Vibrio cholerae O139: how great is the threat of a pandemic?

The emergence of the new strain Vibrio cholerae O139 and its rapid spread in Bangladesh and India together with its detection in several other countries, have raised the question whether this constitutes the beginning of the eighth pandemic of cholera, and if so, how large a threat it poses. In an attempt to answer this question, epidemic spread patterns of Vibrio cholerae O139 strain in Bangladesh were studied. Initially the epidemic moved quickly and affected the entire coastal and estuarine tidal plains of southern Bangladesh.

Emergence of a new epidemic strain of Vibrio cholerae in Bangladesh. An epidemiological study.

For decades, epidemic cholera in Bangladesh has produced contrasting pictures of appearance and disappearance of Vibrio cholerae, which until recently, remained confined to the biotypes and to serotypes of V. cholerae O1. The classical biotype continued to survive and coexisted with El Tor biotype in southern Bangladesh despite its disappearance from the rest of the world during the present pandemic.

Cholera epidemics in Bangladesh: 1985-1991.

In 1991, a major epidemic of diarrhoea broke out in Bangladesh. To estimate the extent of cholera during diarrhoea epidemics and to focus on the public health issues related to cholera in Bangladesh, we have used the government figures of the 1991 epidemic and data from our own experience of epidemic interventions in nearly 400 rural upazilas (sub-district) between 1985 and 1989 and in 1991. Our data showed that V.

1988 floods in Bangladesh: pattern of illness and causes of death.

The worst flood in the history of Bangladesh affected millions of people in 1988. To determine morbidity and mortality during the flood, we investigated the causes of illness in 46,740 patients and causes of death in 154 persons while providing medical relief services in 72 flood affected upazilas (sub-districts). Diarrhoea was the most common illness (34.

Survival of classic cholera in Bangladesh.

During the present cholera pandemic the El Tor biotype of Vibrio cholerae has completely displaced the classic biotype, except in Bangladesh. We studied the distribution of these two biotypes in twenty-four rural districts during epidemics in 1988-89; there was clustering of the classic biotype in the southern region and of the El Tor biotype in all other regions. These findings suggest that the southern coastal region is now (and may always have been) the habitat of classic cholera.