El Tor cholera at the contemporary stage of the seventh pandemia: pathogen evolution, clinical and epidemiological features, laboratory diagnostics

Cover Page

Cite item

Abstract

The phenotypic and molecular genetic properties of 133 strains of genetically modified (genovariant) Vibrio cholerae O1 El Tor biovar isolated from patients in Dagestan (1993, 1994, 1998), and compared with 246 strains of a typical toxigenic cholera vibrio El Tor biovar isolated in 1970–1990 at the Caucasus Region. It was found that 48.7% of the studied genetically modified strain variants had mixed phenotypic properties of the El Tor and classic biovars that evidences about a need to include the marker genes of the classical biovar (ctxBCl+, rtxC–) and the El Tor biovar (ctxBEl+, rtxC+) into the existing biotyping scheme. The genes of the El Tor biovar, isolated from patients in Dagestan, contain in addition to the El Tor ones, the genes of the classical biovar (ctxBCl and/or rstRCl), as well as the typical toxigenic cholera vibrios of El Tor, islands of persistence (EPI), pathogenicity (VPI-1 and VPI-2) and pandemicity (VSP-I and VSP-II). However, only the El Tor biovar genovariants were found to bear an integrative and conjugative SXT element with antibiotic polyresistance genes. Epidemic cholera outbreaks caused by the El Tor biovar genovariants that occurred in 1993–1998 at the Caucasus Region, correspond to classical (Asian) cholera based on disease severity. The epidemiological features of modern cholera were studied: the main way for transmission via fecal-oral route for typical El Tor cholera vibrio is waterborne, whereas for the El Tor gene variant — household. Primary infections upon water drinking and using domestic water from surface water bodies infected with typical El Tor vibrios occur outside the family hearth. In case of cholera caused by hybrid El Tor variants, infection is transmitted among family members via domestic factors under low sanitary level. The development of laboratory diagnostics and epidemiological surveillance of modern El Tor cholera is based on the development of PCR test systems taking into account the evolutionary genome transformations.

About the authors

I. V. Savelyeva

Stavropol Research Institute for Plague Control

Author for correspondence.
Email: Stavnipchi@mail.ru

Irina V. Savelyeva,  PhD (Medicine), Bacteriologist of the Scientific and Production Laboratory of Preparations for the Diagnosis of Highly Dangerous and Other Infections 

355035, Stavropol, Soviet str., 13–15

Phone: +7 962 000-59-18. Fax: +7 (865) 226-03-12 

Russian Federation

A. N. Kulichenko

Stavropol Research Institute for Plague Control

Email: savelev39@inbox.ru

RAS Corresponding Member, PhD, MD (Medicine), Professor, Director 

Stavropol

V. N. Saveliev

Stavropol Research Institute for Plague Control

Email: savelev39@inbox.ru

PhD, MD (Medicine), Senior Researcher, Head of the Laboratory for the Diagnostics of Cholera and Other Intestinal Infections 

Stavropol

D. A. Kovalev

Stavropol Research Institute for Plague Control

Email: savelev39@inbox.ru

PhD (Chemistry), Head of the Biochemistry Laboratory 

Stavropol

T. V. Taran

Stavropol Research Institute for Plague Control

Email: savelev39@inbox.ru

PhD, MD (Medicine), Head of the Laboratory for Specialist Training 

Stavropol

E. I. Podoprigora

Stavropol Research Institute for Plague Control

Email: savelev39@inbox.ru

Junior Researcher, Laboratory for Specialist Training 

Stavropol

O. V. Vasilieva

Stavropol Research Institute for Plague Control

Email: savelev39@inbox.ru

PhD (Medicine), Bacteriologist, Laboratory for the Diagnostics of Cholera and Other Intestinal Infections 

