Major Shift of Toxigenic V. cholerae O1 from Ogawa to Inaba Serotype Isolated from Clinical and Environmental Samples in Haiti.

In October of 2010, an outbreak of cholera was confirmed in Haiti for the first time in more than a century. A single clone of toxigenic Vibrio cholerae O1 biotype El Tor serotype Ogawa strain was implicated as the cause. Five years after the onset of cholera, in October, 2015, we have discovered a major switch (ranging from 7 to 100%) from Ogawa serotype to Inaba serotype. Furthermore, using wbeT gene sequencing and comparative sequence analysis, we now demonstrate that, among 2013 and 2015 Inaba isolates, the wbeT gene, responsible for switching Ogawa to Inaba serotype, sustained a unique nucleotide mutation not found in isolates obtained from Haiti in 2012. Moreover, we show that, environmental Inaba isolates collected in 2015 have the identical mutations found in the 2015 clinical isolates. Our data indicate that toxigenic V. cholerae O1 serotype Ogawa can rapidly change its serotype to Inaba, and has the potential to cause disease in individuals who have acquired immunity against Ogawa serotype. Our findings highlight the importance of monitoring of toxigenic V. cholerae O1 and cholera in countries with established endemic disease

Major Shift of Toxigenic <i>V</i>. <i>cholerae</i> O1 from Ogawa to Inaba Serotype Isolated from Clinical and Environmental Samples in Haiti

<div><p>In October of 2010, an outbreak of cholera was confirmed in Haiti for the first time in more than a century. A single clone of toxigenic <i>Vibrio cholerae</i> O1 biotype El Tor serotype Ogawa strain was implicated as the cause. Five years after the onset of cholera, in October, 2015, we have discovered a major switch (ranging from 7 to 100%) from Ogawa serotype to Inaba serotype. Furthermore, using <i>wbeT</i> gene sequencing and comparative sequence analysis, we now demonstrate that, among 2013 and 2015 Inaba isolates, the <i>wbeT</i> gene, responsible for switching Ogawa to Inaba serotype, sustained a unique nucleotide mutation not found in isolates obtained from Haiti in 2012. Moreover, we show that, environmental Inaba isolates collected in 2015 have the identical mutations found in the 2015 clinical isolates. Our data indicate that toxigenic <i>V</i>. <i>cholerae</i> O1 serotype Ogawa can rapidly change its serotype to Inaba, and has the potential to cause disease in individuals who have acquired immunity against Ogawa serotype. Our findings highlight the importance of monitoring of toxigenic <i>V</i>. <i>cholerae</i> O1 and cholera in countries with established endemic disease.</p></div

Analysis of mutations occurring in <i>wbeT</i> gene in <i>V</i>. <i>cholerae</i> O1 strains isolated from clinical and environmental samples in Haiti.

<p>Analysis of mutations occurring in <i>wbeT</i> gene in <i>V</i>. <i>cholerae</i> O1 strains isolated from clinical and environmental samples in Haiti.</p

Map displaying clinical and environmental sites wherein we obtained toxigenic <i>V</i>. <i>cholerae</i> positive isolates.

<p>Green circular shapes reflect clinical cholera sample collection sites while yellow circular shapes point to sentinel environmental sites yielding toxigenic <i>V</i>. <i>cholerae</i> O1 strains. NDH, Notredame Hospital de Petit-goave; CTC J, Cholera Treatment Center in Jacmel; BLB, Bay Larion Bridge; BRH, Brach; RSD, Reserved; CTC G, Cholera Treatment Center in Gressier; St. Marc, St Marc Hospital.</p

Comparative distribution of toxigenic <i>V</i>. <i>cholerae</i> O1 serotypes Ogawa and Inaba isolated from cholera treatment centers in Haiti.

<p>Comparative distribution of toxigenic <i>V</i>. <i>cholerae</i> O1 serotypes Ogawa and Inaba isolated from cholera treatment centers in Haiti.</p