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Abstract
Cholera is one of the major public health problems in the state of Odisha, India since centuries. The current paper is a comprehensive report on epidemiology of cholera in Odisha, which was documented from 1993. PubMed and Web of Knowledge were searched for publications reporting cholera in Odisha during the period 1993–2015. The search was performed using the keywords ‘Odisha’ and/or ‘Orissa’ and ‘Cholera’. In addition, manual search was undertaken to find out relevant papers. During the study period, a total of 37 cholera outbreaks were reported with an average of >1.5 cholera outbreaks per year and case fatality ratio was 0.3%. Vibrio cholerae O1 Ogawa serotype was the major causative agent in most of the cholera cases. The recent studies demonstrated the prevalence of V. cholerae O1, El Tor variants carrying ctxB1, ctxB7 and Haitian variant tcpA allele associated with polymyxin B sensitivity and these variants are replacing the proto type El Tor. The first report of variant ctxB7 in Odisha during super-cyclone 1999 predicted its emergence and subsequent spread causing cholera outbreaks. The prevalence of multidrug-resistant V. cholerae at different time periods created alarming situation. The efficacy trial of oral cholera vaccine (OCV, Shanchol) in a public health set-up in Odisha has shown encouraging results which should be deployed for community level vaccination among the vulnerable population. This paper has taken an effort to disseminate the valuable information of epidemiology of cholera that will influence the policy-makers and epidemiologists for constant surveillance in other parts of Odisha, India and around the globe.
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Roskosky M, Ali M, Upreti SR, Sack D. Spatial clustering of cholera cases in the Kathmandu Valley: implications for a ring vaccination strategy. Int Health 2021; 13:170-177. [PMID: 32761173 PMCID: PMC7902685 DOI: 10.1093/inthealth/ihaa042] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 05/26/2020] [Accepted: 07/08/2020] [Indexed: 12/17/2022] Open
Abstract
Background In mid-2016, a cholera outbreak occurred in Kathmandu Valley, Nepal. This retrospective study aims to determine if a reactive, ring vaccination strategy would have been useful in preventing cholera transmission during that outbreak. Methods Data on cholera cases were collected as part of hospital-based surveillance in the Kathmandu Valley in 2016. Global Positioning System (GPS) coordinates were obtained during household visits. Geographic clusters of cases were visually determined and tested statistically for clustering. Cluster size was determined based on the distribution of cases around the index case. Results GPS coordinates for 69 cases were analysed. Six geographic clusters were identified, all of which showed significant clustering of cases. Approximately 85% of cases within a cluster occurred more than 7 d after the index case. The median ring size was 1 km, with a population of 14 000 people. Conclusions Cholera cases were clustered in space and the majority of cases occurred over 1 week after the initial cases in the cluster, allowing for an opportunity to prevent transmission through the use of the vaccine soon after the initial case was identified. A ring vaccination strategy may be especially useful for large urban areas with recurrent seasonal outbreaks but where the specific locations for such outbreaks are not predictable.
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Affiliation(s)
- Mellisa Roskosky
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, 615 N Wolfe Street, MD-21205, USA
| | - Mohammad Ali
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, 615 N Wolfe Street, MD-21205, USA
| | | | - David Sack
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, 615 N Wolfe Street, MD-21205, USA
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Pepi M, Focardi S. Antibiotic-Resistant Bacteria in Aquaculture and Climate Change: A Challenge for Health in the Mediterranean Area. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:5723. [PMID: 34073520 PMCID: PMC8198758 DOI: 10.3390/ijerph18115723] [Citation(s) in RCA: 47] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 05/11/2021] [Accepted: 05/22/2021] [Indexed: 12/30/2022]
Abstract
Aquaculture is the productive activity that will play a crucial role in the challenges of the millennium, such as the need for proteins that support humans and the respect for the environment. Aquaculture is an important economic activity in the Mediterranean basin. A great impact is presented, however, by aquaculture practices as they involve the use of antibiotics for treatment and prophylaxis. As a consequence of the use of antibiotics in aquaculture, antibiotic resistance is induced in the surrounding bacteria in the column water, sediment, and fish-associated bacterial strains. Through horizontal gene transfer, bacteria can diffuse antibiotic-resistance genes and mobile resistance genes further spreading genetic determinants. Once triggered, antibiotic resistance easily spreads among aquatic microbial communities and, from there, can reach human pathogenic bacteria, making vain the use of antibiotics for human health. Climate change claims a significant role in this context, as rising temperatures can affect cell physiology in bacteria in the same way as antibiotics, causing antibiotic resistance to begin with. The Mediterranean Sea represents a 'hot spot' in terms of climate change and aspects of antibiotic resistance in aquaculture in this area can be significantly amplified, thus increasing threats to human health. Practices must be adopted to counteract negative impacts on human health, with a reduction in the use of antibiotics as a pivotal point. In the meantime, it is necessary to act against climate change by reducing anthropogenic impacts, for example by reducing CO2 emissions into the atmosphere. The One Health type approach, which involves the intervention of different skills, such as veterinary, ecology, and medicine in compliance with the principles of sustainability, is necessary and strongly recommended to face these important challenges for human and animal health, and for environmental safety in the Mediterranean area.
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Affiliation(s)
- Milva Pepi
- Stazione Zoologica Anton Dohrn, Fano Marine Centre, Viale Adriatico 1-N, 61032 Fano, Italy;
| | - Silvano Focardi
- Department of Environmental Sciences, Università di Siena, Via Mattioli, 4, 53100 Siena, Italy
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Reviving the "Moore Swab": a Classic Environmental Surveillance Tool Involving Filtration of Flowing Surface Water and Sewage Water To Recover Typhoidal Salmonella Bacteria. Appl Environ Microbiol 2020; 86:AEM.00060-20. [PMID: 32332133 PMCID: PMC7301852 DOI: 10.1128/aem.00060-20] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
The “Moore swab” is a classic environmental surveillance tool whereby a gauze pad tied with string is suspended in flowing water or wastewater contaminated with human feces and harboring enteric pathogens that pose a human health threat. In contrast to single volume “grab” samples, Moore swabs act as continuous filters to “trap” microorganisms, which are subsequently isolated and confirmed using appropriate laboratory methods. Continuous filtration is valuable for the isolation of transiently present pathogens such as human-restricted Salmonella enterica serovars Typhi and Paratyphi A and B. The “Moore swab” is a classic environmental surveillance tool whereby a gauze pad tied with string is suspended in flowing water or wastewater contaminated with human feces and harboring enteric pathogens that pose a human health threat. In contrast to single volume “grab” samples, Moore swabs act as continuous filters to “trap” microorganisms, which are subsequently isolated and confirmed using appropriate laboratory methods. Continuous filtration is valuable for the isolation of transiently present pathogens such as human-restricted Salmonella enterica serovars Typhi and Paratyphi A and B. The technique was first proposed (1948) to trace Salmonella Paratyphi B systematically through sewers to pinpoint the residence of a chronic carrier responsible for sporadic outbreaks of paratyphoid fever. From 1948 to 1986, Moore swabs proved instrumental to identify long-term human reservoirs (chronic carriers) and long-cycle environmental transmission pathways of S. Typhi and Paratyphi, for example, to decipher endemic transmission in Santiago, Chile, during the 1980s. Despite limitations such as intermittent shedding of typhoidal Salmonella by humans and the effects of dilution, S. Typhi and S. Paratyphi have been recovered from sewers, surface waters, irrigation canals, storm drains, flush toilets, and septic tanks by using Moore swabs. Driven by the emergence of multiple antibiotic-resistant S. Typhi and S. Paratyphi A strains that limit treatment options, several countries are embarking on accelerated typhoid control programs using vaccines and environmental interventions. Moore swabs, which are regaining appreciation as important components of the public health/environmental microbiology toolbox, can enhance environmental surveillance for typhoidal Salmonella, thereby contributing to the control of typhoid fever.
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Phelps MD, Simonsen L, Jensen PKM. Individual and household exposures associated with cholera transmission in case–control studies: a systematic review. Trop Med Int Health 2019; 24:1151-1168. [DOI: 10.1111/tmi.13293] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- Matthew D. Phelps
- Copenhagen Center for Disaster Research, Department of Public Health, Faculty of Health and Medical Sciences University of Copenhagen Copenhagen Denmark
| | - Lone Simonsen
- Department of Science and Environment Roskilde University Roskilde Denmark
| | - Peter K. M. Jensen
- Copenhagen Center for Disaster Research, Department of Public Health, Faculty of Health and Medical Sciences University of Copenhagen Copenhagen Denmark
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Tepaamorndech S, Chantarasakha K, Kingcha Y, Chaiyapechara S, Phromson M, Sriariyanun M, Kirschke CP, Huang L, Visessanguan W. Effects of Bacillus aryabhattai TBRC8450 on vibriosis resistance and immune enhancement in Pacific white shrimp, Litopenaeus vannamei. FISH & SHELLFISH IMMUNOLOGY 2019; 86:4-13. [PMID: 30419397 DOI: 10.1016/j.fsi.2018.11.010] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Revised: 10/30/2018] [Accepted: 11/04/2018] [Indexed: 06/09/2023]
Abstract
The use of probiotics in aquaculture is a practical alternative to promote animal health and disease prevention. Meanwhile, this practice can also reduce the use of prophylactic antibiotics. The purpose of this study was to identify candidate probiotics that could control pathogen populations in host's gastrointestinal (GI) tract and stimulate host immunity in shrimp aquaculture. Bacillus aryabhattai TBRC8450, a bacterial strain isolated from the environment in a shrimp farm, has an antimicrobial activity against many pathogenic strains of Vibrio harveyi and V. parahaemolyticus. Supplementation of B. aryabhattai to Pacific white shrimp (Litopenaeus vannamei) not only decreased the abundance of Vibrio populations, but also shifted the bacterial community in the shrimp GI tract. We found that supplementation of B. aryabhattai triggered shrimp innate immunity and antioxidant activities. mRNA expression of genes encoding microbial peptides and antioxidant enzymes, including C-type lectin, penaeidin-3, heat shock protein 60, thioredoxin, and ferritin, was significantly upregulated in the hepatopancreas of shrimp fed B. aryabhattai. Furthermore, phenoloxidase activity in the hemocytes and the total antioxidant activity in the plasma were increased, indicating enhanced immune and antioxidant responses at the systemic level. In contrast, supplementation of B. aryabhattai had no effect on the total hemocyte count and superoxide dismutase activity in the plasma and hepatopancreas. Importantly, a pathogen challenge test using V. harveyi 1562 showed a significant increase in survival rates of shrimp fed B. aryabhattai compared to the control group. Our findings suggest that B. aryabhattai TBRC8450 can likely be used as a probiotic to reduce the population of V. harveyi in the shrimp GI tract and to enhance shrimp innate immunity and antioxidant capacity for vibriosis resistance in shrimp aquaculture.
