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Evidence for several waves of global transmission in the seventh cholera pandemic.

Journal article
Authors Ankur Mutreja
DW Kim
Nicholas Thomson
TR Connor
JH Lee
S Kariuki
NJ Croucher
SY Choi
SR Harris
Michael Lebens
SK Niyogi
EJ Kim
T Ramamurthy
J Chun
JL Wood
JD Clemens
Cecil Czerkinsky
GB Nair
Jan Holmgren
Julian Parkhill
Gordon Dougan
Published in Nature
Volume 477
Issue 7365
Pages 462-465
ISSN 0028-0836
Publication year 2012
Published at Institute of Biomedicine, Department of Microbiology and Immunology
Pages 462-465
Language en
Links doi.org/10.1038/nature10392
Subject categories Bioinformatics and Systems Biology

Abstract

Vibrio cholerae is a globally important pathogen that is endemic in many areas of the world and causes 3-5 million reported cases of cholera every year. Historically, there have been seven acknowledged cholera pandemics; recent outbreaks in Zimbabwe and Haiti are included in the seventh and ongoing pandemic. Only isolates in serogroup O1 (consisting of two biotypes known as 'classical' and 'El Tor') and the derivative O139 can cause epidemic cholera. It is believed that the first six cholera pandemics were caused by the classical biotype, but El Tor has subsequently spread globally and replaced the classical biotype in the current pandemic. Detailed molecular epidemiological mapping of cholera has been compromised by a reliance on sub-genomic regions such as mobile elements to infer relationships, making El Tor isolates associated with the seventh pandemic seem superficially diverse. To understand the underlying phylogeny of the lineage responsible for the current pandemic, we identified high-resolution markers (single nucleotide polymorphisms; SNPs) in 154 whole-genome sequences of globally and temporally representative V. cholerae isolates. Using this phylogeny, we show here that the seventh pandemic has spread from the Bay of Bengal in at least three independent but overlapping waves with a common ancestor in the 1950s, and identify several transcontinental transmission events. Additionally, we show how the acquisition of the SXT family of antibiotic resistance elements has shaped pandemic spread, and show that this family was first acquired at least ten years before its discovery in V. cholerae.

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