Consecutive outbreaks of Vibrio cholerae O139 and V. cholerae O1 cholera in a fishing village near Karachi, Pakistan


Siddiqui, FJ; Bhutto, NS; von Seidlein, L; Khurram, I; Rasool, S; Ali, M; Zafar, A; Deen, JL; Clemens, JD; Nizami, Q; Bhutta, ZA; (2006) Consecutive outbreaks of Vibrio cholerae O139 and V. cholerae O1 cholera in a fishing village near Karachi, Pakistan. Transactions of the Royal Society of Tropical Medicine and Hygiene, 100 (5). pp. 476-82. ISSN 0035-9203 DOI: 10.1016/j.trstmh.2005.07.019

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Abstract

In July 2002 and June 2003, cholera outbreaks were detected by a diarrhoea surveillance system in a village outside Karachi, Pakistan. Specimens were culture confirmed. The first outbreak was caused by Vibrio cholerae O139 (n = 30) and the second outbreak by V. cholerae O1 (n = 39). Demographic and clinical features of patients were recorded and case-control studies were conducted following each outbreak. Clinical information was obtained for 29 of the 30 patients in the first outbreak, and 2 of the patients in the second outbreak were either out of the area or lost to follow-up, leaving 29 and 37 cases in the analysis for the first and second outbreak, respectively. Eighteen (49%) of the 37 V. cholerae O1 patients were under 2 years of age compared with 6 (21%) of the 29 V. cholerae O139 patients (P = 0.02). Vibrio cholerae O139-infected patients were more likely to be febrile (16/29) than those infected with V. cholerae O1 (2/37; P<0.001). A household contact with cholera was a risk factor in both outbreaks; water source was a risk factor in the first outbreak only. Geographically, cases were clustered during the first outbreak but not during the second. Person-to-person contact and water reservoirs appear to be the main transmission routes for cholera in this setting.

Item Type: Article
Keywords: Adolescent, Adult, Aged, Animals, Case-Control Studies, Child, Child, Preschool, Cholera/epidemiology/*microbiology/transmission, *Developing Countries, Disease Outbreaks, Disease Reservoirs, Disease Transmission, Horizontal, Female, Humans, Infant, Male, Middle Aged, Pakistan/epidemiology, Rural Population, Vibrio cholerae O1/*isolation & purification, Vibrio cholerae O139/*isolation & purification, Water Microbiology, Adolescent, Adult, Aged, Animals, Case-Control Studies, Child, Child, Preschool, Cholera, epidemiology, microbiology, transmission, Developing Countries, Disease Outbreaks, Disease Reservoirs, Disease Transmission, Horizontal, Female, Humans, Infant, Male, Middle Aged, Pakistan, epidemiology, Rural Population, Vibrio cholerae O1, isolation & purification, Vibrio cholerae O139, isolation & purification, Water Microbiology
Faculty and Department: Faculty of Infectious and Tropical Diseases > Dept of Disease Control
PubMed ID: 16443247
Web of Science ID: 236563600013
URI: http://researchonline.lshtm.ac.uk/id/eprint/10273

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