El Tor cholera at the contemporary stage of the seventh pandemia: pathogen evolution, clinical and epidemiological features, laboratory diagnostics

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Abstract

The phenotypic and molecular genetic properties of 133 strains of genetically modified (genovariant) Vibrio cholerae O1 El Tor biovar isolated from patients in Dagestan (1993, 1994, 1998), and compared with 246 strains of a typical toxigenic cholera vibrio El Tor biovar isolated in 1970–1990 at the Caucasus Region. It was found that 48.7% of the studied genetically modified strain variants had mixed phenotypic properties of the El Tor and classic biovars that evidences about a need to include the marker genes of the classical biovar (ctxBCl+, rtxC–) and the El Tor biovar (ctxBEl+, rtxC+) into the existing biotyping scheme. The genes of the El Tor biovar, isolated from patients in Dagestan, contain in addition to the El Tor ones, the genes of the classical biovar (ctxBCl and/or rstRCl), as well as the typical toxigenic cholera vibrios of El Tor, islands of persistence (EPI), pathogenicity (VPI-1 and VPI-2) and pandemicity (VSP-I and VSP-II). However, only the El Tor biovar genovariants were found to bear an integrative and conjugative SXT element with antibiotic polyresistance genes. Epidemic cholera outbreaks caused by the El Tor biovar genovariants that occurred in 1993–1998 at the Caucasus Region, correspond to classical (Asian) cholera based on disease severity. The epidemiological features of modern cholera were studied: the main way for transmission via fecal-oral route for typical El Tor cholera vibrio is waterborne, whereas for the El Tor gene variant — household. Primary infections upon water drinking and using domestic water from surface water bodies infected with typical El Tor vibrios occur outside the family hearth. In case of cholera caused by hybrid El Tor variants, infection is transmitted among family members via domestic factors under low sanitary level. The development of laboratory diagnostics and epidemiological surveillance of modern El Tor cholera is based on the development of PCR test systems taking into account the evolutionary genome transformations.

About the authors

I. V. Savelyeva

Stavropol Research Institute for Plague Control

Author for correspondence.
Email: Stavnipchi@mail.ru

Irina V. Savelyeva,  PhD (Medicine), Bacteriologist of the Scientific and Production Laboratory of Preparations for the Diagnosis of Highly Dangerous and Other Infections 

355035, Stavropol, Soviet str., 13–15

Phone: +7 962 000-59-18. Fax: +7 (865) 226-03-12 

Russian Federation

A. N. Kulichenko

Stavropol Research Institute for Plague Control

Email: savelev39@inbox.ru

RAS Corresponding Member, PhD, MD (Medicine), Professor, Director 

Stavropol

V. N. Saveliev

Stavropol Research Institute for Plague Control

Email: savelev39@inbox.ru

PhD, MD (Medicine), Senior Researcher, Head of the Laboratory for the Diagnostics of Cholera and Other Intestinal Infections 

Stavropol

D. A. Kovalev

Stavropol Research Institute for Plague Control

Email: savelev39@inbox.ru

PhD (Chemistry), Head of the Biochemistry Laboratory 

Stavropol

T. V. Taran

Stavropol Research Institute for Plague Control

Email: savelev39@inbox.ru

PhD, MD (Medicine), Head of the Laboratory for Specialist Training 

Stavropol

E. I. Podoprigora

Stavropol Research Institute for Plague Control

Email: savelev39@inbox.ru

Junior Researcher, Laboratory for Specialist Training 

Stavropol

O. V. Vasilieva

Stavropol Research Institute for Plague Control

Email: savelev39@inbox.ru

PhD (Medicine), Bacteriologist, Laboratory for the Diagnostics of Cholera and Other Intestinal Infections 

Stavropol

N. A. Shapakov

Stavropol Research Institute for Plague Control

Email: savelev39@inbox.ru

Specialist in Technical Documentation, Biochemistry Laboratory 

Stavropol

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Copyright (c) 2021 Savelyeva I.V., Kulichenko A.N., Saveliev V.N., Kovalev D.A., Taran T.V., Podoprigora E.I., Vasilieva O.V., Shapakov N.A.

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