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Clinical Microbiology Reviews Sep 2022Cholera, caused by Vibrio cholerae, persists in developing countries due to inadequate access to safe water, sanitation, and hygiene. There are approximately 4 million... (Review)
Review
Cholera, caused by Vibrio cholerae, persists in developing countries due to inadequate access to safe water, sanitation, and hygiene. There are approximately 4 million cases and 143,000 deaths each year due to cholera. The disease is transmitted fecally-orally via contaminated food or water. Severe dehydrating cholera can progress to hypovolemic shock due to the rapid loss of fluids and electrolytes, which requires a rapid infusion of intravenous (i.v.) fluids. The case fatality rate exceeds 50% without proper clinical management but can be less than 1% with prompt rehydration and antibiotics. Oral cholera vaccines (OCVs) serve as a major component of an integrated control package during outbreaks or within zones of endemicity. Water, sanitation, and hygiene (WaSH); health education; and prophylactic antibiotic treatment are additional components of the prevention and control of cholera. The World Health Organization (WHO) and the Global Task Force for Cholera Control (GTFCC) have set an ambitious goal of eliminating cholera by 2030 in high-risk areas.
Topics: Anti-Bacterial Agents; Cholera; Cholera Vaccines; Disease Outbreaks; Humans; Water
PubMed: 35726607
DOI: 10.1128/cmr.00211-21 -
F1000Research 2019Cholera infections caused by the gamma-proteobacterium have ravaged human populations for centuries, and cholera pandemics have afflicted every corner of the globe.... (Review)
Review
Cholera infections caused by the gamma-proteobacterium have ravaged human populations for centuries, and cholera pandemics have afflicted every corner of the globe. Fortunately, interventions such as oral rehydration therapy, antibiotics/antimicrobials, and vaccines have saved countless people afflicted with cholera, and new interventions such as probiotics and phage therapy are being developed as promising approaches to treat even more cholera infections. Although current therapies are mostly effective and can reduce disease transmission, cholera outbreaks remain deadly, as was seen during recent outbreaks in Haiti, Ethiopia, and Yemen. This is due to significant underlying political and socioeconomic complications, including shortages of vaccines and clean food and water and a lack of health surveillance. In this review, we highlight the strengths and weaknesses of current cholera therapies, discuss emerging technologies, and argue that a multi-pronged, flexible approach is needed to continue to reduce the worldwide burden of cholera.
Topics: Anti-Bacterial Agents; Cholera; Disease Outbreaks; Humans; Vibrio cholerae
PubMed: 31069064
DOI: 10.12688/f1000research.18093.1 -
Microbiology Spectrum Aug 2016Cholera is an acute disease of the gastrointestinal tract caused by Vibrio cholerae. Cholera was localized in Asia until 1817, when a first pandemic spread from India to... (Review)
Review
Cholera is an acute disease of the gastrointestinal tract caused by Vibrio cholerae. Cholera was localized in Asia until 1817, when a first pandemic spread from India to several other regions of the world. After this appearance, six additional major pandemics occurred during the 19th and 20th centuries, the latest of which originated in Indonesia in the 1960s and is still ongoing. In 1854, a cholera outbreak in Soho, London, was investigated by the English physician John Snow (1813 to 1858). He described the time course of the outbreak, managed to understand its routes of transmission, and suggested effective measures to stop its spread, giving rise to modern infectious disease epidemiology. The germ responsible for cholera was discovered twice: first by the Italian physician Filippo Pacini during an outbreak in Florence, Italy, in 1854, and then independently by Robert Koch in India in 1883, thus favoring the germ theory over the miasma theory of disease. Unlike many other infectious diseases, such as plague, smallpox, and poliomyelitis, cholera persists as a huge public health problem worldwide, even though there are effective methods for its prevention and treatment. The main reasons for its persistence are socioeconomic rather than purely biological; cholera flourishes where there are unsatisfactory hygienic conditions and where a breakdown of already fragile sanitation and health infrastructure occurs because of natural disasters or humanitarian crises.