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Affiliation(s)
- Surapun Tepaamorndech
- Food Biotechnology Laboratory, National Center for Genetic Engineering and Biotechnology (BIOTEC), 113 Phahonyothin Rd., Pathumthani, 12120, Thailand.
| | - Kanittha Chantarasakha
- Food Biotechnology Laboratory, National Center for Genetic Engineering and Biotechnology (BIOTEC), 113 Phahonyothin Rd., Pathumthani, 12120, Thailand
| | - Yutthana Kingcha
- Food Biotechnology Laboratory, National Center for Genetic Engineering and Biotechnology (BIOTEC), 113 Phahonyothin Rd., Pathumthani, 12120, Thailand
| | - Sage Chaiyapechara
- Aquatic Molecular Genetics and Biotechnology Laboratory, BIOTEC, 113 Phahonyothin Rd., Pathumthani, 12120, Thailand
| | - Metavee Phromson
- Aquatic Product Development and Service Laboratory, BIOTEC, 113 Phahonyothin Rd., Pathumthani, 12120, Thailand
| | - Malinee Sriariyanun
- Department of Mechanical and Process Engineering, The Sirindhorn International Thai-German Graduate School of Engineering, King Mongkut's University of Technology North Bangkok, Bangkok, 10800, Thailand
| | - Catherine P Kirschke
- Obesity and Metabolism Research Unit, USDA/ARS/Western Human Nutrition Research Center, 430 West Health Sciences Drive, Davis, CA, 95616, USA
| | - Liping Huang
- Obesity and Metabolism Research Unit, USDA/ARS/Western Human Nutrition Research Center, 430 West Health Sciences Drive, Davis, CA, 95616, USA
| | - Wonnop Visessanguan
- Food Biotechnology Laboratory, National Center for Genetic Engineering and Biotechnology (BIOTEC), 113 Phahonyothin Rd., Pathumthani, 12120, Thailand
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Richterman A, Sainvilien DR, Eberly L, Ivers LC. Individual and Household Risk Factors for Symptomatic Cholera Infection: A Systematic Review and Meta-analysis. J Infect Dis 2018; 218:S154-S164. [PMID: 30137536 PMCID: PMC6188541 DOI: 10.1093/infdis/jiy444] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background Cholera has caused 7 global pandemics, including the current one which has been ongoing since 1961. A systematic review of risk factors for symptomatic cholera infection has not been previously published. Methods In accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, we performed a systematic review and meta-analysis of individual and household risk factors for symptomatic cholera infection. Results We identified 110 studies eligible for inclusion in qualitative synthesis. Factors associated with symptomatic cholera that were eligible for meta-analysis included education less than secondary level (summary odds ratio [SOR], 2.64; 95% confidence interval [CI], 1.41-4.92; I2 = 8%), unimproved water source (SOR, 3.48; 95% CI, 2.18-5.54; I2 = 77%), open container water storage (SOR, 2.03; 95% CI, 1.09-3.76; I2 = 62%), consumption of food outside the home (SOR, 2.76; 95% CI, 1.62-4.69; I2 = 64%), household contact with cholera (SOR, 2.91; 95% CI, 1.62-5.25; I2 = 89%), water treatment (SOR, 0.37; 95% CI, .21-.63; I2 = 74%), and handwashing (SOR, 0.29; 95% CI, .20-.43; I2 = 37%). Other notable associations with symptomatic infection included income/wealth, blood group, gastric acidity, infant breastfeeding status, and human immunodeficiency virus infection. Conclusions We identified potential risk factors for symptomatic cholera infection including environmental characteristics, socioeconomic factors, and intrinsic patient factors. Ultimately, a combination of interventional approaches targeting various groups with risk-adapted intensities may prove to be the optimal strategy for cholera control.
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Affiliation(s)
- Aaron Richterman
- Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts
| | | | - Lauren Eberly
- Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts
| | - Louise C Ivers
- Center for Global Health, Massachusetts General Hospital
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts
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Abrahale K, Sousa S, Albuquerque G, Padrão P, Lunet N. Street food research worldwide: a scoping review. J Hum Nutr Diet 2018; 32:152-174. [DOI: 10.1111/jhn.12604] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- K. Abrahale
- EPIUnit - Unidade de Investigação em Epidemiologia; Instituto de Saúde Pública; Universidade do Porto; Porto Portugal
| | - S. Sousa
- EPIUnit - Unidade de Investigação em Epidemiologia; Instituto de Saúde Pública; Universidade do Porto; Porto Portugal
- Faculdade de Ciências da Nutrição; Alimentação da Universidade do Porto; Porto Portugal
| | - G. Albuquerque
- EPIUnit - Unidade de Investigação em Epidemiologia; Instituto de Saúde Pública; Universidade do Porto; Porto Portugal
| | - P. Padrão
- EPIUnit - Unidade de Investigação em Epidemiologia; Instituto de Saúde Pública; Universidade do Porto; Porto Portugal
- Faculdade de Ciências da Nutrição; Alimentação da Universidade do Porto; Porto Portugal
| | - N. Lunet
- EPIUnit - Unidade de Investigação em Epidemiologia; Instituto de Saúde Pública; Universidade do Porto; Porto Portugal
- Departamento de Ciências da Saúde Pública e Forenses e Educação Médica; Faculdade de Medicina da Universidade do Porto; Porto Portugal
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9
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Abstract
PURPOSE OF REVIEW This review describes the basic epidemiologic, clinical, and microbiologic aspects of cholera, highlights new developments within these areas, and presents strategies for applying currently available tools and knowledge more effectively. RECENT FINDINGS From 1990 to 2016, the reported global burden of cholera fluctuated between 74,000 and 595,000 cases per year; however, modeling estimates suggest the real burden is between 1.3 and 4.0 million cases and 95,000 deaths yearly. In 2018, the World Health Assembly endorsed a new initiative to reduce cholera deaths by 90% and eliminate local cholera transmission in 20 countries by 2030. New tools, including localized GIS mapping, climate modeling, whole genome sequencing, oral vaccines, rapid diagnostic tests, and new applications of water, sanitation, and hygiene interventions, could support this goal. Challenges include a high proportion of fragile states among cholera-endemic countries, urbanization, climate change, and the need for cholera treatment guidelines for pregnant women and malnourished children. SUMMARY Reducing cholera morbidity and mortality depends on real-time surveillance, outbreak detection and response; timely access to appropriate case management and cholera vaccines; and provision of safe water, sanitation, and hygiene.
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Affiliation(s)
- William Davis
- Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, 1600 Clifton Road, Mailstop H24-9, Atlanta, GA 30329, USA
| | - Rupa Narra
- Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, 1600 Clifton Road, Mailstop H24-9, Atlanta, GA 30329, USA
| | - Eric D. Mintz
- Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, 1600 Clifton Road, Mailstop H24-9, Atlanta, GA 30329, USA
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Wolfe M, Kaur M, Yates T, Woodin M, Lantagne D. A Systematic Review and Meta-Analysis of the Association between Water, Sanitation, and Hygiene Exposures and Cholera in Case-Control Studies. Am J Trop Med Hyg 2018; 99:534-545. [PMID: 29968551 PMCID: PMC6090371 DOI: 10.4269/ajtmh.17-0897] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Case-control studies are conducted to identify cholera transmission routes. Water, sanitation, and hygiene (WASH) exposures can facilitate cholera transmission (risk factors) or interrupt transmission (protective factors). To our knowledge, the association between WASH exposures and cholera from case-control studies has not been systematically analyzed. A systematic review was completed to close this gap, including describing the theory of risk and protection, developing inclusion criteria, searching and selecting studies, assessing quality of evidence, and summarizing associations between cholera and seven predicted WASH protective factors and eight predicted WASH risk factors using meta-analysis and sensitivity analysis. Overall, 47 articles describing 51 individual studies from 30 countries met the inclusion criteria. All eight predicted risk factors were associated with higher odds of cholera (odds ratio [OR] = 1.9-5.6), with heterogeneity (I2) of 0-92%. Of the predicted protective factors, five of seven were associated with lower odds of cholera (OR = 0.35-1.4), with heterogeneity of 57-91%; exceptions were insignificant associations for improved water source (OR = 1.1, heterogeneity 91%) and improved sanitation (OR = 1.4, heterogeneity 68%). Results were robust; 3/70 (5%) associations changed directionality or significance in sensitivity analysis. Meta-analysis results highlight that predicted risk factors are associated with cholera; however, predicted protective factors are not as consistently protective. This variable protection is attributed to 1) cholera transmission via multiple routes and 2) WASH intervention implementation quality variation. Water, sanitation, and hygiene interventions should address multiple transmission routes and be well implemented, according to international guidance, to ensure that field effectiveness matches theoretical efficacy. In addition, future case-control studies should detail WASH characteristics to contextualize results.
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Affiliation(s)
- Marlene Wolfe
- Tufts University Civil and Environmental Engineering Department, Medford, Massachusetts
| | - Mehar Kaur
- Tufts University Civil and Environmental Engineering Department, Medford, Massachusetts
| | - Travis Yates
- Tufts University Civil and Environmental Engineering Department, Medford, Massachusetts
| | - Mark Woodin
- Tufts University Civil and Environmental Engineering Department, Medford, Massachusetts
| | - Daniele Lantagne
- Tufts University Civil and Environmental Engineering Department, Medford, Massachusetts
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Kim HY, Go J, Lee KM, Oh YT, Yoon SS. Guanosine tetra- and pentaphosphate increase antibiotic tolerance by reducing reactive oxygen species production in Vibrio cholerae. J Biol Chem 2018; 293:5679-5694. [PMID: 29475943 PMCID: PMC5900777 DOI: 10.1074/jbc.ra117.000383] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Revised: 02/16/2018] [Indexed: 02/06/2023] Open
Abstract
The pathogen Vibrio cholerae is the causative agent of cholera. Emergence of antibiotic-resistant V. cholerae strains is increasing, but the underlying mechanisms remain unclear. Herein, we report that the stringent response regulator and stress alarmone guanosine tetra- and pentaphosphate ((p)ppGpp) significantly contributes to antibiotic tolerance in V. cholerae We found that N16961, a pandemic V. cholerae strain, and its isogenic (p)ppGpp-overexpressing mutant ΔrelAΔspoT are both more antibiotic-resistant than (p)ppGpp0 (ΔrelAΔrelVΔspoT) and ΔdksA mutants, which cannot produce or utilize (p)ppGpp, respectively. We also found that additional disruption of the aconitase B-encoding and tricarboxylic acid (TCA) cycle gene acnB in the (p)ppGpp0 mutant increases its antibiotic tolerance. Moreover, expression of TCA cycle genes, including acnB, was increased in (p)ppGpp0, but not in the antibiotic-resistant ΔrelAΔspoT mutant, suggesting that (p)ppGpp suppresses TCA cycle activity, thereby entailing antibiotic resistance. Importantly, when grown anaerobically or incubated with an iron chelator, the (p)ppGpp0 mutant became antibiotic-tolerant, suggesting that reactive oxygen species (ROS) are involved in antibiotic-mediated bacterial killing. Consistent with that hypothesis, tetracycline treatment markedly increased ROS production in the antibiotic-susceptible mutants. Interestingly, expression of the Fe(III) ABC transporter substrate-binding protein FbpA was increased 10-fold in (p)ppGpp0, and fbpA gene deletion restored viability of tetracycline-exposed (p)ppGpp0 cells. Of note, FbpA expression was repressed in the (p)ppGpp-accumulating mutant, resulting in a reduction of intracellular free iron, required for the ROS-generating Fenton reaction. Our results indicate that (p)ppGpp-mediated suppression of central metabolism and iron uptake reduces antibiotic-induced oxidative stress in V. cholerae.
