Expression in Saccharomyces boulardii of recombinant Toxin-coregulated pilus A subunit (TcpA) of Vibrio cholerae O1

Cholera is endemic in over 50 countries with an estimated mortality of 100,000-120,000. Vaccination is considered the complementary key to prevent and control cholera; therefore, alternative vaccine preparations are needed. Toxin Co-regulated Pilus is part of the toxR virulence regulon, which is necessary for colonization in the intestinal mucosa. In order to express Vibrio cholerae TcpA protein in Saccharomyces boulardii, the expression plasmid pYES2 was constructed by inserting tcpA gene isolated from local Vibrio cholerae Eltor Inaba isolates. The new construct was transferred into Saccharomyces boulardii cells and the expression of tcpA gene was induced from the GAL1 promoter by adding galactose to the medium. The SDS-PAGE and Western blot analysis showed the presence of TcpA in yeast. These results showed that Saccharomyces boulardii is a promising host to express Vibrio cholerae toxin TcpA as the first step in attempt to produce an oral Vibrio cholerae vaccine(AU)

El cólera es endémico en más de 50 países. Se estima una mortalidad entre 100.000 - 120.000 debido a esta enfermedad. La vacunación se considera una medida complementaria para prevenir y controlar el cólera, por lo tanto, se necesitan preparaciones vacunales alternativas a las existentes. El Pili corregulado con la toxina, es parte del regulón de virulencia toxR, y es necesario para la colonización en la mucosa intestinal. Para expresar la proteína tcpA de Vibrio cholerae en Saccharomyces boulardii, se construyó el plásmido de expresión pYES2 insertando el gen tcpA obtenido a partir de aislamientos locales de Vibrio cholerae El Tor Inaba. La nueva construcción se transfirió a las células de Saccharomyces boulardii y se indujo la expresión del gen tcpA a partir del promotor GAL1 mediante la adición de galactosa al medio. El análisis mediante SDS-PAGE y Western blot demostró la presencia de TcpA en levaduras. Los resultados demostraron que Saccharomyces boulardii es un hospedero prometedor para expresar el gen tcpA de Vibrio cholerae como el primer paso en el intento de producir una vacuna oral contra Vibrio cholerae(AU)

New Cholera Outbreak in Somalia

Somalia is being swamped by a new wave of cholera cases in two regions Banadir and Hiran. The Ministry of Health is now flagging up a cumulative total of 334 new cases with 1 associated death [CFR:0.29%] during January 2018

Cholera Outbreak in Somalia

Somalia has been experiencing recurring outbreaks of cholera in the last few years. The current cholera outbreak started in November 2016 and is still ongoing. Since the beginning of the outbreak in early 2016, a cumulative total of 20 684 cases including 689 deaths have been reported so far [CFR=3.2%] from the country

Outbreaks repored in 2016

In the year 2016, several major out-breaks from emerging and re-emerging diseases including cholera in Somalia and Yemen; MERS-CoV in Saudi Arabia; Chikungunya in Somalia, Pakistan and Crimean– Congo Haemorrhagic fever in Pakistan were reported in the Eastern Mediterranean Region [EMR]

Resurgence of Cholera Outbreak in Yemen

The current cholera outbreak in Yemen, started in October 2016, showed a sign of decline in the first three months of the year. An upsurge of cases and deaths were recorded from 27 April 2017. As of 28 May 2017, a cumulative total of 88,849 suspected cholera cases including 657 associated deaths [CFR: 0.73%] were recorded from 261 districts in 19 governorates across the country since the beginning of the outbreak in 2016 [Please see the graph]

Cholera in Yemen: Key questions

The cholera outbreak in Yemen continues to rage and from April to 28 October 2017, a total of 880,987 suspected cholera cases including 2,183 associated deaths with a case fatality rate of 0.25% were reported from Yemen. The cases were reported from almost all governorates [96% of the governorates were affected] and almost all districts [92% of the districts were affected]

Declining trend of cholera in Somalia

Data from the Ministry of Health in Somalia suggests that the cholera outbreak reported in 2017 in the country is gradually levelling off. The number of cholera cases and deaths have significantly decreased in recent months and no deaths were recorded from August up to November. The number of cases reported during the month of November is the lowest in 2017