Stavropol

N. A. Shapakov

Stavropol Research Institute for Plague Control

Email: savelev39@inbox.ru

Specialist in Technical Documentation, Biochemistry Laboratory 

Stavropol

References

  1. Грижебовский Г.М., Асваров Б.М., Попов В.А., Евченко Ю.М., Савельев В.Н., Ефременко В.И., Ляховер М.Л., Рахоев М.-Р.А., Кадиев Ш.З., Сеидова М.М., Таран О.И. О механизмах внутриочагового и территориального распространения холеры в Республике Дагестан // Журнал микробиологии, эпидемиологии и иммунобиологии, приложение. 1995. № 2. С. 27–30. [Grizhebovskiy G.M., Asvarov B.M., Popov V.A., Evchenko Yu.M., Savel’ev V.N., Efremenko V.I., Lyakhover M.L., Rakhoev M.-R.A., Kadiev Sh.Z., Seidova M.M., Taran O.I. About the mechanisms of intrafocal and territorial spreading of cholera in Dagestan Republic. Zhurnal mikrobiologii, epidemiologii i immunobiologii, prilozhenie = Journal of Microbiology, Epidemiology and Immunobiology (Suppl.), 1995, no. 2, pp. 27–30. (In Russ.)]
  2. Заднова С.П., Шашкова А.В., Краснов Я.М., Смирнова Н.И. Фенотипический и генетический анализ измененных вариантов Vibrio cholerae биовара Эль-Тор // Проблемы особо опасных инфекций. 2012. № 1 (111). С. 57–61. [Zadnova S.P., Shashkova A.V., Krasnov Ya.M., Smirnova N.I Phenotypic and Genetic Analysis of Altered Variants of Vibrio cholerae Biovar El Tor. Problemy osobo opasnykh infektsiy = Problems of Particularly Dangerous Infections, Saratov, 2012, no. 1 (111), pp. 57–61 (In Russ.)] doi: 10.21055/0370-1069-2012-1(111)-57-61
  3. Клименко Е.П., Попов В.Ф., Степанов Г.П. Эпидемиологический анализ. М.: Медицина, 1983. 192 с. [Klimenko E.P., Popov V.F., Stepanov G.P. Epidemiological analysis. M.: Medicine, 1983. 192 p. (In Russ.)]
  4. Лабораторная диагностика холеры. Методические указания. МУК 4.2.2218-07. М.: Федеральный центр гигиены и эпидемиологии Роспотребнадзора, 2007. 87 с. [Cholera laboratory diagnostics. Methodical guidelines. MG 4.2.2218-07. M.: Federal Centre of Hygiene and и Epidemiology of Rospotrebnadzor, 2007. 87 p. (In Russ.)]
  5. Онищенко Г.Г., Ломов Ю.М., Москвитина Э.А., Чебураев В.И., Ляховер М.Л., Рахоев М.-Р.А., Терентьев А.Н., Асваров Б.М., Чернышов С.Н., Гаджиева С.З., Исмаилов Ф.М., Бугаков Н.П. Холера в начале века. Прогноз // Журнал микробиологии, эпидемиологии и иммунобиологии, приложение. 2005, № 3. С. 44–48. [Onishchenko G.G., Lomov Yu.M., Moskvitina E.A., Cheburaev V.I., Lyakhover M.L., Rakhoev M.-R.A., Terent’ev A.N., Asvarov B.M., Chernyshov S.N., Gadzhieva S.Z., Ismailov F.M., Bugakov N.P. Cholera at the beginning of the XXI century. Prognosis. Zhurnal mikrobiologii, epidemiologii i immunobiologii = Journal of Microbiology, Epidemiology and Immunobiology, 2005, no. 3, pp. 43–48 (In Russ.)]
  6. Организация работы лабораторий, использующих методы амплификации нуклеиновых кислот при работе с материалом, содержащим микроорганизмы I–IV групп патогенности: методические указания. М.: Федеральный центр гигиены и эпидемиологии Роспотребнадзора, 2010. 51 с. [Arrangement of work of laboratories using Nucleic Acid Amplification Techniques on materials containing microorganisms of I–IV pathogenic risk groups: methodical guidelines. М.: Federal Centre of Hygiene and и Epidemiology of Rospotrebnadzor, 2010. 51 p. (In Russ.)]
  7. Смирнова Н.И., Заднова С.П., Шашкова А.П., Кутырев В.В. Вариабельность генома измененных вариантов Vibrio choleraе биовара Эль-Тор, изолированных на территории России в современный период // Молекулярная генетика, микробиология и вирусология. 2011, № 3. С. 11–17. [Smirnova N.I., Zadnova S.P., Shashkova A.P., Kutyrev V.V. Genome variability in the altered variants of Vibrio cholerae biovar El Tor isolated in Russia. Molekulyarnaya genetika, mikrobiologiya i virusologiya = Molecular Genetics, Microbiology and Virology, 2011, no. 3, pp. 11–17. (In Russ.)]
  8. Шаханина И.Л., Чернова Г.П., Ивлиева И.М. Современный эпидемиологический анализ: обзорная информация. М.: ВНИИМИ, 1987. 71 с. [Shakhanina I.L., Chernova G.P., Ivlieva I.M. Modern epidemiological analysis: survey information. M.: VNIIMI, 1987. 71 p. (In Russ.)]
  9. Ghosh-Banerjee J., Senoh M., Takahashi T., Hamabata T., Barman S., Koley H., Mukhopadhyay A.K., Ramamurthy T., Chatterjee S., Asacura M., Yamasaki S., Nair G.B., Takeda Y. Cholera toxin production by the El Tor variant of Vibrio cholerae O1 compared to prototype El Tor and classical biotypes. J. Clin. Microbiol., 2010, vol. 48, no. 11, pp. 4283–4286. doi: 10.1128/JCM.00799-10
  10. Grim C.J., Hasan N.A., Taviani E. Hybrid Vibrio cholerae O1 MJ-1236, B-33, and CIRS 101 and cjmharative genomics with V. cholerae. J. Bacteriol., 2010, vol. 45, pp. 2991– 3000. doi: 10.1128/JB.00040-10
  11. Haan J., Hirst N.R. Cholera toxin: a paradigme for multi-functional engagement of cellular mechanisms. Mol. Membr. Biol., 2004, vol. 21, no. 2, pp. 77–92. doi: 10.1080/09687680410001663267
  12. Dziejman M., Balon E., Boyd D., Fraser C.M., Heidelberg J.F., Mekalanos J.J. Comparative genomic analysis of Vibrio cholerae: genes that correlate with cholera endemic and handemic disease. Proc. Natl. Acad. Sci. USA, 2002, vol. 99, no. 3, pp. 1556–1561. doi: 10.1073/pnas.042667999
  13. Nair G.B., Qadri F., Holmgren J. Cholerae due to altered El Tor strains of Vibrio cholerae O1 in Bangladesh. J. Clin. Microbiol., 2006, vol. 44, pp. 4211–4213. doi: 10.1128/JCM.01304-06
  14. Nguyen B.M., Lee J.H., Cuong N.T. Сholerae outbreaks caused by an altered Vibrio cholera O1 El Tor strain producing classical cholera toxin B in Vietnam in 2007 to 2008. J. Clin. Microbiol., 2009, vol. 47, no. 5, pp. 1568–1571. doi: 10.1128/JCM.02040-08
  15. Pradhan S., Baidya A.K., Ghosh A., Paul K., Chowthury R. The El Tor biotype of Vibrio cholerae exhibits Vibrio cholerae a growth advantage in the stationary phase in mixt cultures with the classical biotype. J. Bacteriol., 2010, vol. 192, no. 4, pp. 955– 963. doi: 10.1128/JB.01180-09
  16. Raychoudhuri A., Patra T., Ramamurthy T., Nandy R., Takeda Y., Nair G.B., Mukhopadhyay A.K. Classical ctxB in Vibrio cholerae O1, Kalkata, India. Emerg. Infect. Dis., 2009, vol. 15, no. 1, pp. 131–132. doi: 10.3201/eid1501.080543
  17. Safa A., Sultana J., Cam P.D., Mwansa J.C., Kong R.Y.C. Vibrio cholerae O1 hybrid El Tor strains, Asia and Africa. Emerg. Infect. Dis., 2008, vol. 15, no. 6, pp. 987–988. doi: 10.3201/eid1406.080129
  18. Safa A., Nair G.B., Kong R.Y.C. Evolution of new variants of Vibrio cholerae O1. Trends Microbiol., 2010, vol. 18, pp. 46–54. doi: 10.1016/j.tim.2009.10.003
  19. Siddique A.K., Nair G.B., Alam M., Sack D.A., Hug A., Nizam A., Longini I.M., Qadri M., Faruque S.M., Colwell R.R., Ahmed S., Igbal A., Bhuiyan N.A., Sack R.B. El Tor cholera with severe disease: a new threat to Asia and Benond. Epidemiol. Infect., 2010., vol. 138, no. 3, pp. 346–352. doi: 10.1017/S0950268809990550

Supplementary files

There are no supplementary files to display.


Copyright (c) 2021 Savelyeva I.V., Kulichenko A.N., Saveliev V.N., Kovalev D.A., Taran T.V., Podoprigora E.I., Vasilieva O.V., Shapakov N.A.

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies