Skip to main content Accessibility help
×
Home

An epidemic of cholera due to Vibrio cholerae O139 in Dhaka, Bangladesh: clinical and epidemiological features

  • D. Mahalanabis (a1), A. S. G. Faruque (a1), M. J. Albert (a1), M. A. Salam (a1) and S. S. Hoque (a1)...

Summary

We describe the disease spectrum and socio-demographic and epidemiological features of an epidemic of cholera due to a new pathogen. Vibrio cholerae O139, in patients attending a very large hospital in the metropolitan city of Dhaka, Bangladesh.

This hospital treats 70000–90000 patients a year with diarrhoeal diseases. A 4% systematic sample of 1854 patients attending from January to April 1993 were studied.

Five hundred and two (27%) of the 1854 patients were culture positive for V. cholerae O139 and 63 (3%) were culture positive for V. cholerae O1 biotype El Tor. Patients with V. cholerae O139 were mainly adults with a short history of watery diarrhoea. Eight-three percent of patients had moderate to severe dehydration. All recovered except one 80-year-old man with compromised renal function who died. Seventy-eight percent of patients required initial intravenous rehydration followed by oral rehydration therapy with rice ORS; they also received tetracycline to reduce diarrhoea severity. Most patients were from urban slums with inadequate sanitation facilities and hygiene practices.

The newly recognized V. cholerae O139 infection produced an epidemic of severe dehydrating diarrhoea indistinguishable from clinical cholera in a population which experiences two epidemic peaks of cholera in a year due to V. cholerae O1. Infection with the latter does not appear to confer any cross-protection from V. cholerae O139. The new pathogen suppressed, albeit temporarily, V. cholerae O1. Unlike other non-O1 serogroups of V. cholerae this new serogroup appears to have epidemic potential.

    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      An epidemic of cholera due to Vibrio cholerae O139 in Dhaka, Bangladesh: clinical and epidemiological features
      Available formats
      ×

      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      An epidemic of cholera due to Vibrio cholerae O139 in Dhaka, Bangladesh: clinical and epidemiological features
      Available formats
      ×

      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      An epidemic of cholera due to Vibrio cholerae O139 in Dhaka, Bangladesh: clinical and epidemiological features
      Available formats
      ×

Copyright

Corresponding author

*Correspondence should be addressed to: Dr D. Mahalanabis. Associate Director In-Charge, Clinical Sciences Division, ICDDR. B. GPO Box 128. Dhaka. Bangladesh.

References

Hide All
1.Ramamurthy, T. Garg, S. Sharma, R. et al. Emergence of novel strain of Vibrio cholerae with epidemic potential in southern and eastern India. Lancet 1993; 341: 703–4.
2.Albert, MJ. Siddique, AK. Islam, MS. et al. Large outbreak of clinical cholera due to Vibrio cholerae non-O1 in Bangladesh. Lancet 1993; 341: 704.
3.Shimada, T. Nair, GB. Deb, BC. Albert, MJ, Sack, RB. Takeda, Y. Outbreak of Vibrio cholerae. non-O1 in India and Bangladesh. Lancet 1993; 341: 1347.
4.Morris, JO. Non-O group 1 Vibrio cholerae: a look at the epidemiology of an occasional pathogen. Epiderniol Rev 1990; 12: 179–91.
5.Khan, MU. Eeckels, R. Alam, AN. Rahman, N. Cholera, rotavirus and ETEC diarrhoea: some clinico-epidemiological features. Trans R Soc Trop Med Hyg 1988; 28: 485–8.
6.World Health Organization. Programme for control of diarrhoeal diseases (CDD/83.3 Rev 1). In: Manual for laboratory investigation of acute enteric infections. Geneva: World Health Organization. 1987.
7.Monsur, KA. A highly selective gelatin-taurocholate-tellurite medium for the isolation of Vibrio cholerae. Trans R Soc Trop Med Hyg 1961; 55: 440–2.
8.Mclntyre, OR. Feeley, JC. Greenough, WB III. Benenson, AS. Hassan, SI. Saad, A. Diarrhoea caused by non-cholera vibrios. Am J Trop Med Hyg 1965; 14: 412–8.
9.Spira, WM. Daniel, RR. Ahmed, QS. Huq, A. Yusuf, A. Sack, DA. Clinical features and pathogenioity of O group 1 non-agglutinating Vibrio cholerae and other vibrios isolated from cases of diarrhoea in Dacca. Bangladesh. In: Proceedings of 14th Joint Cholera Research Conference. US Japan Cooperative Medical Science Program. Geographic Medicine Branch. National Institute of Allergy and Infectious Diseases. NIH. 1978; 137–53.
10.Khan, MU. Shahidullah, M. Epidemiologic pattern of diarrhoea caused by non-agglutinating vibrios (NAG) and EF-6 organisms in Dhaka. Trop Geogr Med 1982; 34: 1927.
11.Aldova, E. Laznickova, K. Stepankova, E. Lietava, J. Isolation of non-agglutinable vibrios from an enteritis outbreak in Czechoslovakia. J Infect Dis 1968: 118: 2531.
12.World Health Organization. Outbreak of gastroenteritis by non-agglutinable (NAG) vibrios. Weekly Epidemiol Rec 1969; 44: 10.
13.Dakin, WPH. Howell, DJ. Sutton, RGA. O'Keefe, ME. Thomas, P. Gastroenteritis due to non-agglutinable (non-cholera) vibrios. Med J Aust 1974; 2: 487–90.
14.Wilson, R. Lieb, S. Robert, A. et al. Non-O group 1 Vibrio cholerae gastroenteritis associated with eating raw oysters. Am J Epidemiol 1981; 114: 293–8.

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed