the four strains carried CTX; the O27 strain possessed a CTX with a recently reported immune specificity (rstR-4** allele) and a novel ctxB allele, and the O37 strain had an El Tor CTX (rstR ET allele) and novel ctxAB alleles. Although the O53 and O65 strains lacked the ctxAB genes, they carried a pre-CTX (i.e., rstR cla ). Identification of non-O1 and non-O139 serogroups with pathogenic potential in epidemic genetic backgrounds means that attention should be paid to possible future epidemics caused by these serogroups and to the need for new, rapid vaccine development strategies.

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Evidence for the Emergence of Non-O1 and Non-O139 Vibrio cholerae Strains with Pathogenic Potential by Exchange of O-Antigen Biosynthesis Regions

Shimada

Morris

et al. 2002

Infect Immun

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“…Cholera is a waterborne disease that afflicts millions of people every year. The etiological agent of the disease is Vibrio cholerae belonging to serogroups O1 and O139 (4,29). Members of the O1 serogroup have been further subdivided into Ogawa and Inaba serotypes and El Tor and classical biotypes.…”

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Incidence, Virulence Factors, and Clonality among Clinical Strains of Non-O1, Non-O139 Vibrio cholerae Isolates from Hospitalized Diarrheal Patients in Kolkata, India

et al. 2009

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The incidence of Vibrio cholerae non-O1, non-O139 strains from hospitalized patients with acute diarrhea constituted 27.4% (n ‫؍‬ 54) of the total 197 V. cholerae strains isolated from patients in Kolkata, India, in 2003. Of 197 strains, 135 were identified as O1 serotype Ogawa and 2 were identified as O139. In the same time period, six O1 background rough strains that possessed all known virulence factors were identified. Serotype analysis of the non-O1, non-O139 strains placed 42 strains into 19 serogroups, while 12 remained O nontypeable (ONT); the existing serotyping scheme involved antisera to 206 serogroups. Detection of a good number of ONT strains suggested that additional serogroups have arisen that need to be added to the current serotyping scheme. The non-O1, non-O139 strains were nontoxigenic except for an O36 strain (SC124), which regulated expression of cholera toxin as O1 classical strains did. Additionally, strain SC124 carried alleles of tcpA and toxT that were different from those of the O1 counterpart, and these were also found in five clonally related strains belonging to different serogroups. Strains carrying tcpA exhibited higher colonization in an animal model compared to those lacking tcpA. PCR-based analyses revealed remarkable variations in the distribution of other virulence factors, including hlyA, rtxA, Vibrio seventh pandemic island I (VSP-I), VSP-II, and type III secretion system (TTSS). Most strains contained hlyA (87%) and rtxA (81.5%) and secreted cytotoxic factors when grown in vitro. Approximately one-third of the strains (31.5%) contained the TTSS gene cluster, and most of these strains were more motile and hemolytic against rabbit erythrocytes. Partial nucleotide sequence analysis of the TTSS-containing strains revealed silent nucleotide mutations within vcsN2 (type III secretion cytoplasmic ATPase), indicating functional conservation of the TTSS apparatus.In the recorded history of cholera, humans have experienced seven pandemics; the seventh pandemic is still ongoing since its commencement in 1961 (29). Cholera is a waterborne disease that afflicts millions of people every year. The etiological agent of the disease is Vibrio cholerae belonging to serogroups O1 and O139 (4, 29). Members of the O1 serogroup have been further subdivided into Ogawa and Inaba serotypes and El Tor and classical biotypes. The seventh pandemic strains are of the O1 El Tor biotype, which replaced the O1 classical biotype strains that caused previous pandemics (29). The current serotyping scheme of V. cholerae includes 206 serogroups (57). Strains belonging to serogroups other than O1 and O139 are collectively known as non-O1, non-O139 V. cholerae strains and exist in abundance in the aquatic environment. However, recent studies have concluded that considerable incidence of human diarrheal episodes in many countries, including India, is due to V. cholerae non-O1, non-O139 (10,11,27,39,40,48). Studies of diarrheal cases in Thailand between 1993 and 1995 revealed that the prevalence of non-O1, non-O13...

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“…The disease caused by 0139 strains was reported to be indistinguishable from cholera in clinical features and response to treatment [4]. As most of the affected patients were adults who were not primed previously with the 0139 serogroup and prior exposure to l ?…”

Section: Introductionmentioning

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Screening of TnPhoA Mutants of Vibrio Cholerae O139 for Identification of Antigens Involved in Colonisation

Bondre

Srivastava²,

Sinha³

et al. 1997

Journal of Medical Microbiology

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A new serogroup of Vibrio cholerae non-01, designated as 0139, has emerged causing cholera-like disease among adults. Laboratory and field studies clearly show that there is no cross-protection between 01 and 0139 pathogenic strains. Since colonisation of the intestine is a most important step in the pathogenesis of cholera caused by 01 strains and colonising antigens are known to be protective, investigation of the colonising antigens of 0139 strain was initiated. By TnphoA mutagenesis, mutants were generated with insertions in the genome encoding membrane spanning or secretory proteins. Screening of the mutants for adherence to rabbit intestinal surface and colonisation in 5-day-old mice resulted in the identification of mutant clones, which were less adhesive than was the wild-type parent strain and which could not efficiently colonise the gut. Such non-colonising strains were attenuated in virulence. Analysis of the proteins by SDS-PAGE revealed that the non-colonising membrane protein.

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Clinical profile of acute diarrhoea cases infected with the new epidemic strain of Vibrio cholerae O139: designation of the disease as cholera

Cited by 80 publications

References 4 publications

Evidence for the Emergence of Non-O1 and Non-O139 Vibrio cholerae Strains with Pathogenic Potential by Exchange of O-Antigen Biosynthesis Regions

Evidence for the Emergence of Non-O1 and Non-O139 Vibrio cholerae Strains with Pathogenic Potential by Exchange of O-Antigen Biosynthesis Regions

Incidence, Virulence Factors, and Clonality among Clinical Strains of Non-O1, Non-O139 Vibrio cholerae Isolates from Hospitalized Diarrheal Patients in Kolkata, India

Screening of TnPhoA Mutants of Vibrio Cholerae O139 for Identification of Antigens Involved in Colonisation

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