Abstract
Numerous outbreaks of cholera have occurred in Kenya since 1971. To more fully understand the epidemiology of cholera in Kenya, we analyzed the genetic relationships among 170 Vibrio cholerae O1 isolates at 5 loci containing variable tandem repeats. The isolates were collected during January 2009-May 2010 from various geographic areas throughout the country. The isolates grouped genetically into 5 clonal complexes, each comprising a series of genotypes that differed by an allelic change at a single locus. No obvious correlation between the geographic locations of the isolates and their genotypes was observed. Nevertheless, geographic differentiation of the clonal complexes occurred. Our analyses showed that multiple genetic lineages of V. cholerae were simultaneously infecting persons in Kenya. This finding is consistent with the simultaneous emergence of multiple distinct genetic lineages of V. cholerae from endemic environmental reservoirs rather than recent introduction and spread by travelers.
Highlights
Cholera, caused by the bacterium Vibrio cholerae and characterized by a profuse watery diarrhea, has been a serious public health problem since the first recorded pandemic in 1817
Multilocus-variable tandem repeat analysis (MLVA), has been reported to be useful in differentiating V. cholerae O1 strains in various rural communities and within households [11,12,13,14]
To more fully understand the epidemiology of cholera in Kenya, we used MLVA to characterize the genetic relatedness of V. cholerae strains isolated from persons throughout the country
Summary
Cholera, caused by the bacterium Vibrio cholerae and characterized by a profuse watery diarrhea, has been a serious public health problem since the first recorded pandemic in 1817. The most recent outbreak occurred during January 2009–May 2010; cholera was detected in at least 52 districts throughout the country, and a total of 11,769 cases and 274 deaths (case-fatality rate ≈2.3%) were reported to the Kenya Ministry of Public Health and Sanitation. The regularity of these outbreaks indicates that V. cholerae might be frequently spread by travelers or that it is endemic to the area. To more fully understand the epidemiology of cholera in Kenya, we used MLVA to characterize the genetic relatedness of V. cholerae strains isolated from persons throughout the country
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