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Affiliation(s)
- Hwa Young Kim
- From the Department of Microbiology and Immunology, Brain Korea 21 PLUS Project for Medical Science, and ,the Institute for Immunology and Immunological Diseases, Yonsei University College of Medicine, Seoul 03722, Korea and
| | - Junhyeok Go
- From the Department of Microbiology and Immunology, Brain Korea 21 PLUS Project for Medical Science, and ,the Institute for Immunology and Immunological Diseases, Yonsei University College of Medicine, Seoul 03722, Korea and
| | - Kang-Mu Lee
- From the Department of Microbiology and Immunology, Brain Korea 21 PLUS Project for Medical Science, and ,the Institute for Immunology and Immunological Diseases, Yonsei University College of Medicine, Seoul 03722, Korea and
| | - Young Taek Oh
- From the Department of Microbiology and Immunology, Brain Korea 21 PLUS Project for Medical Science, and ,the Freshwater Bioresources Utilization Division, Nakdonggang National Institute of Biological Resources, SangJu 37242, Korea, To whom correspondence may be addressed:
Freshwater Bioresources Utilization Division, Nakdonggang National Institute of Biological Resources, SangJu-si 37242, Korea. Tel.:
82-54-530-0932; Fax:
82-54-530-0949; E-mail:
| | - Sang Sun Yoon
- From the Department of Microbiology and Immunology, Brain Korea 21 PLUS Project for Medical Science, and ,the Institute for Immunology and Immunological Diseases, Yonsei University College of Medicine, Seoul 03722, Korea and , To whom correspondence may be addressed:
Dept. of Microbiology and Immunology, Yonsei University College of Medicine, 250 Seongsanno, Seodaemun-gu Seoul 120-752, Korea. Tel.:
82-2-2228-1824; Fax:
82-2-392-7088; E-mail:
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12
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Acosta-Smith E, Viveros-Jiménez K, Canizalez-Román A, Reyes-Lopez M, Bolscher JGM, Nazmi K, Flores-Villaseñor H, Alapizco-Castro G, de la Garza M, Martínez-Garcia JJ, Velazquez-Roman J, Leon-Sicairos N. Bovine Lactoferrin and Lactoferrin-Derived Peptides Inhibit the Growth of Vibrio cholerae and Other Vibrio species. Front Microbiol 2018; 8:2633. [PMID: 29375503 PMCID: PMC5768654 DOI: 10.3389/fmicb.2017.02633] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Accepted: 12/15/2017] [Indexed: 12/18/2022] Open
Abstract
Vibrio is a genus of Gram-negative bacteria, some of which can cause serious infectious diseases. Vibrio infections are associated with the consumption of contaminated food and classified in Vibrio cholera infections and non-cholera Vibrio infections. In the present study, we investigate whether bovine lactoferrin (bLF) and several synthetic peptides corresponding to bLF sequences, are able to inhibit the growth or have bactericidal effect against V. cholerae and other Vibrio species. The antibacterial activity of LF and LF-peptides was assessed by kinetics of growth or determination of colony forming unit in bacteria treated with the peptides and antibiotics. To get insight in the mode of action, the interaction between bLF and bLF-peptides (coupled to FITC) and V. cholera was evaluated. The damage of effector-induced bacterial membrane permeability was measured by inclusion of the fluorescent dye propidium iodide using flow cytometry, whereas the bacterial ultrastructural damage in bacteria treated was observed by transmission electron microscopy. The results showed that bLF and LFchimera inhibited the growth of the V. cholerae strains; LFchimera permeabilized the bacteria which membranes were seriously damaged. Assays with a multidrug-resistant strain of Vibrio species indicated that combination of sub-lethal doses of LFchimera with ampicillin or tetracycline strongly reduced the concentration of the antibiotics to reach 95% growth inhibition. Furthermore, LFchimera were effective to inhibit the V. cholerae counts and damage due to this bacterium in a model mice. These data suggest that LFchimera and bLF are potential candidates to combat the V. cholerae and other multidrug resistant Vibrio species.
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Affiliation(s)
- Erika Acosta-Smith
- Programa Regional Para el Doctorado en Biotecnología, Facultad de Ciencias Químico-Biológicas, Universidad Autónoma de Sinaloa, Culiacán, Mexico
| | - Karina Viveros-Jiménez
- Centro de Investigación Aplicada para la Salud Pública (CIASaP), Facultad de Medicina, Universidad Autónoma de Sinaloa, Culiacán, Mexico
| | - Adrian Canizalez-Román
- Centro de Investigación Aplicada para la Salud Pública (CIASaP), Facultad de Medicina, Universidad Autónoma de Sinaloa, Culiacán, Mexico.,Hospital de la Mujer, Servicios de Salud de Sinaloa, Culiacán, Mexico
| | - Magda Reyes-Lopez
- Departamento de Biología Celular, Centro de Investigación y de Estudios Avanzados del Instituto Politécnico Nacional, Mexico, Mexico
| | - Jan G M Bolscher
- Department of Oral Biochemistry ACTA, University of Amsterdam and VU University, Amsterdam, Netherlands
| | - Kamran Nazmi
- Department of Oral Biochemistry ACTA, University of Amsterdam and VU University, Amsterdam, Netherlands
| | - Hector Flores-Villaseñor
- Centro de Investigación Aplicada para la Salud Pública (CIASaP), Facultad de Medicina, Universidad Autónoma de Sinaloa, Culiacán, Mexico.,Laboratorio Estatal de Salud Pública de Sinaloa, Culiacán, Mexico
| | - Gerardo Alapizco-Castro
- Centro de Investigación Aplicada para la Salud Pública (CIASaP), Facultad de Medicina, Universidad Autónoma de Sinaloa, Culiacán, Mexico
| | - Mireya de la Garza
- Departamento de Biología Celular, Centro de Investigación y de Estudios Avanzados del Instituto Politécnico Nacional, Mexico, Mexico
| | - Jesús J Martínez-Garcia
- Centro de Investigación Aplicada para la Salud Pública (CIASaP), Facultad de Medicina, Universidad Autónoma de Sinaloa, Culiacán, Mexico.,Departamento de Investigación, Hospital Pediátrico de Sinaloa, Culiacán, Mexico
| | - Jorge Velazquez-Roman
- Centro de Investigación Aplicada para la Salud Pública (CIASaP), Facultad de Medicina, Universidad Autónoma de Sinaloa, Culiacán, Mexico
| | - Nidia Leon-Sicairos
- Centro de Investigación Aplicada para la Salud Pública (CIASaP), Facultad de Medicina, Universidad Autónoma de Sinaloa, Culiacán, Mexico.,Departamento de Investigación, Hospital Pediátrico de Sinaloa, Culiacán, Mexico
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Cohen A, Colford JM. Effects of Boiling Drinking Water on Diarrhea and Pathogen-Specific Infections in Low- and Middle-Income Countries: A Systematic Review and Meta-Analysis. Am J Trop Med Hyg 2017; 97:1362-1377. [PMID: 29016318 PMCID: PMC5817760 DOI: 10.4269/ajtmh.17-0190] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Accepted: 06/05/2017] [Indexed: 12/21/2022] Open
Abstract
Globally, approximately 2 billion people lack microbiologically safe drinking water. Boiling is the most prevalent household water treatment method, yet evidence of its health impact is limited. To conduct this systematic review, we searched four online databases with no limitations on language or publication date. Studies were eligible if health outcomes were measured for participants who reported consuming boiled and untreated water. We used reported and calculated odds ratios (ORs) and random-effects meta-analysis to estimate pathogen-specific and pooled effects by organism group and nonspecific diarrhea. Heterogeneity and publication bias were assessed using I2, meta-regression, and funnel plots; study quality was also assessed. Of the 1,998 records identified, 27 met inclusion criteria and reported extractable data. We found evidence of a significant protective effect of boiling for Vibrio cholerae infections (OR = 0.31, 95% confidence interval [CI] = 0.13-0.79, N = 4 studies), Blastocystis (OR = 0.35, 95% CI = 0.17-0.69, N = 3), protozoal infections overall (pooled OR = 0.61, 95% CI = 0.43-0.86, N = 11), viral infections overall (pooled OR = 0.83, 95% CI = 0.7-0.98, N = 4), and nonspecific diarrheal outcomes (OR = 0.58, 95% CI = 0.45-0.77, N = 7). We found no evidence of a protective effect for helminthic infections. Although our study was limited by the use of self-reported boiling and non-experimental designs, the evidence suggests that boiling provides measureable health benefits for pathogens whose transmission routes are primarily water based. Consequently, we believe a randomized controlled trial of boiling adherence and health outcomes is needed.
