Journal ArticleDOI
Endemic cholera in rural bangladesh, 1966–1980
Roger I. Glass,Roger I. Glass,Stan Becker,M. Imdadul Huq,Barbara J. Stoll,M. U. Khan,Michael H. Merson,Michael H. Merson,John V. Lee,Robert E. Black,Robert E. Black +10 more
TLDR
While little progress has been made in understanding the mode of transmission of v. cholerae 01, and in identifying practices for prevention, fluid therapy in this area has decreased the case fatality rate significantly and provides guidance for similar programs elsewhere.Abstract:
Since 1963, the International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B), formerly the Cholera Research Laboratory, has maintained a field station in Matlab to treat patients from a surveillance population of 240,000 who have cholera and other diarrheal diseases. Since 1966, the authors have analyzed hospital records of 7141 surveillance-area patients culture-positive for v. cholerae 01 to relate the seasonality, age and sex distribution, and geographic trends with hypotheses concerning transmission, immunity, and risk groups. From this review, they have found that: 1) children 2-9 years old and adult women are most commonly hospitalized for cholera; 2) V. cholerae 01 emerges simultaneously throughout the area of surveillance, with the early cases being of different phage types; 3) three patients were hospitalized twice for cholera compared with 29 expected on the basis of life-table analysis (p less than 0.01), suggesting that immunity to severe disease conferred by previous illness may be stable and long-lasting; 4) no constant relationship was found between the times of onset or peaks of the yearly cholera epidemic and the times of onset or peaks of the monsoon rains or river water levels; and 5) an outbreak of multiply antibiotic-resistant V. cholerae 01 infection documented in 1979 raises questions about the dissemination of resistance plasmids, antibiotic-use patterns, and the need for other drugs in addition to tetracycline. While little progress has been made in understanding the mode of transmission of v. cholerae 01, and in identifying practices for prevention, fluid therapy in this area has decreased the case fatality rate significantly and provides guidance for similar programs elsewhere.read more
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Journal ArticleDOI
Global burden of childhood pneumonia and diarrhoea
Christa L Fischer Walker,Igor Rudan,Li Liu,Harish Nair,Harish Nair,Evropi Theodoratou,Zulfiqar A Bhutta,Katherine L. O'Brien,Harry Campbell,Robert E. Black +9 more
TL;DR: The epidemiology of childhood diarrhoea and that of pneumonia overlap, which might be partly because of shared risk factors, such as undernutrition, suboptimum breastfeeding, and zinc deficiency, and action is needed globally and at country level to accelerate the reduction.
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Global Climate and Infectious Disease: The Cholera Paradigm*
TL;DR: The association of Vibrio cholerae with plankton, notably copepods, provides further evidence for the environmental origin of cholera, as well as an explanation for the sporadic and erratic occurrence of Cholera epidemics.
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Epidemiology, Genetics, and Ecology of Toxigenic Vibrio cholerae
TL;DR: It appears that the continual emergence of new toxigenic strains and their selective enrichment during cholera outbreaks constitute an essential component of the natural ecosystem for the evolution of epidemic V. cholerae strains and genetic elements that mediate the transfer of virulence genes.
Journal ArticleDOI
New knowledge on pathogenesis of bacterial enteric infections as applied to vaccine development.
TL;DR: A review of available information leads to the conclusion that an oral vaccine consisting of a combination of antigens, intending to stimulate both antibacterial and antitoxic immunity, would be most likely to succeed.
Journal ArticleDOI
Cholera transmission: the host, pathogen and bacteriophage dynamic
TL;DR: Advances that will help to unravel how interactions between the host, the bacterial pathogen and the lytic bacteriophage might propel and quench cholera outbreaks in endemic settings and in emergent epidemic regions such as Zimbabwe are highlighted.