Cholera By: Nadia Nagy

What is Cholera?

• Cholera is a diarrheal infection caused by ingestion of food or water contaminated with the bacterium Vibrio cholerae

Bhujel 2013

• 3-5 million cholera cases currently with ~120,000 deaths each year (WHO 2013)

Symptoms

• 75% of those infected do not show symptoms

• Symptoms include : Watery diarrhea Severe dehydration

Shock Vomiting

History• In 1882 German bacteriologist Robert Koch,

suggested that cholera was caused by a bacterium that secreted a toxin which caused rapid water loss.

• Reservoir found in the Ganges Delta in India• In the 19th Century 1st pandemic–7 pandemics from 1817-1961

Causes

Cholera transmission: the host, pathogen, and bacteriophage dynamic. (2009)

Pathology

• BOLO News 2013

Treatment• Oral rehydration salts• IV Fluids for severe dehydration• Vaccines for preventive measures:– Shanchol :long term protection– Dukoral : Short term

production

Cholera In the US

• Rare in the U.S.

• Pandemic in 1834 hit Mississippi, New Orleans, and New York

• California, Utah, and Oregon pandemic from 1849–1855

• 150,000 Americans died from both pandemics

Haiti

• On going epidemic from October 2010-present

• Spread quickly after 2010earthquake

• As of November 2013 there has been 689,448 cholera cases and 8,448 deaths

Pan American Health Organization (2013)

Hendriksen et al. (2011)

FIG 1 Genetic relationships among V. cholerae isolates from Nepal and Haiti. A single maximum parsimony tree was reconstructed using 752 SNPs from 34 whole-genome sequences. SNP differences among the three most closely related Nepali groups and the Haitian group are shown.

Hendriksen et al. (2011)

References • Bacterial Morphology. Microbiology. (2013). Retrieved from: http://microbiollogy.blogspot.com/2013/02/bacterial-morphology-contd_17.html

• Cholera: Death by Diarrhoea. Society for General Microbiology. (2011) Retrieved from: http://www.microbiologyonline.org.uk/media/transfer/doc/factfile_cholera.pdf

• Cholera. Mayo Clinic. (2011). Retrieved from: http://www.mayoclinic.org/diseases-conditions/cholera/basics/causes/con-20031469

• Cholera outbreaks and pandemics. Wikipedia. Retrieved from: http://en.wikipedia.org/wiki/Cholera_outbreaks_and_pandemics

• Cholera transmission: The host, pathogen and bacteriophage dynamic. (2009). Nature Reviews Microbiology, 7(10), 693-702. doi:10.1038/nrmicro2204. Retrieved from: http://www.nature.com/nrmicro/journal/v7/n10/fig_tab/nrmicro2204_F2.html

• Cholera .WHO. (2014). Retrieved from: http://www.who.int/mediacentre/factsheets/fs107/en/

• Frerichs, R. R., Keim, P. S., Barrais, R., & Piarroux, R. (2012). Nepalese origin of cholera epidemic in haiti. Clinical Microbiology and Infection : The Official Publication of the European Society of Clinical Microbiology and Infectious Diseases, 18(6), E158-E163. doi:10.1111/j.1469-0691.2012.03841.x.

• Global epidemics and impact of cholera. WHO. Retrieved from: http://www.who.int/topics/cholera/impact/en/

• Goodsell, D (2014). Cholera Toxin. RCSB Protein Data Bank. Retrieved from: http://www.rcsb.org/pdb/101/motm.do?momID=69

• Hendriksen, R. S., Upadhyay, B. P., Shrestha, S. D., Adhikari, S., Shakya, G., Keim, P. S., . . . Waters, A. E. (2011). Population genetics of vibrio cholerae from nepal in 2010: Evidence on the origin of the haitian outbreak. Mbio, 2(4), e00157. doi:10.1128/mBio.00157-11

• Kaper, J., Morris, J., Jr, & Levine, M. (1995). Cholera [published erratum appears in clin microbiol rev 1995 apr;8(2):316].Clinical Microbiology Reviews, 8(1), 48.

• Katz, L. S., Orata, F., Gladney, L. M., Stroika, S., Folster, J. P., Rowe, L., . . . Paxinos, E. E. (2013). Evolutionary dynamics of vibrio cholerae O1 following a single-source introduction to haiti. Mbio, 4(4) doi:10.1128/mBio.00398-13.

• Sack, D., Sack, R., Nair, G., & Siddique, A. (2004). Cholera. Lancet, 363(9404), 223-233. Retrieved from: http://www.ncbi.nlm.nih.gov/pubmed/14738797