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Affiliation(s)
- Alasdair Cohen
- Division of Epidemiology, School of Public Health, University of California at Berkeley, Berkeley, California
- Department of Environmental Science, Policy and Management, University of California at Berkeley, Berkeley, California
| | - John M. Colford
- Division of Epidemiology, School of Public Health, University of California at Berkeley, Berkeley, California
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Antimicrobial Resistance Risks of Cholera Prophylaxis for United Nations Peacekeepers. Antimicrob Agents Chemother 2017; 61:AAC.00026-17. [DOI: 10.1128/aac.00026-17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2017] [Accepted: 05/12/2017] [Indexed: 11/20/2022] Open
Abstract
ABSTRACT
More than 5 years after a United Nations peacekeeping battalion introduced cholera to Haiti, over 150,000 peacekeepers continue to be deployed annually from countries where cholera is endemic. The United Nations has thus far declined to provide antimicrobial chemoprophylaxis to peacekeepers, a policy based largely on concerns that the risks of drug resistance generation and spread would outweigh the potential benefits of preventing future cholera importations. In this study, we sought to better understand the relative benefits and risks of cholera chemoprophylaxis for peacekeepers in terms of antibiotic resistance. Using a stochastic model to quantify the potential impact of chemoprophylaxis on importation and transmission of drug-resistant and drug-sensitive
Vibrio cholerae
, we found that chemoprophylaxis would decrease the probability of cholera importation but would increase the expected number of drug-resistant infections if an importation event were to occur. Despite this potential increase, we found that at least 10 drug-sensitive infections would likely be averted per excess drug-resistant infection under a wide range of assumptions about the underlying prevalence of drug resistance and risk of acquired resistance. Given these findings, policymakers should reconsider whether the potential resistance risks of providing antimicrobial chemoprophylaxis to peacekeepers are sufficient to outweigh the anticipated benefits.
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Nguyen TV, Pham QD, Do QK, Diep TT, Phan HC, Ho TV, Do HT, Phan LT, Tran HN. Cholera returns to southern Vietnam in an outbreak associated with consuming unsafe water through iced tea: A matched case-control study. PLoS Negl Trop Dis 2017; 11:e0005490. [PMID: 28406946 PMCID: PMC5390973 DOI: 10.1371/journal.pntd.0005490] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2016] [Accepted: 03/14/2017] [Indexed: 11/18/2022] Open
Abstract
Background After more than a decade of steadily declining notifications, the number of reported cholera cases has recently increased in Vietnam. We conducted a matched case-control study to investigate transmission of cholera during an outbreak in Ben Tre, southern Vietnam, and to explore the associated risk factors. Methodology/Principal findings Sixty of 71 diarrheal patients confirmed to be infected with cholera by culture and diagnosed between May 9 and August 3, 2010 in Ben Tre were consecutively recruited as case-patients. Case-patients were matched 1:4 to controls by commune, sex, and 5-year age group. Risk factors for cholera were examined by multivariable conditional logistic regression. In addition, environmental samples from villages containing case-patients were taken to identify contamination of food and water sources. The regression indicated that drinking iced tea (adjusted odds ratio (aOR) = 8.40, 95% confidence interval (CI): 1.84–39.25), not always boiling drinking water (aOR = 2.62, 95% CI: 1.03–6.67), having the main source of water for use being close to a toilet (aOR = 4.36, 95% CI: 1.37–13.88), living with people who had acute diarrhea (aOR = 13.72, 95% CI: 2.77–67.97), and little or no education (aOR = 4.89, 95% CI: 1.18–20.19) were significantly associated with increased risk of cholera. In contrast, drinking stored rainwater (aOR = 0.17, 95% CI: 0.04–0.63), eating cooked seafood (aOR = 0.27, 95% CI: 0.10–0.73), and eating steamed vegetables (aOR = 0.22, 95% CI: 0.07–0.70) were protective against cholera. Vibrio cholerae O1 Ogawa carrying ctxA was found in two of twenty-five river water samples and one of six wastewater samples. Conclusions/Significance The magnitude of the cholera outbreak in Ben Tre was lower than in other similar settings. This investigation identified several risk factors and underscored the importance of continued responses targeting cholera prevention in southern Vietnam. The association between drinking iced tea and cholera and the spread of V. cholerae O1, altered El Tor strains warrant further research. These findings might be affected by a number of limitations due to the inability to capture asymptomatic or mildly symptomatic infections, the possible underreporting of personal unhygienic behaviors, and the purposive selection of environmental samples. Cholera is a highly contagious, acute diarrheal illness, which poses a profound health threat in many parts of the less developed world. The majority of cases are reported from Sub-Saharan Africa, South-East Asia, and the Americas (i.e., Haiti) where infections are primarily transmitted through ingestion of contaminated water. Today in the era of widely available rehydration therapies and antibiotics, deaths due to cholera are quite rare. Despite this, early detection of contaminated water sources is crucial for directing early interventions for curbing community-wide transmission. The authors found evidence linking an outbreak of cholera in southern Vietnam to consumption of unsafe water, especially drinking iced tea. This finding suggests the need for a water-monitoring system at ice-making plants. Further research is needed to confirm the biological link between iced tea consumption and cholera infection. Larger studies should also be conducted to understand the clinical consequences of infection with the new cholera agent (V. cholerae O1, altered El Tor strains).
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Affiliation(s)
| | - Quang D. Pham
- Department for Disease Control and Prevention, Pasteur Institute, Ho Chi Minh City, Vietnam
| | - Quoc K. Do
- Department for Disease Control and Prevention, Pasteur Institute, Ho Chi Minh City, Vietnam
| | - Tai T. Diep
- Department of Microbiology and Immunology, Pasteur Institute, Ho Chi Minh City, Vietnam
| | - Hung C. Phan
- Department for Disease Control and Prevention, Pasteur Institute, Ho Chi Minh City, Vietnam
| | - Thang V. Ho
- Department for Disease Control and Prevention, Pasteur Institute, Ho Chi Minh City, Vietnam
| | - Hong T. Do
- Ben Tre Preventive Health Centre, Ben Tre, Vietnam
| | - Lan T. Phan
- Pasteur Institute, Ho Chi Minh City, Vietnam
| | - Huu N. Tran
- Pasteur Institute, Ho Chi Minh City, Vietnam
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Yaya-Beas RE, Cadillo-La-Torre EA, Kujawa-Roeleveld K, van Lier JB, Zeeman G. Presence of helminth eggs in domestic wastewater and its removal at low temperature UASB reactors in Peruvian highlands. WATER RESEARCH 2016; 90:286-293. [PMID: 26748206 DOI: 10.1016/j.watres.2015.11.023] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2015] [Revised: 10/18/2015] [Accepted: 11/08/2015] [Indexed: 06/05/2023]
Abstract
This work studied the anaerobic sludge filtration capacity for pathogens reduction in a 29 L and 1.65 m height lab-scale UASB reactor treating domestic wastewater at low temperatures in the city of Puno (Peru). The anaerobic sludge filtration capacity was performed applying upflow velocities of 0.12, 0.14, 0.16, 0.20, 0.27 and 0.41 m/h. Results show that the HE removal varied between 89 and 95% and the most common specie was Ascaris lumbricoides. Faecal coliform and Escherichia coli removal varied in the range of 0.9-2.1 and 0.8-1.6 log10 respectively. Likely related to the low operational temperatures, the total COD removal varied between 37 and 62%. The best performance in terms of removal of HE, total COD and turbidity was obtained at the lowest upflow velocity of 0.12 m/h. In order to meet WHO standards for water reuse a post-treatment unit will be required to polish the effluent.
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Affiliation(s)
- Rosa-Elena Yaya-Beas
- Environmental Engineering Faculty, National University of Engineering, Lima 25, Peru; Sub-Department of Environmental Technology, University of Wageningen, 6700 AA Wageningen, The Netherlands.
| | | | - Katarzyna Kujawa-Roeleveld
- Sub-Department of Environmental Technology, University of Wageningen, 6700 AA Wageningen, The Netherlands; Lettinga Associates Foundation (LeAF), P.O. Box 500, 6700 AM Wageningen, The Netherlands
| | - Jules B van Lier
- Section Sanitary Engineering, Department of Water Management, Faculty of Civil Engineering and Geosciences, Delft University of Technology, 2600 GA Delft, The Netherlands; Unesco-IHE Institute for Water Education, Westvest 7, 2611 AX Delft, The Netherlands
| | - Grietje Zeeman
- Sub-Department of Environmental Technology, University of Wageningen, 6700 AA Wageningen, The Netherlands; Lettinga Associates Foundation (LeAF), P.O. Box 500, 6700 AM Wageningen, The Netherlands
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Allan M, Grandesso F, Pierre R, Magloire R, Coldiron M, Martinez-Pino I, Goffeau T, Gitenet R, François G, Olson D, Porten K, Luquero FJ. High-resolution spatial analysis of cholera patients reported in Artibonite department, Haiti in 2010-2011. Epidemics 2015; 14:1-10. [PMID: 26972509 DOI: 10.1016/j.epidem.2015.08.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2015] [Revised: 08/25/2015] [Accepted: 08/26/2015] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Cholera is caused by Vibrio cholerae, and is transmitted through fecal-oral contact. Infection occurs after the ingestion of the bacteria and is usually asymptomatic. In a minority of cases, it causes acute diarrhea and vomiting, which can lead to potentially fatal severe dehydration, especially in the absence of appropriate medical care. Immunity occurs after infection and typically lasts 6-36 months. Cholera is responsible for outbreaks in many African and Asian developing countries, and caused localised and episodic epidemics in South America until the early 1990s. Haiti, despite its low socioeconomic status and poor sanitation, had never reported cholera before the recent outbreak that started in October 2010, with over 720,000 cases and over 8700 deaths (Case fatality rate: 1.2%) through 8 december 2014. So far, this outbreak has seen 3 epidemic peaks, and it is expected that cholera will remain in Haiti for some time. METHODOLOGY/FINDINGS To trace the path of the early epidemic and to identify hot spots and potential transmission hubs during peaks, we examined the spatial distribution of cholera patients during the first two peaks in Artibonite, the second-most populous department of Haiti. We extracted the geographic origin of 84,000 patients treated in local health facilities between October 2010 and December 2011 and mapped these addresses to 63 rural communal sections and 9 urban cities. Spatial and cluster analysis showed that during the first peak, cholera spread along the Artibonite River and the main roads, and sub-communal attack rates ranged from 0.1% to 10.7%. During the second peak, remote mountain areas were most affected, although sometimes to very different degrees even in closely neighboring locations. Sub-communal attack rates during the second peak ranged from 0.2% to 13.7%. The relative risks at the sub-communal level during the second phase showed an inverse pattern compared to the first phase. CONCLUSION/SIGNIFICANCE These findings demonstrate the value of high-resolution mapping for pinpointing locations most affected by cholera, and in the future could help prioritize the places in need of interventions such as improvement of sanitation and vaccination. The findings also describe spatio-temporal transmission patterns of the epidemic in a cholera-naïve country such as Haiti. By identifying transmission hubs, it is possible to target prevention strategies that, over time, could reduce transmission of the disease and eventually eliminate cholera in Haiti.
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Affiliation(s)
| | | | - Ronald Pierre
- Artibonite Surveillance Department, MSPP, Gonaïves, Haiti.
| | - Roc Magloire
- Surveillance Department, DELR, Port-au-Prince, Haiti.
| | | | - Isabel Martinez-Pino
- Epicentre, Paris, France; European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden.
| | | | | | | | - David Olson
- Médecins Sans Frontières, New York, NY, USA.
