Survival of classic cholera in Bangladesh

Siddique, A. K.; Baqui, Abdullah H; Eusof, A; Haider, Khaleda; Hossain, M. Anowar; Bashir, Ishtiaque; Zaman, K.

doi:10.1016/0140-6736(91)92789-5

Cited by 65 publications

(49 citation statements)

References 7 publications

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“…In 1982, the classical biotype reappeared as the predominant epidemic strain in Bangladesh (25). In retrospect, it appears that classical cholera did not completely disappear from Bangladesh during the 1970s or late 1980s, but rather, its frequency varied in different regions of the country (26). The classical and El Tor biotypes have temporally overlapped for over a decade and are likely to have interacted and exchanged genetic material either in the human intestinal milieu or in the aquatic environment.…”

Section: Discussionmentioning

confidence: 99%

New Variants of Vibrio cholerae O1 Biotype El Tor with Attributes of the Classical Biotype from Hospitalized Patients with Acute Diarrhea in Bangladesh

et al. 2002

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The sixth pandemic of cholera and, presumably, the earlier pandemics were caused by the classical biotype of Vibrio cholerae O1, which was progressively replaced by the El Tor biotype representing the seventh cholera pandemic. Although the classical biotype of V. cholerae O1 is extinct, even in southern Bangladesh, the last of the niches where this biotype prevailed, we have identified new varieties of V. cholerae O1, of the El Tor biotype with attributes of the classical biotype, from hospitalized patients with acute diarrhea in Bangladesh. Twentyfour strains of V. cholerae O1 isolated between 1991 and 1994 from hospitalized patients with acute diarrhea in Matlab, a rural area of Bangladesh, were examined for the phenotypic and genotypic traits that distinguish the two biotypes of V. cholerae O1. Standard reference strains of V. cholerae O1 belonging to the classical and El Tor biotypes were used as controls in all of the tests. The phenotypic traits commonly used to distinguish between the El Tor and classical biotypes, including polymyxin B sensitivity, chicken cell agglutination, type of tcpA and rstR genes, and restriction patterns of conserved rRNA genes (ribotypes), differentiated the 24 strains of toxigenic V. cholerae O1 into three types designated the Matlab types. Although all of the strains belonged to ribotypes that have been previously found among El Tor vibrios, type I strains had more traits of the classical biotype while type II and III strains appeared to be more like the El Tor biotype but had some classical biotype properties. These results suggest that, although the classical and El Tor biotypes have different lineages, there are possible naturally occurring genetic hybrids between the classical and El Tor biotypes that can cause cholera and thus provide new insight into the epidemiology of cholera in Bangladesh. Furthermore, the existence of such novel strains may have implications for the development of a cholera vaccine.New epidemic strains of toxigenic Vibrio cholerae have appeared at least twice in recent human history (10). Strains of the classical biotype, which had probably been responsible for most of the epidemic disease in the 19th century and much of the 20th century, were largely replaced as the predominant cause of epidemic cholera by strains of the El Tor biotype in most of the regions where cholera is endemic, beginning in 1961. However, the classical biotype strains reemerged as a predominant epidemic strain in parts of Bangladesh in 1982 (8, 25) and coexisted with the El Tor strains, causing disease until 1993. A second new epidemic strain, carrying the O139 rather than the O1 antigen, emerged in southern Asia in 1992 (7, 24). The O139 and El Tor O1 strains continue to cause epidemics of cholera, and there are indications that the incidence of cholera due to the O139 serogroup is on the rise in parts of India and Bangladesh.The classical and El Tor biotypes of V. cholerae are closely related in their O-antigen biosynthetic genes (21, 31), although these two biotypes diffe...

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Section: Discussionmentioning

confidence: 99%

New Variants of Vibrio cholerae O1 Biotype El Tor with Attributes of the Classical Biotype from Hospitalized Patients with Acute Diarrhea in Bangladesh

et al. 2002

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“…The changing ecological balance of different regions of the country and the variations in their salinity and nutrient concentrations were thought to be associated with the geographic clustering of El Tor and classic biotypes of V. cholerae 01 prior to the emergence of 0 1 3 9 strains (Siddique et al 1991). This may also be the case for the difference in the distribution and dynamics of spread of 0 1 3 9 strains in Bangladesh.…”

Section: The Reason For the Emergence Of The New Epidemicmentioning

confidence: 96%

“…But geographic clustering of V. cholerae 01 biotypes (Siddique et al 1991) and surviving clones of the classic biotype of the sixth pandemic (Faruque et a1. 1993) were detected in southern coastal areas of Bangladesh.…”

Section: Discussionmentioning

confidence: 99%

“…This strain, designated El Tor, did not gain international notoriety, despite the local outbreak it caused in 1936 in Celebes, Indonesia (De Moor 1938), until the early sixties when the seventh pandemic of cholera caused by El Tor was well under way (Barua 1992). The new biotype rapidly displaced the classic biotype from all countries where the disease was prevalent, except in Bangladesh where both biotypes coexisted (Siddique et al 1991;Faruque et al 1993).…”

Section: Introductionmentioning

confidence: 99%

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Vibrio cholerae O139: How great is the threat of a pandemic?

