Abstract
In order to control and eradicate epidemic cholera, we need to understand how epidemics begin, how they spread, and how they decline and eventually end. This requires extensive sampling of epidemic disease over time, alongside the background of endemic disease that may exist concurrently with the epidemic. The unique circumstances surrounding the Argentinian cholera epidemic of 1992–1998 presented an opportunity to do this. Here, we use 490 Argentinian V. cholerae genome sequences to characterise the variation within, and between, epidemic and endemic V. cholerae. We show that, during the 1992–1998 cholera epidemic, the invariant epidemic clone co-existed alongside highly diverse members of the Vibrio cholerae species in Argentina, and we contrast the clonality of epidemic V. cholerae with the background diversity of local endemic bacteria. Our findings refine and add nuance to our genomic definitions of epidemic and endemic cholera, and are of direct relevance to controlling current and future cholera epidemics.
Highlights
In order to control and eradicate epidemic cholera, we need to understand how epidemics begin, how they spread, and how they decline and eventually end
The remaining 3,562 isolates originate from the North and Centre of Argentina (Fig. 1b), and may represent over 82% of the Pan American Health Organization (PAHO)/WHO-reported cholera cases for the whole country from this 1990s epidemic
Following the cholera outbreak in Peru, as part of epidemic preparedness, it was decided at the national level that every suspected cholera case reported in Argentina should be tested for Vibrio cholerae and the isolate sent to INEI from all microbiology laboratories from the network across the country, including the South region
Summary
In order to control and eradicate epidemic cholera, we need to understand how epidemics begin, how they spread, and how they decline and eventually end. This requires extensive sampling of epidemic disease over time, alongside the background of endemic disease that may exist concurrently with the epidemic. An antimicrobialsensitive sub-lineage of 7PET (LAT-1) was introduced into Peru in January 1991 and spread rapidly across South America[7,10,11]. The Haitian cholera epidemic in 2010 was caused by 7PET, albeit by a third, independently-introduced sub-lineage, LAT-3 The Haitian cholera epidemic in 2010 was caused by 7PET, albeit by a third, independently-introduced sub-lineage, LAT-3 (refs. 7,8,12)
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