The Seventh Pandemic of Cholera

Cvjetanović, B; Barua, Dipak

doi:10.1038/239137a0

Cited by 80 publications

(45 citation statements)

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“…Nonhemolytic O1 strains of the classical biotype were responsible for the six pandemics of cholera that occurred from the 18th century to the early 20th century. After nearly 40 years of absence, cholera reemerged in 1961, with El Tor O1 being the most prevalent biotype (11). Upon the colonization of the upper intestine, both El Tor and classical strains secrete cholera toxin (CT).…”

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confidence: 99%

Hemolysin and the Multifunctional Autoprocessing RTX Toxin Are Virulence Factors during Intestinal Infection of Mice with Vibrio cholerae El Tor O1 Strains

Olivier¹,

Haines

Tan³

et al. 2007

Infect Immun

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The seventh cholera pandemic that started in 1961 was caused by Vibrio cholerae O1 strains of the El Tor biotype. These strains produce the pore-forming toxin hemolysin, a characteristic used clinically to distinguish classical and El Tor biotypes. Even though extensive in vitro data on the cytolytic activities of hemolysin exist, the connection of hemolysin to virulence in vivo is not well characterized. To study the contribution of hemolysin and other accessory toxins to pathogenesis, we utilized the model of intestinal infection in adult mice sensitive to the actions of accessory toxins. In this study, we showed that 4-to 6-week-old streptomycin-fed C57BL/6 mice were susceptible to intestinal infection with El Tor strains, which caused rapid death at high doses. Hemolysin had the predominant role in lethality, with a secondary contribution by the multifunctional autoprocessing RTX (MARTX) toxin. Cholera toxin and hemagglutinin/protease did not contribute to lethality in this model. Rapid death was not caused by increased dissemination due to a damaged epithelium since the numbers of CFU recovered from spleens and livers 6 h after infection did not differ between mice inoculated with hemolysin-expressing strains and those infected with non-hemolysin-expressing strains. Although accessory toxins were linked to virulence, a strain defective in the production of accessory toxins was still immunogenic since mice immunized with a multitoxin-deficient strain were protected from a subsequent lethal challenge with the wild type. These data suggest that hemolysin and MARTX toxin contribute to vaccine reactogenicity but that the genes for these toxins can be deleted from vaccine strains without affecting vaccine efficacy.

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confidence: 99%

Hemolysin and the Multifunctional Autoprocessing RTX Toxin Are Virulence Factors during Intestinal Infection of Mice with Vibrio cholerae El Tor O1 Strains

Olivier¹,

Haines

Tan³

et al. 2007

Infect Immun

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“…We are currently experiencing a seventh pandemic of cholera, which started in 1961 in Indonesia and is also caused by V . cholerae O1, but of a different biotype, named El Tor from its original discovery in El Tor, Egypt (2). …”

Section: Commentarymentioning

confidence: 99%

Sustained Local Diversity of Vibrio cholerae O1 Biotypes in a Previously Cholera-Free Country

Boucher

2016

mBio

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Although the current cholera pandemic can trace its origin to a specific time and place, many variants of Vibrio cholerae have caused this disease over the last 50 years. The relative clinical importance and geographical distribution of these variants have changed with time, but most remain in circulation. Some countries, such as Mexico and Haiti, had escaped the current pandemic, until large epidemics struck them in 1991 and 2010, respectively. Cholera has been endemic in these countries ever since. A recent retrospective study in mBio presents the results of more than 3 decades of V. cholerae monitoring from environmental and clinical sources in Mexico (S. Y. Choi et al., mBio 7:e02160-15, 2016, http://dx.doi.org/10.1128/mBio.02160-15). It reveals that multiple V. cholerae variants, including classical strains from the previous pandemic, as well as completely novel biotypes, have been circulating in Mexico. This discovery has important implications for the epidemiology and evolution of V. cholerae.

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“…The pandemic (i.e. the seventh) reached India in 1964, Africa in 1970 (Barua, 1972;Cvjetanovic and Barua, 1972;Goodgame and Greenough, 1975;Küstner et al, 1981, Glass et al, 1991, southern Europe in 1970(Editorial, 1971, and South America in 1991 (Swerdlow et al, 1992;Weil and Berche, 1992). The seventh pandemic was confined in Asia for nearly 10 years which later reached the west coast of Africa, the south coast of Europe, and the western Pacific islands in 1970.…”

Section: Global Distributionmentioning

confidence: 99%