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Web Review of Todar's Online Textbook of Bacteriology. "The Good, the Bad, and the Deadly". (SCIENCE Magazine- June 4, 2004 - Vol 304: p. 1421).

Tag words: Vibrio cholerae, V cholerae, V cholerae O139, cholera, diarrhea.

Vibrio cholerae

Kingdom: Bacteria
Phylum: Proteobacteria
Class: Gamma Proteobacteria
Order: Vibrionales
Family: Vibrionaceae
Genus: Vibrio
Species: V. cholerae


Kenneth Todar currently teaches Microbiology 100 at the University of Wisconsin-Madison.  His main teaching interests include general microbiology, bacterial diversity, microbial ecology and pathogenic bacteriology.

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Vibrio cholerae and Asiatic Cholera (page 1)

(This chapter has 4 pages)

© 2009 Kenneth Todar, PhD

December 9, 2010
Update on cholera outbreak in Haiti from Reuters (unedited, remember Vibrio cholerae is NOT A VIRUS>

From Reuters Health Information
Full Sequence Confirms Haiti Cholera Came From Asia
By Maggie Fox

WASHINGTON (Reuters) Dec 09 - Detailed genetic tests confirm that the cholera strain that has killed more than 2,000 people in Haiti came from south Asia and most closely resembles a strain circulating in Bangladesh, U.S. researchers reported on Thursday.

While they cannot trace who or what precisely carried the cholera to Haiti, the team at Harvard Medical School and Pacific Biosciences of California Inc say their findings show extra measures may be needed to help prevent the spread of cholera from one disaster area to another -- a contentious issue because many Haitians have blamed the outbreak on Nepalese troops sent to help them as part of a United Nations mission.

Aid workers from more than 10,000 organizations all over the world have poured into Haiti to help after the devastating January earthquake.

Writing in the New England Journal of Medicine today, Harvard's Dr. John Mekalanos and colleagues said they also confirmed that Haiti's cholera strain carries a mutation associated with more severe disease.

"Our genome data puts the Haiti strain in the group that is the worst of the worst," Dr. Mekalanos said.

"In the future when people go to work in disaster zones ... they should be screened or just presumptively given a dose of antibiotics or a vaccine so that they will not transfer cholera," Dr. Matthew Waldor of Harvard and Brigham and Women's Hospital added in a telephone interview.

Haiti's health ministry reports more than 93,000 people have been sickened by cholera since it broke out in Haiti in October. Haiti had not had a case of cholera in a century, but the ongoing devastation from January's giant earthquake made conditions perfect for its spread.

In early November the U.S. Centers for Disease Control and Prevention said genetic fingerprinting showed Haiti's cholera strain was part of a 49-year-old global pandemic that began in Indonesia and likely was brought to the Caribbean country in a single instance.

The CDC said it was possible the strain could circulate for years in Haiti and the best options were to try to prevent deaths.

When they got some cholera samples from Haiti in early November, the Harvard team contacted Eric Schadt at Pacific Biosciences, which makes a DNA sequencer. They used this $695,000 sequencer to analyze the Haitian cholera's DNA and compared it to strains from elsewhere.

"We definitely linked it to the recent outbreak strains in Bangladesh," Schadt said in a telephone interview. But it is not identical, he added, which raises the possibility that the virus may have traveled via elsewhere, perhaps West Africa.

What is clear is that the cholera did not originate locally, Dr. Mekalanos said. "Human activity coming from a far-away place brought this strain to Haiti," he said.

"Our work is by no way intended to assign blame here," Dr. Waldor added. "I do think it is important to understand how cholera likely got to Haiti to see if we can prevent it from happening again."

Many in Haiti have blamed the outbreak on Nepalese United Nations troops stationed near a river that is believed to have been the source of the outbreak. Without a sample from Nepal, however, this would be impossible to prove or disprove, the Harvard team said.

The complete report is available online for free on the New England Journal of Medicine website: N Engl J Med. Posted December 9, 2010




Introduction

The genus Vibrio consists of Gram-negative straight or curved rods, motile by means of a single polar flagellum. Vibrios are capable of both respiratory and fermentative metabolism. O2 is a universal electron acceptor; they do not denitrify. Most species are oxidase-positive. In most ways vibrios are related to enteric bacteria, but they share some properties with pseudomonads a well. The Family Vibrionaceae is found in the "Facultatively Anaerobic Gram-negative Rods" in Bergey's Manual (1986), on the level with the Family Enterobacteriaceae. In the revisionist taxonomy of 2001 (Bergey's Manual), based on phylogenetic analysis, Vibrionaceae, Pseudomonadaceae and Enterobacteriaceae are all landed in the  Gammaproteobacteria. Vibrios are distinguished from enterics by being oxidase-positive and motile by means of polar flagella. Vibrios are distinguished from pseudomonads by being fermentative as well as oxidative in their metabolism. Of the vibrios that are clinically significant to humans, Vibrio cholerae,the agent of cholera, is the most important.

