4 years ago

Genomic history of the seventh pandemic of cholera in Africa

Fati Sidikou, Myriam Henkens, Karen H. Keddy, Julian Parkhill, Goutam Chowdhury, Elena Monakhova, Roland Grunow, Marie-Laure Quilici, Kathryn E. Holt, Renaud Piarroux, Berthe-Marie Njanpop-Lafourcade, Maria Damian, Jean Rauzier, Benoit Garin, Asish K. Mukhopadhyay, Patrick A. D. Grimont, Carlo Pazzani, Cheryl Tarr, Martin Mengel, Sébastien Breurec, Laurence Bonte, Christiane Bouchier, Guillaume Sapriel, Francisco J. Luquero, Henrik Salje, François-Xavier Weill, Ankur Mutreja, Antoinette Ngandjio, Anne-Laure Page, Gordon Dougan, Elisabeth Njamkepo, Daryl Domman, Jean-Louis Koeck, Raymond Bercion, Nizar Fawal, Sandra Moore, Monzer Hamze, Mireille Dosso, Nicholas R. Thomson, Jean-Michel Fournier, Thandavarayan Ramamurthy

The seventh cholera pandemic has heavily affected Africa, although the origin and continental spread of the disease remain undefined. We used genomic data from 1070 Vibrio cholerae O1 isolates, across 45 African countries and over a 49-year period, to show that past epidemics were attributable to a single expanded lineage. This lineage was introduced at least 11 times since 1970, into two main regions, West Africa and East/Southern Africa, causing epidemics that lasted up to 28 years. The last five introductions into Africa, all from Asia, involved multidrug-resistant sublineages that replaced antibiotic-susceptible sublineages after 2000. This phylogenetic framework describes the periodicity of lineage introduction and the stable routes of cholera spread, which should inform the rational design of control measures for cholera in Africa.

Publisher URL: http://science.sciencemag.org/cgi/content/short/358/6364/785

DOI: 10.1126/science.aad5901

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