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Spiegel JM, Breilh J, Yassi A. Why language matters: insights and challenges in applying a social determination of health approach in a North-South collaborative research program. Global Health 2015; 11:9. [PMID: 25880442 PMCID: PMC4353467 DOI: 10.1186/s12992-015-0091-2] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2014] [Accepted: 01/27/2015] [Indexed: 01/21/2023] Open
Abstract
Background Focus on “social determinants of health” provides a welcome alternative to the bio-medical illness paradigm. However, the tendency to concentrate on the influence of “risk factors” related to living and working conditions of individuals, rather than to more broadly examine dynamics of the social processes that affect population health, has triggered critical reaction not only from the Global North but especially from voices the Global South where there is a long history of addressing questions of health equity. In this article, we elaborate on how focusing instead on the language of “social determination of health” has prompted us to attempt to apply a more equity-sensitive approaches to research and related policy and praxis. Discussion In this debate, we briefly explore the epistemological and historical roots of epidemiological approaches to health and health equity that have emerged in Latin America to consider its relevance to global discourse. In this region marked by pronounced inequity, context-sensitive concepts such as “collective health” and “critical epidemiology” have been prominent, albeit with limited acknowledgement by the Global North. We illustrate our attempts to apply a social determination approach (and the “4 S” elements of bio-Security, Sovereignty, Solidarity and Sustainability) in five projects within our research collaboration linking researchers and knowledge users in Ecuador and Canada, in diverse settings (health of healthcare workers; food systems; antibiotic resistance; vector borne disease [dengue]; and social circus with street youth). Conclusions We argue that the language of social determinants lends itself to research that is more reductionist and beckons the development of different skills than would be applied when adopting the language of social determination. We conclude that this language leads to more direct analysis of the systemic factors that drive, promote and reinforce disparities, while at the same time directly considering the emancipatory forces capable of countering negative health impacts. It follows that “reverse innovation” must not only recognize practical solutions being developed in low and middle income countries, but must also build on the strengths of the theoretical-methodological reasoning that has emerged in the South.
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Affiliation(s)
- Jerry M Spiegel
- School of Population and Public Health, Department of Medicine, the University of British Columbia, Rm. 430 - 2206 East Mall, Vancouver, V6T 1Z3, BC, Canada.
| | - Jaime Breilh
- Health Sciences Area, University Andina Simon Bolivar, Quito, Ecuador.
| | - Annalee Yassi
- School of Population and Public Health, Department of Medicine, the University of British Columbia, Rm. 430 - 2206 East Mall, Vancouver, V6T 1Z3, BC, Canada.
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Nguyen VD, Sreenivasan N, Lam E, Ayers T, Kargbo D, Dafae F, Jambai A, Alemu W, Kamara A, Islam MS, Stroika S, Bopp C, Quick R, Mintz ED, Brunkard JM. Cholera epidemic associated with consumption of unsafe drinking water and street-vended water--Eastern Freetown, Sierra Leone, 2012. Am J Trop Med Hyg 2014; 90:518-23. [PMID: 24470563 PMCID: PMC3945698 DOI: 10.4269/ajtmh.13-0567] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2013] [Accepted: 12/05/2013] [Indexed: 11/07/2022] Open
Abstract
During 2012, Sierra Leone experienced a cholera epidemic with 22,815 reported cases and 296 deaths. We conducted a matched case-control study to assess risk factors, enrolling 49 cases and 98 controls. Stool specimens were analyzed by culture, polymerase chain reaction (PCR), and pulsed-field gel electrophoresis (PFGE). Conditional logistic regression found that consuming unsafe water (matched odds ratio [mOR]: 3.4; 95% confidence interval [CI]: 1.1, 11.0), street-vended water (mOR: 9.4; 95% CI: 2.0, 43.7), and crab (mOR: 3.3; 95% CI: 1.03, 10.6) were significant risk factors for cholera infection. Of 30 stool specimens, 13 (43%) showed PCR evidence of toxigenic Vibrio cholerae O1. Six specimens yielded isolates of V. cholerae O1, El Tor; PFGE identified a pattern previously observed in seven countries. We recommended ensuring the quality of improved water sources, promoting household chlorination, and educating street vendors on water handling practices.
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Affiliation(s)
- Von D. Nguyen
- Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Disease Control and Prevention, Sierra Leone Ministry of Health and Sanitation, Freetown, Sierra Leone; WHO Representative Office, Sierra Leone World Health Organization Country Office, Freetown, Sierra Leone; Environmental Microbiology Laboratory, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
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AL-ARYDAH MO, MWASA ABUBAKAR, TCHUENCHE JEANM, SMITH? ROBERTJ. MODELING CHOLERA DISEASE WITH EDUCATION AND CHLORINATION. J BIOL SYST 2014. [DOI: 10.1142/s021833901340007x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Cholera, characterized by severe diarrhea and rapid dehydration, is a water-borne infectious disease caused by the bacterium Vibrio cholerae. Haiti offers the most recent example of the tragedy that can befall a country and its people when cholera strikes. While cholera has been a recognized disease for two centuries, there is no strategy for its effective control. We formulate and analyze a mathematical model that includes two essential and affordable control measures: water chlorination and education. We calculate the basic reproduction number and determine the global stability of the disease-free equilibrium for the model without chlorination. We use Latin Hypercube Sampling to demonstrate that the model is most sensitive to education. We also derive the minimal effective chlorination period required to control the disease for both fixed and variable chlorination. Numerical simulations suggest that education is more effective than chlorination in decreasing bacteria and the number of cholera cases.
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Affiliation(s)
- MO'TASSEM AL-ARYDAH
- Department of Mathematics, The University of Ottawa, 585 King Edward Ave, Ottawa ON K1N 6N5, Canada
| | - ABUBAKAR MWASA
- Department of Mathematics, Busitema University, P.O. Box 236, Tororo, Uganda
| | - JEAN M. TCHUENCHE
- Department of Mathematics, The University of Guelph, 50 Stone Rd E, Guelph, ON N1G 2W1, Canada
| | - ROBERT J. SMITH?
- Department of Mathematics and Faculty of Medicine, The University of Ottawa, 585 King Edward Ave, Ottawa ON K1N 6N5, Canada
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Robins WP, Mekalanos JJ. Genomic science in understanding cholera outbreaks and evolution of Vibrio cholerae as a human pathogen. Curr Top Microbiol Immunol 2014; 379:211-29. [PMID: 24590676 DOI: 10.1007/82_2014_366] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Modern genomic and bioinformatic approaches have been applied to interrogate the V. cholerae genome, the role of genomic elements in cholera disease, and the origin, relatedness, and dissemination of epidemic strains. A universal attribute of choleragenic strains includes a repertoire of pathogenicity islands and virulence genes, namely the CTXϕ prophage and Toxin Co-regulated Pilus (TCP) in addition to other virulent genetic elements including those referred to as Seventh Pandemic Islands. During the last decade, the advent of Next Generation Sequencing (NGS) has provided highly resolved and often complete genomic sequences of epidemic isolates in addition to both clinical and environmental strains isolated from geographically unconnected regions. Genomic comparisons of these strains, as was completed during and following the Haitian outbreak in 2010, reveals that most epidemic strains appear closely related, regardless of region of origin. Non-O1 clinical or environmental strains may also possess some virulence islands, but phylogenic analysis of the core genome suggests they are more diverse and distantly related than those isolated during epidemics. Like Haiti, genomic studies that examine both the Vibrio core and pan-genome in addition to Single Nucleotide Polymorphisms (SNPs) conclude that a number of epidemics are caused by strains that closely resemble those in Asia, and often appear to originate there and then spread globally. The accumulation of SNPs in the epidemic strains over time can then be applied to better understand the evolution of the V. cholerae genome as an etiological agent.
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Affiliation(s)
- William P Robins
- Department of Microbiology and Immunobiology, Harvard Medical School, Boston, MA, 02115, USA,
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Rolain JM. Food and human gut as reservoirs of transferable antibiotic resistance encoding genes. Front Microbiol 2013; 4:173. [PMID: 23805136 PMCID: PMC3690338 DOI: 10.3389/fmicb.2013.00173] [Citation(s) in RCA: 146] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2013] [Accepted: 06/10/2013] [Indexed: 12/12/2022] Open
Abstract
The increase and spread of antibiotic resistance (AR) over the past decade in human pathogens has become a worldwide health concern. Recent genomic and metagenomic studies in humans, animals, in food and in the environment have led to the discovery of a huge reservoir of AR genes called the resistome that could be mobilized and transferred from these sources to human pathogens. AR is a natural phenomenon developed by bacteria to protect antibiotic-producing bacteria from their own products and also to increase their survival in highly competitive microbial environments. Although antibiotics are used extensively in humans and animals, there is also considerable usage of antibiotics in agriculture, especially in animal feeds and aquaculture. The aim of this review is to give an overview of the sources of AR and the use of antibiotics in these reservoirs as selectors for emergence of AR bacteria in humans via the food chain.
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Affiliation(s)
- Jean-Marc Rolain
- Unité de Recherche sur les Maladies Infectieuses et Tropicales Émergentes, UM63, CNRS 7278, IRD 198, INSERM 1095, Institut Hospitalo-Universitaire Méditerranée Infection, Aix-Marseille Université Marseille, France
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Mathurand P, Schaffner DW. Effect of lime juice on Vibrio parahaemolyticus and Salmonella enterica inactivation during the preparation of the raw fish dish ceviche. J Food Prot 2013; 76:1027-30. [PMID: 23726199 DOI: 10.4315/0362-028x.jfp-12-526] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Ceviche is a raw fish dish common in Peru and other Latin American counties. The most characteristic feature of ceviche is the use of lime juice for marinating or "cooking" the raw fish. Confirmed cases of cholera in Peru, New Jersey, and Florida have been associated with ceviche. Although the effect of organic acids on pathogenic bacteria has been well characterized, few data exist on the effect of these acids in seafood systems. The objective of the study was to evaluate the effects of lime juice marination on pathogens likely to be present in ceviche. Tilapia (Oreochromis niloticus) fillet pieces were inoculated with Vibrio parahaemolyticus and Salmonella enterica (>7 log CFU/g) and incubated at 25 and 4°C for 30 or 120 min in the presence of fresh lime juice at concentrations typical for the preparation of ceviche. Similar levels of cells were also inoculated into fresh lime juice without tilapia. Surviving cells were enumerated on selective (xylose lysine Tergitol 4 and thiosulfate-bile-citrate-sucrose) and nonselective (tryptic soy agar) media. V. parahaemolyticus levels were reduced to below detection limits (∼5-log reduction) under all conditions studied. Salmonella strains on tilapia were much more resistant to inactivation and were only slightly reduced (∼1- to 2-log reduction). Salmonella and V. parahaemolyticus inoculated directly into lime juice without tilapia were all reduced to below detection limits (∼5-log reduction). A typical ceviche recipe reduces V. parahaemolyticus risk significantly but is less effective for control of S. enterica.
