Cholera: possible infection from aircraft effluent

The seventh pandemic of cholera in Europe revisited by microbial genomics

In 1970, the seventh pandemic of cholera (7 P) reached both Africa and Europe. Between 1970 and 2011, several European countries reported cholera outbreaks of a few to more than 2,000 cases. We report here a whole-genome analysis of 1,324 7 P V. cholerae El Tor (7 PET) isolates, including 172 from autochthonous sporadic or outbreak cholera cases occurring between 1970 and 2011 in Europe, providing insight into the spatial and temporal spread of this pathogen across Europe. In this work, we show that the 7 PET lineage was introduced at least eight times into two main regions: Eastern and Southern Europe. Greater recurrence of the disease was observed in Eastern Europe, where it persisted until 2011. It was introduced into this region from Southern Asia, often circulating regionally in the countries bordering the Black Sea, and in the Middle East before reaching Eastern Africa on several occasions. In Southern Europe, the disease was mostly seen in individual countries during the 1970s and was imported from North and West Africa, except in 1994, when cholera was imported into Albania and Italy from the Black Sea region. These results shed light on the geographic course of cholera during the seventh pandemic and highlight the role of humans in its global dissemination.

Impact of global change on transmission of human infectious diseases

Global change, which refers to large-scale changes in the earth system and human society, has been changing the outbreak and transmission mode of many infectious diseases. Climate change affects infectious diseases directly and indirectly. Meteorological factors including temperature, precipitation, humidity and radiation influence infectious disease by modulating pathogen, host and transmission pathways. Meteorological disasters such as droughts and floods directly impact the outbreak and transmission of infectious diseases. Climate change indirectly impacts infectious diseases by altering the ecological system, including its underlying surface and vegetation distribution. In addition, anthropogenic activities are a driving force for climate change and an indirect forcing of infectious disease transmission. International travel and rural-urban migration are a root cause of infectious disease transmission. Rapid urbanization along with poor infrastructure and high disease risk in the rural-urban fringe has been changing the pattern of disease outbreaks and mortality. Land use changes, such as agricultural expansion and deforestation, have already changed the transmission of infectious disease. Accelerated air, road and rail transportation development may not only increase the transmission speed of outbreaks, but also enlarge the scope of transmission area. In addition, more frequent trade and other economic activities will also increase the potential risks of disease outbreaks and facilitate the spread of infectious diseases.

Investigation of cholera acquired from the riverine environment in Queensland

Since February 1977, five patients with cholera apparently acquired the infection from the riverine environment in Queensland. A total of 13 rivers have now yielded at least one isolate of Vibrio cholerae 01 biovar El Tor. Investigations indicate that the organism, including toxigenic strains, can survive and multiply in the riverine environment. No human or animal reservoirs and no ecological niches were identified and no route of importation or dissemination of the organism was discovered. The microbiological examination of faeces in all medical laboratories in Australia should include methods for detecting the cholera organism as a routine. When confronted with a cholera infection, medical practitioners should obtain a history of recent travel, both in Australia and overseas.

Occurrence of Vibrio cholerae serotype O1 in Maryland and Louisiana estuaries

Vibrio cholerae serotype O1 has been isolated from Chesapeake Bay in Maryland and estuaries and sewers in Louisiana. The occurrence of V. cholerae O1 in the aquatic environment in the absence of human disease suggests that this organism survives and multiples in the natural environment.