Topics: Cholera; Communicable Disease Control; Disease Transmission, Infectious; Global Health; History, 19th Century; History, 20th Century; History, 21st Century; Humans; Pandemics; Socioeconomic Factors; Vibrio cholerae
PubMed: 27726771
DOI: 10.1128/microbiolspec.PoH-0012-2015 -
Lancet (London, England) Jun 2012Cholera is an acute, secretory diarrhoea caused by infection with Vibrio cholerae of the O1 or O139 serogroup. It is endemic in more than 50 countries and also causes... (Review)
Review
Cholera is an acute, secretory diarrhoea caused by infection with Vibrio cholerae of the O1 or O139 serogroup. It is endemic in more than 50 countries and also causes large epidemics. Since 1817, seven cholera pandemics have spread from Asia to much of the world. The seventh pandemic began in 1961 and affects 3-5 million people each year, killing 120,000. Although mild cholera can be indistinguishable from other diarrhoeal illnesses, the presentation of severe cholera is distinct, with pronounced diarrhoeal purging. Management of patients with cholera involves aggressive fluid replacement; effective therapy can decrease mortality from more than 50% to less than 0·2%. Antibiotic treatment decreases volume and duration of diarrhoea by 50% and is recommended for patients with moderate to severe dehydration. Prevention of cholera depends on access to safe water and sanitation. Two oral cholera vaccines are available and the most effective use of these in integrated prevention programmes is being actively assessed.
Topics: Anti-Bacterial Agents; Cholera; Cholera Vaccines; Fluid Therapy; Humans
PubMed: 22748592
DOI: 10.1016/S0140-6736(12)60436-X -
Trends in Microbiology Sep 2019
Topics: Biofilms; Cholera; Cholera Toxin; Humans; Quorum Sensing; Vibrio cholerae; Virulence Factors
PubMed: 31029488
DOI: 10.1016/j.tim.2019.03.005 -
Microbiology Spectrum Apr 2016Infectious diseases kill nearly 9 million people annually. Bacterial pathogens are responsible for a large proportion of these diseases, and the bacterial agents of... (Review)
Review
Infectious diseases kill nearly 9 million people annually. Bacterial pathogens are responsible for a large proportion of these diseases, and the bacterial agents of pneumonia, diarrhea, and tuberculosis are leading causes of death and disability worldwide. Increasingly, the crucial role of nonhost environments in the life cycle of bacterial pathogens is being recognized. Heightened scrutiny has been given to the biological processes impacting pathogen dissemination and survival in the natural environment, because these processes are essential for the transmission of pathogenic bacteria to new hosts. This chapter focuses on the model environmental pathogen Vibrio cholerae to describe recent advances in our understanding of how pathogens survive between hosts and to highlight the processes necessary to support the cycle of environmental survival, transmission, and dissemination. We describe the physiological and molecular responses of V. cholerae to changing environmental conditions, focusing on its survival in aquatic reservoirs between hosts and its entry into and exit from human hosts.
Topics: Adaptation, Physiological; Animals; Cholera; Disease Outbreaks; Environmental Microbiology; Humans; Microbial Viability; Stress, Physiological; Vibrio cholerae
PubMed: 27227302
DOI: 10.1128/microbiolspec.VMBF-0015-2015 -
Vaccine Feb 2020The unique genetic makeup and remarkable competency of Vibrio cholerae are the key factors that help the cholera pathogen adapt rapidly to adverse environmental... (Review)
Review
The unique genetic makeup and remarkable competency of Vibrio cholerae are the key factors that help the cholera pathogen adapt rapidly to adverse environmental conditions and resist the detrimental effect of antimicrobial agents. In the last few decades, V. cholerae that causes acute watery diarrhoeal disease cholera has emerged as a notorious multidrug resistant (MDR) enteric pathogen. Although chromosomal mutations can contribute to antimicrobial resistance (AMR), the frequent acquisition of extrachromosomal mobile genetic elements (MGEs) from closely/distantly related bacterial species are major players in V. cholerae drug resistance. Whole genome sequence analysis of clinical and environmental V. cholerae strains revealed that the genome of most of the recent isolates harbour integrating conjugative elements (ICEs), plasmids, superintegron, transposable elements and insertion sequences, which are the key carriers of genetic traits encoding antimicrobial resistance function. Different antimicrobial resistance genes identified in V. cholerae can contribute in antibiotic resistance by facilitating one of the following three mechanisms; (i) reduced permeability or active efflux of the antibiotics, (ii) alteration of the antibiotic targets by introducing post-transcriptional/translational modifications and (iii) hydrolysis or chemical modification of antibiotics. Here, we present an overview of the present insights on the emergence and mechanisms of AMR in V. cholerae.
