Recent Clonal Origin of Cholera in Haiti

Ali, Afsar; Chen, Yuansha; Johnson, Judith A.; Redden, Edsel; Mayette, Yfto; Rashid, Mohammed H.; Stine, O. Colin; Morris, J. Glenn

doi:10.3201/eid1704.101973

Cited by 54 publications

(68 citation statements)

References 12 publications

(26 reference statements)

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“…The emergence and prevalence of V. cholerae El Tor variants has been reported in several geographic regions (1,6,12,13,33,38,45), and their independent evolution has led to various combinations of classical traits possessed by the different variant strains identified. Even in the 11 clinical El Tor variants isolated from the same hospital and from Haiti presented here, there exists significant variation among them, with regard not only to virulence gene expression but also to other phenotypic properties, such as alteration in basic metabolic pathways, biofilm production, and differing hemolytic activities.…”

Section: Discussionmentioning

confidence: 99%

“…6D, as variants Bgd1, Bgd2, Bgd7, and Bgd8 grouped with wild-type N16961 and Bgd3, Bgd4, Bgd5, Bgd6, MQ1795, MQ04, and BAA-2163 clustered together. been limited to Bangladesh and Mozambique, it also has been isolated and identified in parts of Asia (38,45) and now in Haiti (1,6,7,8), with cases originating from Haiti being reported in different parts of the United States (9) and even Canada. With the differences in the locations of where these diverse variants are being isolated come the inherent differences in genotypic and phenotypic profiles, as previously described elsewhere (28,29,33,39,44,45).…”

Section: Vol 49 2011 Characterization Of Clinical El Tor Variant Ismentioning

confidence: 99%

“…These clinical El Tor O1 strains were found to contain the classical biotype cholera toxin B subunit gene (ctxB) and have since been termed El Tor variants (34,39). These El Tor variants have become a major focus of research, since other El Tor variants also have been identified in Asia and Mozambique (29,34,35,38) and recently have been a focus of attention in Haiti (1,6,7,8,9). Of particular concern are the recently published results indicating that some of the clinically isolated El Tor variants produce different levels of cholera toxin, including some isolates that produce higher levels than classical biotype strains (16).…”

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Characterization of Vibrio cholerae O1 El Tor Biotype Variant Clinical Isolates from Bangladesh and Haiti, Including a Molecular Genetic Analysis of Virulence Genes

et al. 2011

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Vibrio cholerae serogroup O1, the causative agent of the diarrheal disease cholera, is divided into two biotypes: classical and El Tor. Both biotypes produce the major virulence factors toxin-coregulated pilus (TCP) and cholera toxin (CT). Although possessing genotypic and phenotypic differences, El Tor biotype strains displaying classical biotype traits have been reported and subsequently were dubbed El Tor variants. Of particular interest are reports of El Tor variants that produce various levels of CT, including levels typical of classical biotype strains. Here, we report the characterization of 10 clinical isolates from the International Centre for Diarrhoeal Disease Research, Bangladesh, and a representative strain from the 2010 Haiti cholera outbreak. We observed that all 11 strains produced increased CT (2-to 10-fold) compared to that of wild-type El Tor strains under in vitro inducing conditions, but they possessed various TcpA and ToxT expression profiles. Particularly, El Tor variant MQ1795, which produced the highest level of CT and very high levels of TcpA and ToxT, demonstrated hypervirulence compared to the virulence of El Tor wild-type strains in the infant mouse cholera model. Additional genotypic and phenotypic tests were conducted to characterize the variants, including an assessment of biotype-distinguishing characteristics. Notably, the sequencing of ctxB in some El Tor variants revealed two copies of classical ctxB, one per chromosome, contrary to previous reports that located ctxAB only on the large chromosome of El Tor biotype strains.Vibrio cholerae is a Gram-negative, curved-rod-shaped bacterium that is the causative agent of the watery diarrheal disease cholera. The structure of the cell surface lipopolysaccharide O antigen is used to classify V. cholerae into more than 200 serogroups, of which only two, O1 and O139, possess the potential to cause epidemic or pandemic cholera. The O1 serogroup is further divided into two biotypes, classical and El Tor, which evolved from independent lineages (20, 22), and they display genotypic and phenotypic differences.V. cholerae O1 is distinguished by two of its major virulence factors, cholera toxin (CT) and the toxin-coregulated pilus (TCP). The cholera toxin is encoded by ctxA and ctxB, which are found on the CTX prophage (49), and is responsible for the manifestation of diarrheal disease with severe water and electrolyte loss. The TCP, encoded by the tcp operon in the Vibrio pathogenicity island (VPI), is required for V.