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Affiliation(s)
- Prateek Mathurand
- Department of Food Science, Rutgers University, New Brunswick, New Jersey 08901, USA
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Rosewell A, Addy B, Komnapi L, Makanda F, Ropa B, Posanai E, Dutta S, Mola G, Man WYN, Zwi A, MacIntyre CR. Cholera risk factors, Papua New Guinea, 2010. BMC Infect Dis 2012; 12:287. [PMID: 23126504 PMCID: PMC3531249 DOI: 10.1186/1471-2334-12-287] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2011] [Accepted: 11/01/2012] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Cholera is newly emergent in Papua New Guinea but may soon become endemic. Identifying the risk factors for cholera provides evidence for targeted prevention and control measures. METHODS We conducted a hospital-based case-control study to identify cholera risk factors. Using stool culture as the standard, we evaluated a cholera point of care test in the field. RESULTS 176 participants were recruited: 54 cases and 122 controls. Independent risk factors for cholera were: being over 20 years of age (aOR 2.5; 95%CI 1.1, 5.4), defecating in the open air (or river) (aOR 4.5; 95% CI 1.4, 14.4) and knowing someone who travelled to a cholera affected area (aOR 4.1; 95%CI 1.6, 10.7); while the availability of soap for handwashing at home was protective (aOR 0.41; 95%CI 0.19, 0.87). Those reporting access to a piped water distribution system in the home were twice as likely to report the availability of soap for handwashing. The sensitivity and specificity of the rapid test were 72% (95% CI 47-90) and 71% (95%CI 44-90%). CONCLUSIONS Improving population access to the piped water distribution system and sanitation will likely reduce transmission by enabling enhanced hygiene and limiting the contamination of water sources. The One step V. cholerae O1/O139 Antigen Test is of limited utility for clinical decision making in a hospital setting with access to traditional laboratory methods. Settlement dwellers and mobile populations of all age groups should be targeted for interventions in Papua New Guinea.
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Beau De Rochars VEM, Tipret J, Patrick M, Jacobson L, Barbour KE, Berendes D, Bensyl D, Frazier C, Domercant JW, Archer R, Roels T, Tappero JW, Handzel T. Knowledge, attitudes, and practices related to treatment and prevention of cholera, Haiti, 2010. Emerg Infect Dis 2012; 17:2158-61. [PMID: 22204033 PMCID: PMC3310585 DOI: 10.3201/eid1711.110818] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
In response to the recent cholera outbreak, a public health response targeted high-risk communities, including resource-poor communities in Port-au-Prince, Haiti. A survey covering knowledge and practices indicated that hygiene messages were received and induced behavior change, specifically related to water treatment practices. Self-reported household water treatment increased from 30.3% to 73.9%.
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Wright AP, Gould LH, Mahon B, Sotir MJ, Tauxe RV. Overview of the impact of epidemic-assistance investigations of foodborne and other enteric disease outbreaks, 1946-2005. Am J Epidemiol 2011; 174:S23-35. [PMID: 22135391 DOI: 10.1093/aje/kwr308] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Epidemic-assistance investigations (Epi-Aids) in response to outbreaks of foodborne and other enteric pathogens have identified novel pathogens, clinical syndromes, and sequelae; described new reservoirs and vehicles of transmission; evaluated existing prevention strategies; and identified deficiencies in the food safety systems on local, national, and international levels. Since the first Epi-Aid was issued in 1946, approximately 23% (1,023 of 4,484 for which investigations were initiated) of all Epi-Aids have been related to foodborne or other enteric diseases. Epi-Aid results have yielded valuable insights into the epidemiology of these pathogens and have molded prevention strategies for detecting, responding to, and preventing future outbreaks. New challenges, brought about in part by centralization and globalization of the food supply, will continue to emerge. The need for Epi-Aids of such outbreaks undoubtedly will persist as an integral part of future public health response efforts, prevention strategies, and training programs.
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Affiliation(s)
- Ashton P Wright
- Atlanta Research and Education Foundation, 723 Cramer Avenue, Lexington, KY 40502, USA.
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Reveiz L, Chapman E, Ramon-Pardo P, Koehlmoos TP, Cuervo LG, Aldighieri S, Chambliss A. Chemoprophylaxis in contacts of patients with cholera: systematic review and meta-analysis. PLoS One 2011; 6:e27060. [PMID: 22102873 PMCID: PMC3216950 DOI: 10.1371/journal.pone.0027060] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2011] [Accepted: 10/10/2011] [Indexed: 12/02/2022] Open
Abstract
INTRODUCTION There is a pressing need for effective measures to prevent the spread of cholera. Our systematic review assesses the effects of chemoprophylaxis in preventing cholera among exposed contacts. METHODS AND FINDINGS We considered published and unpublished reports of studies up to July 2011. For this we searched: PubMed (1966 to July, 2011), Embase (1980 to July 2011), Cochrane Central Register of Controlled Trials (6; 2011), LILACS (1982 to July, 2011), the International Clinical Trials Registry Platform (July 2011) and references of identified publications. We included controlled clinical trials (randomized and non-randomized) in which chemoprophylaxis was used to prevent cholera among patient contacts. The main outcome measures were hospitalization and laboratory diagnosis of cholera in contacts for cholera patients. We assessed the risk of bias. We identified 2638 references and these included 2 randomized trials and 5 controlled trials that added up to a total of 4,154 participants. The risk of bias scored high for most trials. The combined results from two trials found that chemoprophylaxis reduced hospitalization of contacts during the follow-up period by 8-12 days (2826 participants; RR 0.54 95% CI 0.40-0.74;I² 0%). A meta-analysis of five trials found a significant reduction in disease among contacts with at least one positive sample who received chemoprophylaxis during the overall follow-up (range 4-15 days) (1,414 participants; RR 0.35 95% CI 0.18-0.66;I² 74%). A significant reduction in the number of positive samples was also found with chemoprophylaxis (3 CCT; 6,918 samples; RR 0.39 95% CI 0.29-0.51;I² 0%). CONCLUSION Our findings suggest that chemoprophylaxis has a protective effect among household contacts of people with cholera but the results are based on studies with a high risk of bias. Hence, there is a need for adequate reliable research that allows balancing benefits and harms by evaluating the effects of chemoprophylaxis.
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Affiliation(s)
- Ludovic Reveiz
- Public Policies and Research for Health-Health Systems based on Primary Health Care, Pan American Health Organization/World Health Organization, Washington, District of Columbia, United States of America.
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Dunkle SE, Mba-Jonas A, Loharikar A, Fouché B, Peck M, Ayers T, Archer WR, De Rochars VMB, Bender T, Moffett DB, Tappero JW, Dahourou G, Roels T, Quick R. Epidemic cholera in a crowded urban environment, Port-au-Prince, Haiti. Emerg Infect Dis 2011; 17:2143-6. [PMID: 22099120 PMCID: PMC3310575 DOI: 10.3201/eid1711.110772] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
We conducted a case-control study to investigate factors associated with epidemic cholera. Water treatment and handwashing may have been protective, highlighting the need for personal hygiene for cholera prevention in contaminated urban environments. We also found a diverse diet, a possible proxy for improved nutrition, was protective against cholera.
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Affiliation(s)
- Stacie E Dunkle
- Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
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Effects of probiotic forms, compositions of and mode of probiotic administration on rearing of Pacific white shrimp (Litopenaeus vannamei) larvae and postlarvae. Anim Feed Sci Technol 2011. [DOI: 10.1016/j.anifeedsci.2011.07.003] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Abstract
Antimicrobials are valuable therapeutics whose efficacy is seriously compromised by the emergence and spread of antimicrobial resistance. The provision of antibiotics to food animals encompasses a wide variety of nontherapeutic purposes that include growth promotion. The concern over resistance emergence and spread to people by nontherapeutic use of antimicrobials has led to conflicted practices and opinions. Considerable evidence supported the removal of nontherapeutic antimicrobials (NTAs) in Europe, based on the "precautionary principle." Still, concrete scientific evidence of the favorable versus unfavorable consequences of NTAs is not clear to all stakeholders. Substantial data show elevated antibiotic resistance in bacteria associated with animals fed NTAs and their food products. This resistance spreads to other animals and humans-directly by contact and indirectly via the food chain, water, air, and manured and sludge-fertilized soils. Modern genetic techniques are making advances in deciphering the ecological impact of NTAs, but modeling efforts are thwarted by deficits in key knowledge of microbial and antibiotic loads at each stage of the transmission chain. Still, the substantial and expanding volume of evidence reporting animal-to-human spread of resistant bacteria, including that arising from use of NTAs, supports eliminating NTA use in order to reduce the growing environmental load of resistance genes.
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Affiliation(s)
- Bonnie M. Marshall
- Alliance for the Prudent Use of Antibiotics, Boston, Massachusetts
- Department of Molecular Biology and Microbiology
| | - Stuart B. Levy
- Alliance for the Prudent Use of Antibiotics, Boston, Massachusetts
- Department of Molecular Biology and Microbiology
- Department of Medicine, Tufts University School of Medicine, Boston, Massachusetts
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Abstract
Antimicrobials are valuable therapeutics whose efficacy is seriously compromised by the emergence and spread of antimicrobial resistance. The provision of antibiotics to food animals encompasses a wide variety of nontherapeutic purposes that include growth promotion. The concern over resistance emergence and spread to people by nontherapeutic use of antimicrobials has led to conflicted practices and opinions. Considerable evidence supported the removal of nontherapeutic antimicrobials (NTAs) in Europe, based on the "precautionary principle." Still, concrete scientific evidence of the favorable versus unfavorable consequences of NTAs is not clear to all stakeholders. Substantial data show elevated antibiotic resistance in bacteria associated with animals fed NTAs and their food products. This resistance spreads to other animals and humans-directly by contact and indirectly via the food chain, water, air, and manured and sludge-fertilized soils. Modern genetic techniques are making advances in deciphering the ecological impact of NTAs, but modeling efforts are thwarted by deficits in key knowledge of microbial and antibiotic loads at each stage of the transmission chain. Still, the substantial and expanding volume of evidence reporting animal-to-human spread of resistant bacteria, including that arising from use of NTAs, supports eliminating NTA use in order to reduce the growing environmental load of resistance genes.
