A 4-year study of the epidemiology of Vibrio cholerae in four rural areas of Bangladesh.
How Vibrio cholerae spreads around the world and what determines its seasonal peaks in endemic areas are not known. These features of cholera have been hypothesized to be primarily the result of environmental factors associated with aquatic habitats that can now be identified. Since 1997, fortnightly surveillance in 4 widely separated geographic locations in Bangladesh has been performed to identify patients with cholera and to collect environmental data. A total of 5670 patients (53% <5 years of age) have been studied; 14.3% had cholera (10.4% due to V. cholerae O1 El Tor, 3.8% due to O139). Both serogroups were found in all locations; outbreaks were seasonal and often occurred simultaneously. Water-use patterns showed that bathing and washing clothes in tube-well water was significantly protective in two of the sites. These data will be correlated with environmental factors, to develop a model for prediction of cholera outbreaks.
Sack
R Bradley
RB
Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland 21205, USA. rsack@jhsph.edu
Siddique
A Kasem
AK
Longini
Ira M
IM
Nizam
Azhar
A
Yunus
Md
M
Islam
M Sirajul
MS
Morris
J Glenn
JG
Ali
Afsar
A
Huq
Anwar
A
Nair
G Balakrish
GB
Qadri
Firdausi
F
Faruque
Shah M
SM
Sack
David A
DA
Colwell
Rita R
RR
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D001459:Bangladesh / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D002771:Cholera / Q000453:epidemiology*; D004196:Disease Outbreaks; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008875:Middle Aged; D012621:Seasons; D014871:Water Microbiology