Protection from cholera by adding lime juice to food – results from community and laboratory studies in Guinea‐Bissau, West Africa

Abstract

SummaryEpidemiological studies have shown that food plays an important role in the transmission of Vibrio cholerae, and different foods have been incriminated in many epidemic outbreaks of cholera. Storing contaminated meals at ambient temperatures allows growth of V. cholerae. Some ingredients such as lime juice may inhibit the survival of V. cholerae in foods. During an epidemic caused by V. cholerae O1 in Guinea-Bissau in 1996, a case control study was conducted in the capital Bissau, the main affected region with an attack rate of 7.4%. Cases were hospitalized patients and controls were matched for area, gender and age. Lime juice in the sauce eaten with rice gave a strong protective effect (odds ratio [OR] ϭ 0.31, 95% confidence interval [CI] ϭ 0.17-0.56), and tomato sauce was also protective (OR ϭ 0.36, 95% CI ϭ 0.24-0.54). On the other hand, use of a bucket for storage of water in the house was associated with increased risk (OR ϭ 4.4, CI ϭ 2.21-8.74). Laboratory experiments to elucidate the inhibitory effect of different concentrations of lime juice on survival of V. cholerae in meals showed that V. cholerae thrives in rice with peanut sauce, but lime juice inhibited its growth. Since lime juice is a common ingredient of sauces, its use should be further encouraged to prevent foodborne transmission in the household during cholera outbreaks.

Effect of Lime Juice on Vibrio parahaemolyticus and Salmonella enterica Inactivation during the Preparation of the Raw Fish Dish Ceviche

“…The effect of lime juice in bacterial reduction is in agreement with previous studies by Mata et al (1994) and Rodrigues (2000) in which V. cholerae O1 was inhibited by lime juice, respectively, in solution and in a sauce eaten with rice.…”

“…Medicine & International Health, showed that V. cholerae O1 was inhibited by lime juice in the sauce eaten with rice (Rodrigues, 2000). Tomato sauce had a similar effect while peanut sauce failed to inhibit and Vibrio thrived in its presence.…”

“…In a meal prepared with lime juice, V. cholerae decreased 2.5 fold for 2 limes and 5 fold for five limes instantaneously. It could not survive in curdled milk further underlining the inhibitory effect of low pH for Vibrio (Rodrigues, 2000). Another important factor is the quality of fruit used to obtain the juice.…”

Assessment of physicochemical characteristics and hygienic practices along the value chain of raw fruit juice vended in Dar es Salaam City, Tanzania

“…Lower pH of fruit and ultimately the raw juice have inhibitory effects to microbial contamination (Castillo et al, 2000;Rodrigues et al, 2000). However, during the processing, a large part of the quality characteristics of the fresh fruits undergo remarkable changes which could reduce the nutritional value of the products (Wenkam, 1990;Landon, 2007).…”

Using Limes and Synthetic Psoralens to Enhance Solar Disinfection of Water (SODIS): A Laboratory Evaluation with Norovirus, Escherichia coli, and MS2

“…30 Interestingly, lime juice has been shown to reduce levels of Vibrio cholerae in food and water, although a specific mechanism for this effect has not yet been identified. [31][32][33] PET, the plastic that constitutes most SODIS bottles, is highly transmissive to 365 nm light, suggesting that psoralens could retain their photoreactive effects inside a PET bottle exposed to sunlight. 34 We selected three microorganisms to study based on their relevance to human disease.…”