Abstract
BackgroundSince 1971, Kenya has had repeated cholera outbreaks. However, the cause of seasonal epidemics of cholera is not fully understood and neither are the factors that drive epidemics, both in Kenya and globally.ObjectivesThe objectives of the study were to determine the environmental reservoirs of V. cholerae during an interepidemic period in Kenya and to characterise their virulence factors.MethodsOne hundred (50 clinical, 50 environmental) samples were tested for V. cholerae isolates using both simplex and multiplex polymerase chain reaction.ResultsBoth sediments and algae from fishing and landing bays yielded isolates of V. cholerae. Clinical strains were characterised along with the environmental strains for comparison. All clinical strains harboured ctxA, tcpA (El Tor), ompU, zot, ace, toxR, hylA (El Tor) and tcpI genes. Prevalence for virulence genes in environmental strains was hylA (El Tor) (10%), toxR (24%), zot (22%), ctxA (12%), tcpI (8%), hylA (26%) and tcpA (12%).ConclusionThe study sites, including landing bays and beaches, contained environmental V. cholerae, suggesting that these may be reservoirs for frequent epidemics. Improved hygiene and fish-handling techniques will be important in reducing the persistence of reservoirs.
Highlights
Since 1971, Kenya has suffered repeated cholera outbreaks
Significant advances have been made in understanding the molecular basis of Vibrio cholerae pathogenicity, including the identification of environmental reservoirs for the microorganism.[4]
Ahmed et al.[7] 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
Summary
Significant advances have been made in understanding the molecular basis of Vibrio cholerae pathogenicity, including the identification of environmental reservoirs for the microorganism.[4] It has been shown that a 7th cholera pandemic spread from the Bay of Bengal in at least three independent but overlapping waves with a common ancestor in the 1950s and several transcontinental transmission events have been identified.[5] The main reservoirs of V. cholerae are humans and aquatic sources such as brackish water and estuaries.[6] Ahmed et al.[7] showed that multiple genetic lineages of V. cholerae were simultaneously infecting persons in Kenya. The cause of seasonal epidemics of cholera is not fully understood and neither are the factors that drive epidemics, both in Kenya and globally
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