Abstract
The prevalence of reported cholera was relatively low around the Lake Chad basin until 1991. Since then, cholera outbreaks have been reported every couple of years. The objective of this study was to investigate the 2010/2011 Vibrio cholerae outbreak in Cameroon to gain insight into the genomic make-up of the V. cholerae strains responsible for the outbreak. Twenty-four strains were isolated and whole genome sequenced. Known virulence genes, resistance genes and integrating conjugative element (ICE) elements were identified and annotated. A global phylogeny (378 genomes) was inferred using a single nucleotide polymorphism (SNP) analysis. The Cameroon outbreak was found to be clonal and clustered distant from the other African strains. In addition, a subset of the strains contained a deletion that was found in the ICE element causing less resistance. These results suggest that V. cholerae is endemic in the Lake Chad basin and different from other African strains.
Highlights
Cholera is a serious and potential life-threatening waterborne communicable disease caused by Vibrio cholerae [1,2]
Cholera has become endemic in the Lake Chad basin following a pattern of cross-border transmission among the four countries with large coinciding outbreaks reported from the area in the years 1996, 1998/1999, and 2004/2005/2006
The outbreak around the Lake Chad basin in 2010 was previously believed to be caused by a multi-drug resistant atypical El Tor O1 V. cholerae strain similar to the Indian Orissa variant [32,33,34,35], which was confirmed in this study
Summary
Cholera is a serious and potential life-threatening waterborne communicable disease caused by Vibrio cholerae [1,2]. The disease is associated with poor water quality and inadequate sanitation, [3] and is transmitted by the fecal-oral route [4,5]. Cholera outbreaks are commonly reported and often related to collateral damage of natural disasters or flooding [6,7,8,9]. Asymptomatic healthy carriers have been observed, mainly infected with the El Tor biotype [10]. V. cholerae produces the hallmark of cholera; the enterotoxin: CTXφ and is classified into approximately 200 serogroups of which O1 and O139 are mostly associated with clinical cases.
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