Siddique¹,

Akram²,

Zaman³

et al. 1996

Tropical Med Int Health

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Epidemic Control Preparedness Programme, ICCDR, BTbe/obns Hopkins University, USA SummaryThe emergence of the new strain Vibrio cholerae 0139 and its rapid spread in Bangladesh and India together with its detection in several other countries, have raised the question whether this constitutes the beginning of the eighth pandemic of cholera, and if so, how large a threat it poses. In an attempt to answer this question, epidemic spread patterns of Vibrio cholerae 0 1 3 9 strain in Bangladesh were studied. Initially the epidemic moved quickly and affected the entire coastal and estuarine tidal plains of southern Bangladesh. In the flood plains of the northern regions it affected mostly the north-eastern and north-central areas, at a slower pace than in the southern areas. In the beginning the new strain totally displaced both biotypes (classic and El Tor) of Vibrio cholerae 01. Nearly z years after its initial detection, striking differences in the distribution of V. cholerae 0139 and 01 were observed. In most northern areas, the new strain was replaced by V. cholerae 01, whereas in the southern coastal regions, the 0139 strain continues to dominate epidemics. The study suggests that the 0 1 3 9 strain may become endemic in the coastal ecosystem. The threat of a pandemic, therefore, may not be as large as it first seemed.

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“…Although the ET biotype was first reported in 1905 and the 6th pandemic, caused by the CL biotype, lasted until 1923, it was not until the early 1960s that the ET biotype displaced the CL biotype in Asia and became the causal agent of the 7th pandemic (33). The CL biotype maintained a low profile in its last recognized niche in the coastal ecosystem of the Bay of Bengal, before it disappeared as a causal agent of clinical disease in the 1980s (33).…”

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confidence: 99%

Cholera between 1991 and 1997 in Mexico Was Associated with Infection by Classical, El Tor, and El Tor Variants of Vibrio cholerae

et al. 2010

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Vibrio cholerae O1 biotype El Tor (ET), the cause of the current 7th pandemic, has recently been replaced in Asia and Africa by an altered ET biotype possessing cholera toxin (CTX) of the classical (CL) biotype that originally caused the first six pandemics before becoming extinct in the 1980s. Until recently, the ET prototype was the biotype circulating in Peru; a detailed understanding of the evolutionary trend of V. cholerae causing endemic cholera in Latin America is lacking. The present retrospective microbiological, molecular, and phylogenetic study of V. cholerae isolates recovered in Mexico (n ‫؍‬ 91; 1983 to 1997) shows the existence of the pre-1991 CL biotype and the ET and CL biotypes together with the altered ET biotype in both epidemic and endemic cholera between 1991 and 1997. According to sero-and biotyping data, the altered ET, which has shown predominance in Mexico since 1991, emerged locally from ET and CL progenitors that were found coexisting until 1997. In Latin America, ET and CL variants shared a variable number of phenotypic markers, while the altered ET strains had genes encoding the CL CTX (CTX CL ) prophage, ctxB CL and rstR CL , in addition to resident rstR ET , as the underlying regional signature. The distinct regional fingerprints for ET in Mexico and Peru and their divergence from ET in Asia and Africa, as confirmed by subclustering patterns in a pulsed-field gel electrophoresis (NotI)-based dendrogram, suggest that the Mexico epidemic in 1991 may have been a local event and not an extension of the epidemics occurring in Asia and South America. Finally, the CL biotype reservoir in Mexico is unprecedented and must have contributed to the changing epidemiology of global cholera in ways that need to be understood.

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Survival of classic cholera in Bangladesh

Cited by 65 publications

References 7 publications

New Variants of Vibrio cholerae O1 Biotype El Tor with Attributes of the Classical Biotype from Hospitalized Patients with Acute Diarrhea in Bangladesh

New Variants of Vibrio cholerae O1 Biotype El Tor with Attributes of the Classical Biotype from Hospitalized Patients with Acute Diarrhea in Bangladesh

Vibrio cholerae O139: How great is the threat of a pandemic?

Cholera between 1991 and 1997 in Mexico Was Associated with Infection by Classical, El Tor, and El Tor Variants of Vibrio cholerae

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