Cholera in Somalia

Somalia, recently, reported a huge outbreak of acute watery diarrhea cases affecting at-least 15 districts in South Central regions of the country. From January to April 2016, a total of 8,838 cases and 433 deaths [CFR=4.9%] have been reported. Children under 5 years of age represented 59% and 66% of total reported cases and deaths respectively

Cholera in Somalia: outbreak contained but sporadic cases continue

The cholera outbreak in Somalia which was reported at the beginning of the year is gradually tapering off despite slight increase in number of reported cases during epidemiological week from 45 to 47. As of 30 November 2016, a total of 14, 710 suspected cases including 497 related deaths [CFR: 3.51%] were reported from this outbreak so far

La epidemia de cólera en América Latina: reemergencia y morbimortalidad / The cholera epidemic in Latin America: reemergence, morbidity, and mortality

OBJETIVO: Identificar la morbilidad y la mortalidad por cólera entre distintos segmentos del período 1991-2011 en los países de América Latina. MÉTODO: Mediante el uso de fuentes de información provenientes de una búsqueda bibliográfica no sistemática de trabajos sobre epidemias del cólera, se realizó un estudio ecológico mixto dirigido a analizar series de tiempo de morbilidad, mortalidad y letalidad de estos eventos sanitarios ocurridos entre los años 1991 y 2011 en 18 países de América Latina. RESULTADOS: Durante el período 1991 y 2011 en América Latina se notificaron 1 839 037 casos de cólera, con 19 538 muertes y una letalidad de 1,06%. Los países más afectados fueron Perú entre 1991 y 2002 -con una incidencia acumulada anual máxima de 1 452,72 casos por 100 000 habitantes, pero con baja letalidad (0,72%)- y Haití entre 2010 y 2011, con una incidencia acumulada anual máxima de 3 319,13 por 100 000 habitantes y una letalidad de 1,32%. CONCLUSIONES: La epidemia de cólera ha provocado morbilidad, mortalidad y letalidad altas en algunos países de América Latina, debidas en gran medida a factores fundamentalmente socioeconómicos y climáticos. La reemergencia de esta enfermedad y la diversidad de factores relacionados con los comportamientos de sus brotes ameritan el desarrollo y el fortalecimiento de estrategias regionales de prevención y control en los países, junto con estudios de los determinantes que influyen en la emergencia y reemergencia de las enfermedades infecciosas en América Latina.

OBJECTIVE: To determine morbidity and mortality from cholera during different segments of the period 1991-2011 in the countries of Latin America. METHODS: Using information sources from a nonsystematic literature search for works on cholera epidemics, a mixed ecological study was conducted aimed at a time series analysis of morbidity, mortality, and case-fatality in cholera-related health events between 1991 and 2011 in 18 Latin American countries. RESULTS: During the period 1991-2011, 1 839 037 cases of cholera were reported in Latin America, with 19 538 deaths and a case fatality rate of 1.06%. The most affected countries were Peru between 1991 and 2002-with a maximum annual cumulative incidence of 1 452.72 cases per 100 000 population but a low case fatality rate (0.72%)-and Haiti between 2010 and 2011, with a maximum annual cumulative incidence of 3 319.13 per 100 000 population and a case fatality rate of 1.32%. CONCLUSIONS: The cholera epidemic has resulted in high morbidity, mortality, and case fatality in some Latin American countries, due largely to basically socioeconomic and climatic factors. The reemergence of this disease and the many factors related to how cholera outbreaks evolve call for the development and strengthening of regional prevention and control strategies in the countries as well as a study on the determinants that influence the emergence and reemergence of infectious diseases in Latin America.

use of OCV in Somalia

In 2011, cholera claimed more than 1000 lives in Somalia, majority of them in children under 5 years of age group. Given the precarious situation prevailing in the country, considerations for the use of oral cholera vaccines [OCVs] for a mass immunization campaign to reduce deaths particularly amongst the children were explored in a meeting held on 5-6 March 2011 in Nairobi with participation from WHO CO, EMRO, HQ and UNICEF

Lessons from cholera & Vibrio cholerae.

