Abstract
In August 2010, Pakistan experienced major floods and a subsequent cholera epidemic. To clarify the population dynamics and transmission of Vibrio cholerae in Pakistan, we sequenced the genomes of all V. cholerae O1 El Tor isolates and compared the sequences to a global collection of 146 V. cholerae strains. Within the global phylogeny, all isolates from Pakistan formed 2 new subclades (PSC-1 and PSC-2), lying in the third transmission wave of the seventh-pandemic lineage that could be distinguished by signature deletions and their antimicrobial susceptibilities. Geographically, PSC-1 isolates originated from the coast, whereas PSC-2 isolates originated from inland areas flooded by the Indus River. Single-nucleotide polymorphism accumulation analysis correlated river flow direction with the spread of PSC-2. We found at least 2 sources of cholera in Pakistan during the 2010 epidemic and illustrate the value of a global genomic data bank in contextualizing cholera outbreaks.
Highlights
In August 2010, Pakistan experienced major floods and a subsequent cholera epidemic
This study showed that the 2010 cholera outbreak was, an epidemic within an epidemic explained by 2 independent introductions of cholera in the country, 1 from the south and 1 following the flood water as it moved from north to south along the Indus River
Sample Collection A total of 319 fecal samples were collected from patients who had acute diarrhea who reported in the KPK, Sindh, and Punjab Provinces during August–October 2010
Summary
In August 2010, Pakistan experienced major floods and a subsequent cholera epidemic. To clarify the population dynamics and transmission of Vibrio cholerae in Pakistan, we sequenced the genomes of all V. cholerae O1 El Tor isolates and compared the sequences to a global collection of 146 V. cholerae strains. We found at least 2 sources of cholera in Pakistan during the 2010 epidemic and illustrate the value of a global genomic data bank in contextualizing cholera outbreaks. Pakistan is at risk for waterborne disease because it is an agricultural economy with one of the most expansive water distribution systems in the world. This vast irrigation system depends largely on the Indus River, which originates on the northern slopes of the Kailash mountain range in India and runs north to south through the entire length of Pakistan with many tributaries, including the Zaskar, the Shyok, the Nubra, and the Hunza, converging in the northern region and flowing through the provinces of Ladakh, Baltistan, and Gilgit. This study showed that the 2010 cholera outbreak was, an epidemic within an epidemic explained by 2 independent introductions of cholera in the country, 1 from the south and 1 following the flood water as it moved from north to south along the Indus River
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
