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Cholera map to aid prediction

Friday November 10th, 2017

Cholera has been endemic in Asia for 50 years, repeatedly crossing into Africa and Latin America, according to a major study of the disease published last night.

This has resulted in a pandemic lasting half a century, the seventh of its kind in the last two centuries, according to a global research team led by the Wellcome Trust Sanger Institute, Cambridge, UK and the Institut Pasteur in France.

It has also led to the largest epidemic in recorded history, now under way in Yemen, where nearly a million people have been infected.

The World Health Organisation has announced plans to stop cholera transmission by 2030.

The research shows that the 7PET strain, endemic in Asia, repeatedly found its way to West Africa and East and Southern Africa, causing new epidemics.

It eventually found its way to Latin America in 1991, bringing the disease back to the continent after a gap of a century.

The researchers say the findings, reported in Science, will help predict the path of the disease in the future and help the development of plans to stop it.

Daryl Domman, from the Wellcome Trust Sanger Institute, said: “Our data show that when a 7PET pandemic strain enters into Latin America from elsewhere, it can cause massive epidemics, like those seen in Peru in the 1990s and Haiti in 2010.

“However, we now know that other strains already in this region can still make people sick, but seem to not have this epidemic potential. Knowing which strain is which allows for an appropriate public health response from regional or national governments.”

His colleague Professor Nick Thomson said: “We are now getting a real sense of how cholera is moving across the globe, and with that information we can inform improved control strategies as well as basic science to better understand how a simple bacterium continues to pose such a threat to human health.”

François-Xavier Weill, from the Institut Pasteur, added: “Our results show that multiple new versions of 7PET bacteria have entered Africa since the 1970s. Once introduced, cholera outbreaks follow similar paths when spreading across that continent.

“The results give us a sense of where we can target specific regions of Africa for improved surveillance and control.”

Francois-Xavier Weill et al. Genomic history of the seventh pandemic of cholera in Africa. Science 10 November 2017; doi: 10.1126/science.aad5901

Daryl Domman et al. Integrated view of Vibrio cholerae in the Americas. Science 10 November 2017; doi: 10.1126/science.aao2136

Tags: Africa | Asia | Europe | Gastroenterology | South America | UK News

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