title: Shifting prevalence of major diarrheal pathogens in patients seeking hospital care during floods in 1998, 2004, and 2007 in Dhaka, Bangladesh.
abstract: Bangladesh experienced severe flooding and diarrheal epidemics in 2007. We compared flood data from 2007 with 2004 and 1998 for diarrheal patients attending the ICDDR,B hospital in Dhaka. In 2007, Vibrio cholerae O1 (33%), rotavirus (12%), and enterotoxigenic Escherichia coli (ETEC) (12%) were most prevalent. More severe dehydration was seen in 2007 compared with 2004 and 1998 (P < 0.001). In 2007, V. cholerae O1 Inaba (52%) and Ogawa (48%) were seen, whereas in 2004 and 1998 it was primarily Inaba and the Ogawa types, respectively (P < 0.001). In 2007, 51% of ETEC produced the heat labile toxin (LT) (P < 0.001 compared with 2004), 22% expressed the heat stable (ST) (P < 0.001), and 27% were ST/LT positive (P = 0.231). The CS7 colonization factor (CF) was the most prevalent in 2007 (20% compared with 6% in 2004; P = 0.05). Our findings demonstrate alterations in clinical features and phenotypic changes of major bacterial pathogens in the recent Bangladesh flood.
authors.affiliation: International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh. aaron.harris@tufts.edu
authors.forename: Aaron M
authors.initials: AM
authors.lastname: Harris
authors.forename: Fahima
authors.initials: F
authors.lastname: Chowdhury
authors.forename: Yasmin Ara
authors.initials: YA
authors.lastname: Begum
authors.forename: Ashraful Islam
authors.initials: AI
authors.lastname: Khan
authors.forename: Abu S G
authors.initials: AS
authors.lastname: Faruque
authors.forename: Ann-Mari
authors.initials: AM
authors.lastname: Svennerholm
authors.forename: Jason B
authors.initials: JB
authors.lastname: Harris
authors.forename: Edward T
authors.initials: ET
authors.lastname: Ryan
authors.forename: Alejandro
authors.initials: A
authors.lastname: Cravioto
authors.forename: Stephen B
authors.initials: SB
authors.lastname: Calderwood
authors.forename: Firdausi
authors.initials: F
authors.lastname: Qadri
mesh_terms: D000293:Adolescent; D001459:Bangladesh / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D003967:Diarrhea / Q000453:epidemiology* / Q000382:microbiology / Q000821:virology; D004797:Enzyme-Linked Immunosorbent Assay; D004926:Escherichia coli / Q000302:isolation & purification*; D005260:Female; D055868:Floods; D006761:Hospitals; D006801:Humans; D007223:Infant; D008297:Male; D010342:Patient Acceptance of Health Care; D015995:Prevalence; D012401:Rotavirus / Q000302:isolation & purification*; D014734:Vibrio cholerae / Q000302:isolation & purification*