Consecutive outbreaks of Vibrio cholerae O139 and V. cholerae O1 cholera in a fishing village near Karachi, Pakistan

Abstract

In July 2002 and June 2003, cholera outbreaks were detected by a diarrhoea surveillance system in a village outside Karachi, Pakistan. Specimens were culture confirmed. The first outbreak was caused by Vibrio cholerae O139 (n = 30) and the second outbreak by V. cholerae O1 (n = 39). Demographic and clinical features of patients were recorded and case-control studies were conducted following each outbreak. Clinical information was obtained for 29 of the 30 patients in the first outbreak, and 2 of the patients in the second outbreak were either out of the area or lost to follow-up, leaving 29 and 37 cases in the analysis for the first and second outbreak, respectively. Eighteen (49%) of the 37 V. cholerae O1 patients were under 2 years of age compared with 6 (21%) of the 29 V. cholerae O139 patients (P = 0.02). Vibrio cholerae O139-infected patients were more likely to be febrile (16/29) than those infected with V. cholerae O1 (2/37; P<0.001). A household contact with cholera was a risk factor in both outbreaks; water source was a risk factor in the first outbreak only. Geographically, cases were clustered during the first outbreak but not during the second. Person-to-person contact and water reservoirs appear to be the main transmission routes for cholera in this setting.

Cholera Outbreaks in South and Southeast Asia: Descriptive Analysis, 2003&ndash;2012

“…Contaminated imported seafood products were identified as a major source for a cholera outbreak in Singapore in October 2004 (23). An additional 44 people suffered from two consecutive cholera outbreaks in Tak (16) 2003 Miri, Indonesia Contaminated water (17) 2003 Karachi, Pakistan Contaminated water (18) 2004 Mathbaria, Bangladesh Contaminated water (18) 2004 Mathbaria, Bangladesh Contaminated water (18) 2004 Bakherjanj, Bangladesh Contaminated water (19) 2004 Bhind, India Contaminated water (20) 2004 Kolkata, India Contaminated water from leaked pipelines (21) 2004 Kashmir, India Contaminated water (22) 2004 South 24 Parganas, West Bengal, India Contaminated pond water (21) 2004 Myanmar Heavy rainfall leading to contamination of water (21) 2004 Singapore Contaminated food (23) 2004 Bedok and Tampines, Singapore Contaminated imported seafood Screening of food handlers (18) 2005 Mathbaria, Bangladesh Contaminated water (18) 2005 Bakherjanj, Bangladesh Contaminated water (24) 2005 Delhi, India Contaminated water (25) 2005 Sangli, Maharastra, India Contaminated water (26) 2005 Orissa, India Contaminated food products and water (27) 2006 Kolkata, India Contaminated water Discarding unsafe water and chlorination (28) 2006 Orissa, India Contaminated water (22) 2006 South 24 Parganas, West Bengal, India Contaminated pond water (29) 2006 Andaman and Nicobar Island, India Contaminated pond water Chlorination of water (30) 2006 Garulia, West Bengal, India Contamination of water and low chlorine content Repair of leakage and chlorination of water (22) 2007 South 24 Parganas, West Bengal, India Contaminated pond water (31) 2007 Orissa, India Contaminated water (32) 2007 Orissa, India Contaminated water (33,34) 2007 Thateng and Lamam, Laos, PDR Contaminated water, interpersonal transmission Providing safe water, improving water, sanitation, and health education (35) 2007 Xekong province, Laos Contaminated water (36)<...>…”

A survey of <i>Vibrio cholerae</i> O1 and O139 in estuarine waters and sediments of Beira, Mozambique

“…Noteworthy is the detection of V. cholerae O1 and O139 in fish mucus and scale samples and the co-existence of O1 and O139 observed in 1 sample. Although V. cholerae O1 and O139 have previously been associated with raw seafood and fish (Siddique et al, 2006;Chen et al, 2004) and V. vulnificus with mussels, gills and fish mucus (Høi et al, 1998) and more recently in fish intestines (Sendorovich et al, 2010), we are not aware of other studies with similar findings. Recent information has shown that fish mucus acts as a nutrient source, from where V. anguillarum moves to the fish scale surface to form biofilms by synthesising exopolyssacharides (Croxatto et al, 2007).…”

Gastroenteritis in a Taipei emergency department: aetiology and risk factors

“…Regarding the strong association between other household members having gastroenteritis and our participants suffering from gastroenteritis, household transmission is a known risk factor for rotaviruses, noroviruses, Salmonella spp., Shigella spp., Campylobacter spp., DEC, Giardia , Cryptosporidium spp. [20,21] and Vibrio cholerae [22]. The association between honey peach consumption and gastroenteritis could be expected because the peach was not properly washed before consumption, and/or it was not peeled before eating.…”