Cholera is an acute form of diarrhoeal disease that plagued human civilization over the centuries. The sudden and explosive onset of the disease in the form of an outbreak or epidemic, coupled with high mortality and morbidity rates, had a tragic impact on the personal as well as social life of people living in the affected areas. The enormity of human sufferings led clinicians and scientists to carry out extensive research on cholera and Vibrio cholerae (the causative bacterium of the disease) leading to major discoveries that opened up novel areas of research or new disciplines in biomedical sciences. An attempt is made here to summarize some of these breakthroughs and outline their significance in broader perspectives. Finally, the possible impact of the global socio-political scenario on the spread of cholera epidemics (pandemicity of cholera) is briefly discussed.

Cholera in Afghanistan

During the last week of April, 2011, cases of acute watery diarrhoea [AWD] were reported from different villages of Giro district under the Ghazni province of Afghanistan. Following field investigation by the Disease Early Warning System [DEWS] surveillance officers of the province, 255 cases of AWD with mild to moderate degree of dehydration were detected. One stool sample collected from one of the suspected cases, was tested positive for Vibrio cholerae 01 serotype Ogawa. Three [3] deaths were also reported from the area so far

Suspected cholera outbreaks in Afghanistan

Between 11 April and 11 July 2011, the Ministry of Public Health, Afghanistan has reported small isolated outbreaks of acute watery diarrhoea [suspected cholera] from several districts in nine provinces [Samangan, Kandahar, Zabul, Kabul, Khost, Ghazni, Paktya, Nangahar and Faryab]. A total of 1093 cases and 11 related deaths were recorded. Teams from the Disease Early Warning System with the support of WHO and other stakeholders rapidly investigated, responded to and contained these outbreaks were within the affected districts. Control measures included case management, health education and water and sanitation measures

Cholera in Yemen

As of 23 September, 2011, the Ministry of Public Health and Population [MOPH and P] in Yemen has reported a total of 18,276 cases of acute watery diarrhea/cholera, with 40 related deaths. The cases were reported from the governorates of Abyan, Lahj, Dhalae, Aden and Ibb. Some stool samples have tested positive for Vibrio cholerae 01 Eltor. The cases started in April in Abyan Governorate and spread to four other governorates. WHO, UNICEF, UNHCR and other partners are supporting the MOPH and P to control the outbreak. Public health control measures including case managements, surveillance and water and sanitation services have been strengthened in the affected areas

Cholera in Djibouti

As of epidemiological week 18 of 2010, the Ministry of Health [MoH] in Djibouti reported 2,047 cases of cholera from five of six regions in the Country. There were 19 related deaths reported during the same period. The cases are reported from multiple foci in the affected regions. The highest number of cases [1,371] were reported from the capital, Djibouti City. The MOH, WHO Country Office and UNICEF are responding to contain this outbreak and have appealed for assistance. Most of the cases are reported to be among people coming across the border from Ethiopia

Cholera in Yemen

The Ministry of Public Health and Population [MOPH and P] in Yemen has reported an outbreak of acute watery diarrhea [AWD] in Lahj Governorate [South Yemen] in the region of Alshat and Ras Alara districts. The outbreak started on 29 June 2010 and as of 2 July, a total of 300 suspected cases including 4 deaths [CFR: 1.3%] have been reported. Majority [about 50%] of the cases were described as presenting with moderate dehydration. Some cases were transferred to Aden for admission and laboratory investigations. Nine out of 50 samples were tested were positive for Vibrio cholerae. The MOPH and P has initiated control measures that include case management, chlorination of affected wells and other domestic water sources and as a result, the number of cases are coming down in recent days

Cholera continues to claim lives but cases decline in 2010

In 2010, cholera was detected and laboratory-confirmed in four countries [Afghanistan, Djibouti, Pakistan and Yemen] of the Eastern Mediterranean Region. 3,983 suspected cases including 92 deaths [CFR=2.3%] were reported from cholera in 2010 from the Region. Although, number of cases declined in 2010 compared to the previous years [Please see the graph], cholera is still claiming lives despite the fact that many of these deaths are preventable by simply re-hydrating the patients at an early stage with simple and inexpensive yet highly effective life saving treatment