title: Bacterial shedding in household contacts of cholera patients in Dhaka, Bangladesh.
abstract: Multiple Vibrio cholerae infections within the same household are common. Household contacts of patients with cholera were observed with daily clinical assessments and collection of rectal swab cultures for nine days after presentation of the index case. During the follow-up period, 71 (24%) of 294 household contacts developed a positive V. cholerae rectal swab, signifying bacterial shedding. The average length of bacterial shedding was 2.0 days (95% confidence interval 1.7-2.4). However, 16 (5%) of 294 contacts shed V. cholerae for ≥ 4 days. In a multivariate analysis, malnutrition was predictive of long-term shedding (odds ratio = 1.4, 95% confidence interval = 1.3-13, P = 0.02). High rates of V. cholerae infection and bacterial shedding among household contacts of cholera patients represent an opportunity for intervention to reduce V. cholerae transmission.
authors.affiliation: Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts; Department of Medicine, Department of Microbiology and Immunobiology, and Department of Pediatrics, Harvard Medical School, Boston, Massachusetts; Centre for Vaccine Sciences, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh; Department of Immunology and Infectious Diseases, Harvard School of Public Health, Boston, Massachusetts.
authors.forename: Ana A
authors.initials: AA
authors.lastname: Weil
authors.affiliation: Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts; Department of Medicine, Department of Microbiology and Immunobiology, and Department of Pediatrics, Harvard Medical School, Boston, Massachusetts; Centre for Vaccine Sciences, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh; Department of Immunology and Infectious Diseases, Harvard School of Public Health, Boston, Massachusetts.
authors.forename: Yasmin
authors.initials: Y
authors.lastname: Begum
authors.affiliation: Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts; Department of Medicine, Department of Microbiology and Immunobiology, and Department of Pediatrics, Harvard Medical School, Boston, Massachusetts; Centre for Vaccine Sciences, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh; Department of Immunology and Infectious Diseases, Harvard School of Public Health, Boston, Massachusetts.
authors.forename: Fahima
authors.initials: F
authors.lastname: Chowdhury
authors.affiliation: Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts; Department of Medicine, Department of Microbiology and Immunobiology, and Department of Pediatrics, Harvard Medical School, Boston, Massachusetts; Centre for Vaccine Sciences, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh; Department of Immunology and Infectious Diseases, Harvard School of Public Health, Boston, Massachusetts.
authors.forename: Ashraful I
authors.initials: AI
authors.lastname: Khan
authors.affiliation: Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts; Department of Medicine, Department of Microbiology and Immunobiology, and Department of Pediatrics, Harvard Medical School, Boston, Massachusetts; Centre for Vaccine Sciences, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh; Department of Immunology and Infectious Diseases, Harvard School of Public Health, Boston, Massachusetts.
authors.forename: Daniel T
authors.initials: DT
authors.lastname: Leung
authors.affiliation: Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts; Department of Medicine, Department of Microbiology and Immunobiology, and Department of Pediatrics, Harvard Medical School, Boston, Massachusetts; Centre for Vaccine Sciences, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh; Department of Immunology and Infectious Diseases, Harvard School of Public Health, Boston, Massachusetts.
authors.forename: Regina C
authors.initials: RC
authors.lastname: LaRocque
authors.affiliation: Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts; Department of Medicine, Department of Microbiology and Immunobiology, and Department of Pediatrics, Harvard Medical School, Boston, Massachusetts; Centre for Vaccine Sciences, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh; Department of Immunology and Infectious Diseases, Harvard School of Public Health, Boston, Massachusetts.
authors.forename: Richelle C
authors.initials: RC
authors.lastname: Charles
authors.affiliation: Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts; Department of Medicine, Department of Microbiology and Immunobiology, and Department of Pediatrics, Harvard Medical School, Boston, Massachusetts; Centre for Vaccine Sciences, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh; Department of Immunology and Infectious Diseases, Harvard School of Public Health, Boston, Massachusetts.
authors.forename: Edward T
authors.initials: ET
authors.lastname: Ryan
authors.affiliation: Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts; Department of Medicine, Department of Microbiology and Immunobiology, and Department of Pediatrics, Harvard Medical School, Boston, Massachusetts; Centre for Vaccine Sciences, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh; Department of Immunology and Infectious Diseases, Harvard School of Public Health, Boston, Massachusetts.
authors.forename: Stephen B
authors.initials: SB
authors.lastname: Calderwood
authors.affiliation: Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts; Department of Medicine, Department of Microbiology and Immunobiology, and Department of Pediatrics, Harvard Medical School, Boston, Massachusetts; Centre for Vaccine Sciences, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh; Department of Immunology and Infectious Diseases, Harvard School of Public Health, Boston, Massachusetts.
authors.forename: Firdausi
authors.initials: F
authors.lastname: Qadri
authors.affiliation: Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts; Department of Medicine, Department of Microbiology and Immunobiology, and Department of Pediatrics, Harvard Medical School, Boston, Massachusetts; Centre for Vaccine Sciences, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh; Department of Immunology and Infectious Diseases, Harvard School of Public Health, Boston, Massachusetts jbharris@partners.org.
authors.forename: Jason B
authors.initials: JB
authors.lastname: Harris
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D057138:Bacterial Shedding; D001459:Bangladesh / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D002771:Cholera / Q000453:epidemiology* / Q000382:microbiology / Q000635:transmission; D015331:Cohort Studies; D003967:Diarrhea; D005191:Family Characteristics; D005243:Feces / Q000382:microbiology; D005260:Female; D006801:Humans; D008297:Male; D044342:Malnutrition / Q000150:complications; D008875:Middle Aged; D015999:Multivariate Analysis; D012307:Risk Factors; D013997:Time Factors; D014734:Vibrio cholerae / Q000302:isolation & purification*; D055815:Young Adult
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