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Section: Discussionmentioning

confidence: 99%

Section: Vol 49 2011 Characterization Of Clinical El Tor Variant Ismentioning

confidence: 99%

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confidence: 99%

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Characterization of Vibrio cholerae O1 El Tor Biotype Variant Clinical Isolates from Bangladesh and Haiti, Including a Molecular Genetic Analysis of Virulence Genes

et al. 2011

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“…Although these polymorphic alleles occur within coding sequences (thus increasing the size of the protein by two amino acids for each additional repeat) in four of the five loci, whether or not these have a selective value is not known. In Haiti in 2010, the founder genotype radiated into eight additional MLVA genotypes (Ali, Chen et al 2011). In Dhaka from 2004–2006, the three major clonal complexes all included additional genotypes as the years progressed (Kendall, Chowdhury et al 2010).…”

Section: Genetic Variation and Founder Flush Eventsmentioning

confidence: 99%

Circulation and Transmission of Clones of Vibrio cholerae During Cholera Outbreaks

Stine

Morris

2013

Current Topics in Microbiology and Immunology

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Cholera is still a major public health problem. The underlying bacterial pathogen Vibrio cholerae (V. cholerae) is evolving and some of its mutations have set the stage for outbreaks. After V. cholerae acquired the mobile elements VSP I & II, the El Tor pandemic began and spread across the tropics. The replacement of the O1 serotype encoding genes with the O139 encoding genes triggered an outbreak that swept across the Indian subcontinent. The sxt element generated a third selective sweep and most recently a fourth sweep was associated with the exchange of the El Tor ctx allele for a classical ctx allele in the El Tor background. In Kenya, variants of this fourth selective sweep have differentiated and become endemic residing in and emerging from environmental reservoirs. On a local level, studies in Bangladesh have revealed that outbreaks may arise from a nonrandom subset of the genetic lineages in the environment and as the population of the pathogen expands, many novel mutations may be found increasing the amount of genetic variation, a phenomenon known as a founder flush. In Haiti, after the initial invasion and expansion of V. cholerae in 2010, a second outbreak occurred in the winter of 2011–2012 driven by natural selection of specific mutations.

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“…Endemic cholera continues to be a major public health problem in vast regions of South Asia and Africa. Introduction of virulent V. cholerae O1 in non-endemic areas with low sanitation can result in rapidly spreading outbreaks as occurred in 2010 in Haiti [3]. The typical symptoms of this illness include a profuse rice-watery diarrhea and vomiting.…”

Section: Introductionmentioning

confidence: 99%

Vibrio cholerae hemagglutinin(HA)/protease: An extracellular metalloprotease with multiple pathogenic activities

Benítez

Silva

2016

Toxicon

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Vibrio cholerae of serogroup O1 and O139, the etiological agent of the diarrheal disease cholera, expresses the extracellular Zn-dependent metalloprotease hemagglutinin (HA)/protease also reported as vibriolysin. This enzyme is also produced by non-O1/O139 (non-cholera) strains that cause mild, sporadic illness (i.e. gastroenteritis, wound or ear infections). Orthologs of HA/protease are present in other members of the Vibrionaceae family pathogenic to humans and fish. HA/protease belongs to the M4 neutral peptidase family and displays significant amino acid sequence homology to Pseudomonas aeruginosa elastase (LasB) and Bacillus thermoproteolyticus thermolysin. It exhibits a broad range of potentially pathogenic activities in cell culture and animal models. These activities range from the covalent modification of other toxins, the degradation of the protective mucus barrier and disruption of intestinal tight junctions. Here we review (i) the structure and regulation of HA/protease expression, (ii) its interaction with other toxins and the intestinal mucosa and (iii) discuss the possible role(s) of HA/protease in the pathogenesis of cholera.

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Recent Clonal Origin of Cholera in Haiti

Cited by 54 publications

References 12 publications

Characterization of Vibrio cholerae O1 El Tor Biotype Variant Clinical Isolates from Bangladesh and Haiti, Including a Molecular Genetic Analysis of Virulence Genes

Characterization of Vibrio cholerae O1 El Tor Biotype Variant Clinical Isolates from Bangladesh and Haiti, Including a Molecular Genetic Analysis of Virulence Genes

Circulation and Transmission of Clones of Vibrio cholerae During Cholera Outbreaks

Vibrio cholerae hemagglutinin(HA)/protease: An extracellular metalloprotease with multiple pathogenic activities

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