Flies and water as reservoirs for bacterial enteropathogens in urban and rural areas in and around Lahore, Pakistan

Khalil, K; Lindblom, Gun-Britt; Mazhar, Khadija; Kaijser, B

doi:10.1017/s0950268800068448

Cited by 60 publications

(52 citation statements)

References 28 publications

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“…Shigellosis is thought to be mostly transmitted from person to person. Flies may in some places play a role in the transmission of this disease [40]. The transmission of Campylobacter is less well understood.…”

Section: Discussionmentioning

confidence: 99%

A comparison of disease caused by Shigella and Campylobacter species: 24 months community based surveillance in 4 slums of Karachi, Pakistan

Soofi

Habib

Seidlein

et al. 2011

Journal of Infection and Public Health

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Despite the efforts of the international community diarrheal diseases still pose a major threat to children in children less than five years of age. Bacterial diarrhea has also emerged as a public health concern due to the proliferation of drug resistant species in many parts of the world. There is a paucity of population-based data about the incidence of shigellosis and Campylobacter infections in Pakistan. We report country specific results for Shigella diarrhea that were derived from a multicenter study conducted in six Asian countries. Disease surveillance was conducted over a 24 month period in urban slums of Karachi, Pakistan, a city with a population of 59,584. Cases were detected through passive detection in study treatment centers. Stool specimens or rectal swabs were collected from all consenting patients. Between January 2002 and December 2003 10,540 enteric infection cases were detected. The incidence rate of treated diarrhea in children under 5 was 488/1000/year. In children, 5 years and older, the diarrhea rate was 22/1000/year. 576 (7%) Campylobacter isolates were detected. The pre-dominant Campylobacter species was C. jenuni with an increase of 29/1000 year in children under 5 years. Shigella species were isolated from 394 of 8032 children under 5 years of age. Shigella flexneri was the dominant species (10/1000/year in children under 5 years) followed by Shigella sonnei (3.9/1000/year), Shigella boydii (2.0/1000/year) and Shigella dysenteriae (1.3/1000/year). Shigellosis and Campylobacter infection rates peaked during the second year of life. The incidence rate of shigellosis increased in old age but such a trend was not observed in Campylobacter infections. Of 394 shigellosis patients 123 (31%) presented with dysentery in contrast to only 54 (9%) of 576 patients with Campylobacter infections (p<0.001). Both Campylobacter infections and shigellosis are common in community settings of Pakistan but shigellosis presented more frequently with abdominal pain and dysentery than Campylobacter infections indicating that shigellosis may be a more severe illness than Campylobacter infections. Due to the increased and disease severity, drug resistant shigella have become a significant health problem; moreover it is a disease of poor and impoverished people who do not have the access to standard water and sanitary conditions, health care services or optimal treatment. In the face of these facts it is empirically important to develop a low cost effective vaccine that can protect these populations for a longer duration.

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Section: Discussionmentioning

confidence: 99%

A comparison of disease caused by Shigella and Campylobacter species: 24 months community based surveillance in 4 slums of Karachi, Pakistan

Soofi

Habib

Seidlein

et al. 2011

Journal of Infection and Public Health

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“…Enteropathogens previously isolated from flies in field and laboratory experiments include Campylobacter spp. (4)(5)(6), Salmonella spp. (4,5,7), Shigella spp.…”

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confidence: 99%

“…(4,5,7), Shigella spp. (4,5,(8)(9)(10), Vibrio cholerae (4,9), Escherichia coli, including enterohemorrhagic E. coli (4,5,7,8,(11)(12)(13), Bacillus cereus (8), Cryptosporidium spp. (3,(14)(15)(16), Giardia lamblia (3), and rotavirus (17).…”

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confidence: 99%

Environmental Factors Associated with High Fly Densities and Diarrhea in Vellore, India

Collinet-Adler

Babji

Francis

et al. 2015

Appl Environ Microbiol

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Diarrhea causes significant morbidity and mortality in Indian children under 5 years of age. Flies carry enteric pathogens and may mediate foodborne infections. In this study, we characterized fly densities as a determinant of infectious diarrhea in a longitudinal cohort of 160 urban and 80 rural households with 1,274 individuals (27% under 5 years of age) in Vellore, India. Household questionnaires on living conditions were completed at enrollment. Fly abundance was measured during the wet and dry seasons using fly ribbons placed in kitchens. PCRs for enteric bacteria, viruses, and protozoa were performed on 60 fly samples. Forty-three (72%) fly samples were positive for the following pathogens: norovirus (50%), Salmonella spp. (46.7%), rotavirus (6.7%), and Escherichia coli (6.7%). Ninety-one episodes of diarrhea occurred (89% in children under 5 years of age). Stool pathogens isolated in 24 of 77 (31%) samples included E. coli, Shigella spp., Vibrio spp., Giardia, Cryptosporidium, and rotavirus. Multivariate log-linear models were used to explore the relationships between diarrhea and fly densities, controlling for demographics, hygiene, and human-animal interactions. Fly abundance was 6 times higher in rural than urban sites (P < 0.0001). Disposal of garbage close to homes and rural living were significant risk factors for high fly densities. The presence of latrines was protective against high fly densities and diarrhea. The adjusted relative risks of diarrheal episodes and duration of diarrhea, associated with fly density at the 75th percentile, were 1.18 (95% confidence interval [CI], 1.03 to 1.34) and 1.15 (95% CI, 1.02 to 1.29), respectively. Flies harbored enteric pathogens, including norovirus, a poorly documented pathogen on flies. Diarrhea has been shown to be the cause of death of over 10% of Indian children under the age of 5 (1). Transmission of infectious diarrhea is fecal to oral, with zoonotic and/or anthroponotic cycles depending on the pathogen. Environmental factors that appear to be associated with the epidemiology of enteric pathogens include a wide range of events and processes. These include strong seasonal patterns, such as rain events, temperature extremes, soil and water ammonia levels, soil characteristics and vegetation cover, proximity of infective feces to water and food supplies ultimately used for human consumption, type of water disinfection used and the use of untreated or undertreated wastewater for agricultural irrigation, predation and sequestration of pathogens by invertebrates, pathogen reservoir characteristics, such as number and age of animals in direct and indirect contact with water and food supplies, and pathogen transport by flies and other flying insects (2).Flies are known to carry enteric pathogens, and it is thought that some foodborne transmission of enteric infections may be mediated by flies (3). Enteropathogens previously isolated from flies in field and laboratory experiments include Campylobacter

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“…However, flies are common carriers of Campylobacter spp. especially in conditions where sanitation and excreta disposal is underdeveloped (Khalil et al, 1994).…”

Section: Airmentioning

confidence: 99%

Members of the family Campylobacteraceae: Campylobacter jejuni, Campylobacter coli

Pitkänen¹,

Hänninen²

2019

Water and Sanitation for the 21st Century: Health and Microbiological Aspects of Excreta and Wastewater Management (Global Wate

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Flies and water as reservoirs for bacterial enteropathogens in urban and rural areas in and around Lahore, Pakistan

Cited by 60 publications

References 28 publications

A comparison of disease caused by Shigella and Campylobacter species: 24 months community based surveillance in 4 slums of Karachi, Pakistan

A comparison of disease caused by Shigella and Campylobacter species: 24 months community based surveillance in 4 slums of Karachi, Pakistan

Environmental Factors Associated with High Fly Densities and Diarrhea in Vellore, India

Members of the family Campylobacteraceae: Campylobacter jejuni, Campylobacter coli

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