Most vibrios have relatively simple growth factor requirements and will grow in synthetic media with glucose as a sole source of carbon and energy. However, since vibrios are typically marine organisms, most species require 2-3% NaCl or a sea water base for optimal growth. Vibrios vary in their nutritional versatility, but some species will grow on more than 150 different organic compounds as carbon and energy sources, occupying the same level of metabolic versatility as Pseudomonas. In liquid media vibrios are motile by polar flagella that are enclosed in a sheath continuous with the outer membrane of the cell wall. On solid media they may synthesize numerous lateral flagella which are not sheathed.

Vibrios are one of the most common organisms in surface waters of the world. They occur in both marine and freshwater habitats and in associations with aquatic animals. Some species are bioluminescent and live in mutualistic associations with fish and other marine life. Other species are pathogenic for fish, eels, and frogs, as well as other vertebrates and invertebrates.

V. cholerae and V. parahaemolyticus are pathogens of humans. Both produce diarrhea, but in ways that are entirely different. V. parahaemolyticus is an invasive organism affecting primarily the colon; V. cholerae is noninvasive, affecting the small intestine through secretion of an enterotoxin. Vibrio vulnificus is an emerging pathogen of humans. This organism causes wound infections, gastroenteritis, or a syndrome known as "primary septicemia."

Campylobacter jejuni (formerly Vibrio fetus), is now moved to the class Epsilonproteobacteria in the the family Campylobacteraceae. Campylobacter jejuni has been associated with dysentery-like gastroenteritis, as well as with other types of infection, including bacteremic and central nervous system infections in humans. Another vibrio-like organism, Helicobacter pylori causes duodenal and gastric ulcers and gastric cancer. It is also reclassified into the class Epsilonproteobacteria family Helicobacteraceae.


Vibrio cholerae

Cholera

Cholera (frequently called Asiatic cholera or epidemic cholera) is a severe diarrheal disease caused by the bacterium Vibrio cholerae. Transmission to humans is by water or food. The natural reservoir of the organism is not known. It was long assumed to be humans, but some evidence suggests that it is the aquatic environment.

V. cholerae produces cholera toxin, the model for enterotoxins, whose action on the mucosal epithelium is responsible for the characteristic diarrhea of the disease cholera. In its extreme manifestation, cholera is one of the most rapidly fatal illnesses known. A healthy person may become hypotensive within an hour of the onset of symptoms and may die within 2-3 hours if no treatment is provided. More commonly, the disease progresses from the first liquid stool to shock in 4-12 hours, with death following in 18 hours to several days.

The clinical description of cholera begins with sudden onset of massive diarrhea. The patient may lose gallons of protein-free fluid and associated electrolytes, bicarbonates and ions within a day or two. This results from the activity of the cholera enterotoxin which activates the adenylate cyclase enzyme in the intestinal cells, converting them into pumps which extract water and electrolytes from blood and tissues and pump it into the lumen of the intestine. This loss of fluid leads to dehydration, anuria, acidosis and shock. The watery diarrhea is speckled with flakes of mucus and epithelial cells ("rice-water stool") and contains enormous numbers of vibrios. The loss of potassium ions may result in cardiac complications and circulatory failure. Untreated cholera frequently results in high (50-60%) mortality rates.

Treatment of cholera involves the rapid intravenous replacement of the lost fluid and ions. Following this replacement, administration of isotonic maintenance solution should continue until the diarrhea ceases. If glucose is added to the maintenance solution it may be administered orally, thereby eliminating the need for sterility and iv. administration. By this simple treatment regimen, patients on the brink of death seem to be miraculously cured and the mortality rate of cholera can be reduced more than ten-fold. Most antibiotics and chemotherapeutic agents have no value in cholera therapy, although a few (e.g. tetracyclines) may shorten the duration of diarrhea and reduce fluid loss.


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Kenneth Todar is an emeritus lecturer at University of Wisconsin-Madison. He has taught microbiology to undergraduate students at The University of Texas, University of Alaska and University of Wisconsin since 1969.

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