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Asok A, Arshad E, Jasmin C, Pai SS, Singh ISB, Mohandas A, Anas A. Reducing Vibrio load in Artemia nauplii using antimicrobial photodynamic therapy: a promising strategy to reduce antibiotic application in shrimp larviculture. Microb Biotechnol 2011; 5:59-68. [PMID: 21951316 PMCID: PMC3815272 DOI: 10.1111/j.1751-7915.2011.00297.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
We propose antimicrobial photodynamic therapy (aPDT) as an alternative strategy to reduce the use of antibiotics in shrimp larviculture systems. The growth of a multiple antibiotic resistant Vibrio harveyi strain was effectively controlled by treating the cells with Rose Bengal and photosensitizing for 30 min using a halogen lamp. This resulted in the death of > 50% of the cells within the first 10 min of exposure and the 50% reduction in the cell wall integrity after 30 min could be attributed to the destruction of outer membrane protein of V. harveyi by reactive oxygen intermediates produced during the photosensitization. Further, mesocosm experiments with V. harveyi and Artemia nauplii demonstrated that in 30 min, the aPDT could kill 78.9% and 91.2% of heterotrophic bacterial and Vibrio population respectively. In conclusion, the study demonstrated that aPDT with its rapid action and as yet unreported resistance development possibilities could be a propitious strategy to reduce the use of antibiotics in shrimp larviculture systems and thereby, avoid their hazardous effects on human health and the ecosystem at large.
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Affiliation(s)
- Aparna Asok
- National Centre for Aquatic Animal Health, Cochin University of Science and Technology, Kochi 682016, India
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Malavade S, Narvaez A, Mitra A, Ochoa T, Naik E, Sharma M, Galwankar S, Breglia M, Izurieta R. Cholera in ecuador: current relevance of past lessons learnt. J Glob Infect Dis 2011; 3:189-94. [PMID: 21731309 PMCID: PMC3125035 DOI: 10.4103/0974-777x.81699] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
This report analyses the trends in the cholera epidemic that hit Ecuador in 1991. The study is based on personal experiences and analysis of epidemiological databases from the Ministry of Public Health of Ecuador. The number of cases and initial attack rates in an immunologically naive population are described by province. An analysis of the Andean and coastal cholera patterns of transmission are described along with its associated risk factors. The logistical, environmental, and socio-cultural risk factors prevalent during the epidemic and the control measures implemented are also reviewed. Also, the role of the epidemic in the development of the public health and healthcare resources in Ecuador is discussed here. Current data indicate favorable conditions for another outbreak of cholera in Ecuador. In view of the existing risk factors, new strategies are proposed to prevent such an epidemic in the future.
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Affiliation(s)
- Ss Malavade
- Department of Global Health, University of South Florida, Florida, USA
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Farmer P, Almazor CP, Bahnsen ET, Barry D, Bazile J, Bloom BR, Bose N, Brewer T, Calderwood SB, Clemens JD, Cravioto A, Eustache E, Jérôme G, Gupta N, Harris JB, Hiatt HH, Holstein C, Hotez PJ, Ivers LC, Kerry VB, Koenig SP, Larocque RC, Léandre F, Lambert W, Lyon E, Mekalanos JJ, Mukherjee JS, Oswald C, Pape JW, Gretchko Prosper A, Rabinovich R, Raymonville M, Réjouit JR, Ronan LJ, Rosenberg ML, Ryan ET, Sachs JD, Sack DA, Surena C, Suri AA, Ternier R, Waldor MK, Walton D, Weigel JL. Meeting cholera's challenge to Haiti and the world: a joint statement on cholera prevention and care. PLoS Negl Trop Dis 2011; 5:e1145. [PMID: 21655350 PMCID: PMC3104956 DOI: 10.1371/journal.pntd.0001145] [Citation(s) in RCA: 93] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Affiliation(s)
- Paul Farmer
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, United States of America.
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Sarter S, Randrianarivelo R, Ruez P, Raherimandimby M, Danthu P. Antimicrobial effects of essential oils of Cinnamosma fragrans on the bacterial communities in the rearing water of Penaeus monodon larvae. Vector Borne Zoonotic Dis 2011; 11:433-7. [PMID: 21395412 DOI: 10.1089/vbz.2010.0069] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Farmed shrimps are vectors of various Vibrio species that are considered a potential health hazard. Previous study has shown that Vibrio parahaemolyticus, Vibrio vulnificus, and Vibrio alginolyticus dominated in the water and larval samples of shrimp hatchery (Randrianarivelo et al. 2010 ). The effects of two essential oils (EOs) of Cinnamosma fragrans, an endemic plant to Madagascar (B8: linalool-type and B143: 1,8-cineole-type), were determined on the total heterotrophic aerobic bacteria and the Vibrio concentrations in the rearing water of Penaeus monodon hatchery. The assays took place in OSO Farming's shrimp hatchery in Madagascar. EOs were directly added to the water tank. The bacterial concentrations of water tank were assessed on marine agar and thiosulfate citrate bile sucrose agar. The larvae culture corresponded to four replicates each of B8, B143, erythromycin (E), and control (oil and antibiotic free). The bacterial concentration of the rearing water in B8, B143, and antibiotic (E) tanks were significantly lower (p < 0.05) than in the control. Further, there was no significant difference (p > 0.05) between the three treatments B8, B143, and E. This study demonstrated that both EOs of C. fragrans, like antibiotic, inhibited bacterial growth in the rearing water of P. monodon larvae. The potential of C. fragrans EO to control the bacterial load in in vivo conditions of P. monodon hatchery makes it a relevant option for producers to minimize risk of Vibrio growth in the rearing water of larvae, which is the primary source of colonization of shrimp larvae.
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Affiliation(s)
- Samira Sarter
- CIRAD, UMR QUALISUD, Ampandrianomby, 101 Antananarivo, Madagascar.
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Giebultowicz S, Ali M, Yunus M, Emch M. A comparison of spatial and social clustering of cholera in Matlab, Bangladesh. Health Place 2010; 17:490-7. [PMID: 21195655 DOI: 10.1016/j.healthplace.2010.12.004] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2010] [Revised: 12/01/2010] [Accepted: 12/06/2010] [Indexed: 11/15/2022]
Abstract
Infectious diseases often cluster spatially, but can also cluster socially because they are transmitted within social networks. This study compares spatial and social clustering of cholera in rural Bangladesh. Data include a spatially referenced longitudinal demographic database, which consists of approximately 200,000 people and laboratory-confirmed cholera cases from 1983 to 2003. Matrices are created of kinship ties between households using a complete network design and distance matrices are also created to model spatial relationships. Moran's I statistics are calculated to measure clustering within both social and spatial matrices. The results show that cholera always clusters in space and seldom within social networks. Cholera is transmitted mostly through the local environment rather than through person-to-person contact. Comparing spatial and social network analysis can help improve understanding of disease transmission.
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Affiliation(s)
- Sophia Giebultowicz
- Department of Geography, University of North Carolina at Chapel Hill, CB 3220, Chapel Hill, NC 27599-3220, USA
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40
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Foodborne antimicrobial resistance as a biological hazard - Scientific Opinion of the Panel on Biological Hazards. EFSA J 2008. [DOI: 10.2903/j.efsa.2008.765] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Probiotics in aquaculture: importance and future perspectives. Indian J Microbiol 2008; 48:299-308. [PMID: 23100726 DOI: 10.1007/s12088-008-0024-3] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2007] [Accepted: 01/11/2008] [Indexed: 10/21/2022] Open
Abstract
Aquaculture is one of the fastest developing growth sectors in the world and Asia presently contributes about 90% to the global production. However, disease outbreaks are constraint to aquaculture production thereby affects both economic development of the country and socio-economic status of the local people in many countries of Asia-Pacifi c region. Disease control in aquaculture industry has been achieved by following different methods using traditional ways, synthetic chemicals and antibiotics. However, the use of such expensive chemotherapeutants for controlling diseases has been widely criticized for their negative impacts like accumulation of residues, development of drug resistance, immunosuppressants and reduced consumer preference for aqua products treated with antibiotics and traditional methods are ineffective against controlling new diseases in large aquaculture systems. Therefore, alternative methods need to be developed to maintain a healthy microbial environment in the aquaculture systems there by to maintain the health of the cultured organisms. Use of probiotics is one of such method that is gaining importance in controlling potential pathogens. This review provides a summary of the criteria for the selection of the potential probiotics, their importance and future perspectives in aquaculture industry.
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Sirajul Islam M, Brooks A, Kabir MS, Jahid IK, Shafiqul Islam M, Goswami D, Nair GB, Larson C, Yukiko W, Luby S. Faecal contamination of drinking water sources of Dhaka city during the 2004 flood in Bangladesh and use of disinfectants for water treatment. J Appl Microbiol 2008; 103:80-7. [PMID: 17584454 DOI: 10.1111/j.1365-2672.2006.03234.x] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIMS To describe the extent of faecal pollution and point of use water treatment strategy during and after the 2004 flood in Dhaka. METHODS A total of 300 water samples were collected from 20 different drinking water sources in Kamalapur, Dhaka city from August 2004 to January 2005. The level of faecal contamination was estimated using measurements of faecal indicator bacteria (total coliforms, faecal coliforms and faecal streptococci) and isolation of Vibrio cholerae was carried out following standard procedures. Total dissolved solids, dissolved oxygen, hardness, chloride and pH were also monitored. The efficacy of four disinfectants including Halotab, Zeoline-200, alum potash and bleaching powder were tested as point of use water treatment agents. The unacceptable level of contamination of total coliforms (TC), faecal coliforms (FC) and faecal streptococci (FS) ranged from 23.8% to 95.2%, 28.6% to 95.2% and 33.3% to 90.0%, respectively. The isolation rates of V. cholerae O1 and O139 were both 0.33%, and non-O1/non-O139 was 7.0%. CONCLUSION Water collected during and after floods was contaminated with TC, FC, FS and V. cholerae. Although alum potash, bleaching powder, Halotab and Zeoline-200 were all effective general disinfectants, Halotab and Zeoline-200 were superior to bleaching powder and alum potash against FC. SIGNIFICANCE AND IMPACT OF THE STUDY During and after floods, point of use water treatment could reduce waterborne diseases among flood-affected people.
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Affiliation(s)
- M Sirajul Islam
- International Centre for Diarrhoeal Disease Research, Bangladesh.
