title: A 4-year study of the epidemiology of Vibrio cholerae in four rural areas of Bangladesh.
abstract: 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.
authors.affiliation: Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland 21205, USA. rsack@jhsph.edu
authors.forename: R Bradley
authors.initials: RB
authors.lastname: Sack
authors.forename: A Kasem
authors.initials: AK
authors.lastname: Siddique
authors.forename: Ira M
authors.initials: IM
authors.lastname: Longini
authors.forename: Azhar
authors.initials: A
authors.lastname: Nizam
authors.forename: Md
authors.initials: M
authors.lastname: Yunus
authors.forename: M Sirajul
authors.initials: MS
authors.lastname: Islam
authors.forename: J Glenn
authors.initials: JG
authors.lastname: Morris
authors.forename: Afsar
authors.initials: A
authors.lastname: Ali
authors.forename: Anwar
authors.initials: A
authors.lastname: Huq
authors.forename: G Balakrish
authors.initials: GB
authors.lastname: Nair
authors.forename: Firdausi
authors.initials: F
authors.lastname: Qadri
authors.forename: Shah M
authors.initials: SM
authors.lastname: Faruque
authors.forename: David A
authors.initials: DA
authors.lastname: Sack
authors.forename: Rita R
authors.initials: RR
authors.lastname: Colwell
mesh_terms: 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