Topics: Anti-Bacterial Agents; Cholera; DNA Transposable Elements; Drug Resistance, Multiple, Bacterial; Humans; Integrons; Plasmids; Vibrio cholerae
PubMed: 31272870
DOI: 10.1016/j.vaccine.2019.06.031 -
Annual Review of Microbiology Sep 2022Cholera is a severe diarrheal disease caused by the bacterium and constitutes a significant public health threat in many areas of the world. infection elicits potent... (Review)
Review
Cholera is a severe diarrheal disease caused by the bacterium and constitutes a significant public health threat in many areas of the world. infection elicits potent and long-lasting immunity, and efforts to develop cholera vaccines have been ongoing for more than a century. Currently available inactivated two-dose oral cholera vaccines are increasingly deployed to both prevent and actively curb cholera outbreaks, and they are key components of the global effort to eradicate cholera. However, these killed whole-cell vaccines have several limitations, and a variety of new oral and nonoral cholera vaccine platforms have recently been developed. Here, we review emerging concepts in cholera vaccine design and implementation that have been driven by insights from human and animal studies. As a prototypical vaccine-preventable disease, cholera continues to be an excellent target for the development and application of cutting-edge technologies and platforms that may transform vaccinology.
Topics: Animals; Cholera; Cholera Vaccines; Humans; Vaccines, Inactivated; Vibrio cholerae
PubMed: 35759873
DOI: 10.1146/annurev-micro-041320-033201 -
Nature Apr 2022Horizontal gene transfer can trigger rapid shifts in bacterial evolution. Driven by a variety of mobile genetic elements-in particular bacteriophages and plasmids-the...
Horizontal gene transfer can trigger rapid shifts in bacterial evolution. Driven by a variety of mobile genetic elements-in particular bacteriophages and plasmids-the ability to share genes within and across species underpins the exceptional adaptability of bacteria. Nevertheless, invasive mobile genetic elements can also present grave risks to the host; bacteria have therefore evolved a vast array of defences against these elements. Here we identify two plasmid defence systems conserved in the Vibrio cholerae El Tor strains responsible for the ongoing seventh cholera pandemic. These systems, termed DdmABC and DdmDE, are encoded on two major pathogenicity islands that are a hallmark of current pandemic strains. We show that the modules cooperate to rapidly eliminate small multicopy plasmids by degradation. Moreover, the DdmABC system is widespread and can defend against bacteriophage infection by triggering cell suicide (abortive infection, or Abi). Notably, we go on to show that, through an Abi-like mechanism, DdmABC increases the burden of large low-copy-number conjugative plasmids, including a broad-host IncC multidrug resistance plasmid, which creates a fitness disadvantage that counterselects against plasmid-carrying cells. Our results answer the long-standing question of why plasmids, although abundant in environmental strains, are rare in pandemic strains; have implications for understanding the dissemination of antibiotic resistance plasmids; and provide insights into how the interplay between two defence systems has shaped the evolution of the most successful lineage of pandemic V. cholerae.
Topics: Cholera; Genomic Islands; Humans; Pandemics; Plasmids; Vibrio cholerae
PubMed: 35388218
DOI: 10.1038/s41586-022-04546-y -
Vaccine Feb 2020Cholera has been extremely pervasive during the past four decades and continues to remain a significant public health concern. The disease has plagued humankind in the...
Cholera has been extremely pervasive during the past four decades and continues to remain a significant public health concern. The disease has plagued humankind in the form of seven pandemics since the last two centuries. There is considerable scientific evidence based on research on cholera and its etiologic agent Vibrio cholerae, however we are still unable to accurately forecast and pre-empt the occurrence of cholera outbreaks. The commentary discusses the contrasts and contradictions of cholera, its control and its unpredictable nature. Through a multi-sectoral approach and broad stakeholder collaboration cholera control is possible with meticulous country-level planning for early detection and response to outbreaks. The commentary reiterates that every potential death on account of cholera is preventable because of the available knowledge and tools to effectively prevent and treat cholera.
Topics: Cholera; Disease Outbreaks; Humans; Vibrio cholerae
PubMed: 31451324
DOI: 10.1016/j.vaccine.2019.08.022