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TUNUNG R, CHAI L, USHA M, LESLEY M, CHEAH Y, PATRICK G, FARINAZLEEN M, FATIMAH A, MALAKAR P, SON R. INCIDENCE AND CHARACTERIZATION OF SALMONELLA SPECIES IN STREET FOOD AND CLINICAL SAMPLES. J Food Saf 2007. [DOI: 10.1111/j.1745-4565.2007.00089.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Mwansa JCL, Mwaba J, Lukwesa C, Bhuiyan NA, Ansaruzzaman M, Ramamurthy T, Alam M, Balakrish Nair G. Multiply antibiotic-resistant Vibrio cholerae O1 biotype El Tor strains emerge during cholera outbreaks in Zambia. Epidemiol Infect 2007; 135:847-53. [PMID: 17121691 PMCID: PMC2870619 DOI: 10.1017/s0950268806007254] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/10/2006] [Indexed: 11/07/2022] Open
Abstract
Antibiotic resistance data, made available from laboratory records during eight cholera outbreaks between 1990 and 2004 showed Vibrio cholerae serogroup O1 to have a low level of resistance (2-3%) to tetracycline during 1990-1991. Resistance increased for tetracycline (95%), chloramphenicol (78%), doxycycline (70%) and trimethoprim-sulphamethoxazole (97%) in subsequent outbreaks. A significant drop in resistance to tetracycline and chloramphenicol followed the adoption of a national policy to replace tetracycline with erythromycin for treating cholera. Sixty-nine strains from cholera outbreaks in Zambia between 1996 and 2004, were examined for antibiotic resistance and basic molecular traits. A 140 MDa conjugative, multidrug-resistant plasmid was found to encode tetracycline resistance in strains from 1996/1997 whereas strains from 2003/2004 were resistant to furazolidone, but susceptible to tetracycline, and lacked this plasmid. PCR revealed 25 of 27 strains from 1996/1997 harboured the intl1 class 1 integron but lacked SXT, a conjugative transposon element. Similar screening of 42 strains from 2003/2004 revealed all carried SXT but not the intl1 class 1 integron. All 69 strains, except two, one lacking ctxA and the other rstR and thus presumably truncated in the CTX prophage region, were positive for important epidemic markers namely rfbO1, ctxA, rstR2, and tcpA of El Tor biotype. Effective cholera management is dependent on updated reports on culture and sensitivity to inform the choice of antibiotic. Since the emergence of antibiotic resistance may significantly influence strategies for controlling cholera, continuous monitoring of epidemic strains is crucial.
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Affiliation(s)
- J C L Mwansa
- University Teaching Hospital, Department of Pathology and Microbiology, Lusaka, Zambia.
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Chiang WC, Chen SY, Chien KL, Wu GHM, Yen AMF, Su CP, Lee CC, Chen YC, Chang SC, Chen SC, Chen WJ, Chen THH. Predictive model of antimicrobial-resistant Gram-negative bacteremia at the ED. Am J Emerg Med 2007; 25:597-607. [PMID: 17606081 DOI: 10.1016/j.ajem.2006.11.024] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2006] [Revised: 11/30/2006] [Accepted: 11/30/2006] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Despite numerous studies identifying the risk factors related to gram-negative antimicrobial resistance, an epidemiological model to reliably predict antimicrobial gram-negative resistance in clinics, before the bacterial culture result is available, has not yet been developed. OBJECTIVES The aim of this study was to develop a predictive model to assist physicians in selecting appropriate antimicrobial agents before the details of the microbiology and drug susceptibility are known. MATERIALS AND METHODS A prospective study was conducted between June 1, 2001, and May 31, 2002, at the emergency department (ED) of National Taiwan University Hospital. Enrollees were patients with gram-negative bacteremia (GNB) at ED. Other information collected included demographic characteristics, underlying comorbidities, hospital exposure and health care-associated factors, and details of initial presentation. Two primary outcomes were defined, including cefazolin-resistant (CZ-RES) GNB and ceftriaxone-resistant (CTX-RES) GNB. Two thirds of the data was randomly allocated to a derivation data set (for developing predictive models), and the rest, to a validation data set (for testing model validity). Simplified models, using a coefficient-based scoring method, were also developed for clinical applications. RESULTS Based on 695 episodes of GNB, predictors of CZ-RES GNB were time since last hospitalization (increased risk for durations <1 month), prior infection with a CTX-RES strain, post-transplantation immunosuppressant use, residence in a nursing home or history of stroke with repeated choking, and poor oxygen saturation (<95%) at admission to ED. Cirrhosis showed a protective effect by reducing the odds of antimicrobial-resistant GNB. The area under receiver operating characteristic (ROC) curve for the CZ-RES model was 0.76 (95% confidence interval, 0.71-0.81). The CTX-RES model included all the variables that were in the CZ-RES model plus abnormal leukocyte count (<1000 or >15,000 /mm3) at entry to ED. In this case, however, previous hospitalization within the last 2 weeks was a key factor. The area under this ROC curve was 0.82 (95% confidence interval, 0.76-0.88). There was lacking of difference in the area under the ROC curve between the 2 final (simplified) models either based on the derivation or validation data sets. CONCLUSION We have developed 2 models for predicting risk of antimicrobial gram-negative infection by identifying and quantifying associated risk factors. These models could be used by physicians to determine the most appropriate choice of antibiotic for first-line therapy, particularly in situations where the culture result is not yet known.
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Affiliation(s)
- Wen-Chu Chiang
- Department of Emergency Medicine, National Taiwan University Hospital, Taipei 100, Taiwan.
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Sarkar R, Prabhakar AT, Manickam S, Selvapandian D, Raghava MV, Kang G, Balraj V. Epidemiological investigation of an outbreak of acute diarrhoeal disease using geographic information systems. Trans R Soc Trop Med Hyg 2007; 101:587-93. [PMID: 17267000 DOI: 10.1016/j.trstmh.2006.11.005] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2006] [Revised: 11/07/2006] [Accepted: 11/07/2006] [Indexed: 11/21/2022] Open
Abstract
An outbreak of acute diarrhoeal disease in a village in southern India was investigated through personal interviews of all households. Maps were drawn using geographic information system (GIS) tools of the water supply system, sewage channels and areas with observed faecal contamination of soil within and around the village. Geographic coordinates for each house in the village were extracted from a central database from the healthcare service provider for the village. Geographical clustering of cases was looked for using the SaTScan software, and diarrhoeal disease attack rates were calculated. Diarrhoeal disease occurred uniformly throughout the village without clustering in any area. All ages and both sexes were affected, but extremes of ages were at higher risk. Water samples collected for microbiological examination after instituting control measures showed high coliform counts. Chlorine levels in the water tested were found to be inadequate to decontaminate common pathogens. Local cultural practices such as indiscriminate defecation in public places, washing clothes and cleaning utensils from water taps where the community collected its drinking water, and poor engineering design and maintenance of the water supply system were the risk factors that could have contributed to this outbreak.
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Affiliation(s)
- Rajiv Sarkar
- Department of Community Health, Christian Medical College, Vellore 632 002, Tamil Nadu, India
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Fleming LE, Broad K, Clement A, Dewailly E, Elmir S, Knap A, Pomponi SA, Smith S, Solo Gabriele H, Walsh P. Oceans and human health: Emerging public health risks in the marine environment. MARINE POLLUTION BULLETIN 2006; 53:545-60. [PMID: 16996542 PMCID: PMC2573863 DOI: 10.1016/j.marpolbul.2006.08.012] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
There has been an increasing recognition of the inter-relationship between human health and the oceans. Traditionally, the focus of research and concern has been on the impact of human activities on the oceans, particularly through anthropogenic pollution and the exploitation of marine resources. More recently, there has been recognition of the potential direct impact of the oceans on human health, both detrimental and beneficial. Areas identified include: global change, harmful algal blooms (HABs), microbial and chemical contamination of marine waters and seafood, and marine models and natural products from the seas. It is hoped that through the recognition of the inter-dependence of the health of both humans and the oceans, efforts will be made to restore and preserve the oceans.
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Affiliation(s)
- L E Fleming
- National Science Foundation (NSF), National Institute of Environmental Health Sciences (NIEHS), Oceans and Human Health Center, University of Miami, Miami, FL, USA.
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Cabello FC. Heavy use of prophylactic antibiotics in aquaculture: a growing problem for human and animal health and for the environment. Environ Microbiol 2006; 8:1137-44. [PMID: 16817922 DOI: 10.1111/j.1462-2920.2006.01054.x] [Citation(s) in RCA: 948] [Impact Index Per Article: 52.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The accelerated growth of finfish aquaculture has resulted in a series of developments detrimental to the environment and human health. The latter is illustrated by the widespread and unrestricted use of prophylactic antibiotics in this industry, especially in developing countries, to forestall bacterial infections resulting from sanitary shortcomings in fish rearing. The use of a wide variety of antibiotics in large amounts, including non-biodegradable antibiotics useful in human medicine, ensures that they remain in the aquatic environment, exerting their selective pressure for long periods of time. This process has resulted in the emergence of antibiotic-resistant bacteria in aquaculture environments, in the increase of antibiotic resistance in fish pathogens, in the transfer of these resistance determinants to bacteria of land animals and to human pathogens, and in alterations of the bacterial flora both in sediments and in the water column. The use of large amounts of antibiotics that have to be mixed with fish food also creates problems for industrial health and increases the opportunities for the presence of residual antibiotics in fish meat and fish products. Thus, it appears that global efforts are needed to promote more judicious use of prophylactic antibiotics in aquaculture as accumulating evidence indicates that unrestricted use is detrimental to fish, terrestrial animals, and human health and the environment.
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Affiliation(s)
- Felipe C Cabello
- Department of Microbiology and Immunology, New York Medical College, Valhalla, NY 10595, USA.
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DuBois AE, Sinkala M, Kalluri P, Makasa-Chikoya M, Quick RE. Epidemic cholera in urban Zambia: hand soap and dried fish as protective factors. Epidemiol Infect 2006; 134:1226-30. [PMID: 16623992 PMCID: PMC2870514 DOI: 10.1017/s0950268806006273] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/08/2006] [Indexed: 11/07/2022] Open
Abstract
Between 28 November 2003 and 23 February 2004, 4343 cases and 154 deaths from cholera (case-fatality rate 3.5%) were reported in Lusaka, Zambia. A case-control study was conducted in February 2004 to assess potential transmission routes and prevention strategies. Consumption of raw vegetables was significantly associated with cholera [adjusted odds ratio (aOR) 4.7, 95% confidence interval (CI) 1.7-13, P=0.003). Consumption of a local sardine-like fish was protective (aOR 0.3, 95% CI 0.1-0.7, P=0.008). Hand soap was present in 90% of control homes and 58% of case homes. Observed hand soap was a strongly protective factor (aOR 0.1, 95% CI 0.04-0.4, P=0.001). No water source or treatment practice was significantly associated with cholera. This study documents the importance of foodborne transmission of cholera, illustrates the protective role of hand washing in an epidemic setting, and identifies a novel possible protective factor, a local fish, which warrants further research.
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Affiliation(s)
- A E DuBois
- Foodborne and Diarrheal Diseases Branch, Centers for Disease Control and Prevention, Atlanta, GA, USA.
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