The role of China in the global spread of the current cholera pandemic.
The role of China in the global spread of the current cholera pandemic.
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DOI：
10.1371/journal.pgen.1005072
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发表时间：
2015-03
期刊：
影响因子：
4.5
通讯作者：
Kan B
中科院分区：
文献类型：
--
作者：
Didelot X;Pang B;Zhou Z;McCann A;Ni P;Li D;Achtman M;Kan B
霍乱是一种严重的腹泻病，自 19 世纪初以来就已经发生过流行病，并且至今仍在持续流行。霍乱流行病是由霍乱弧菌的个体、基因单型谱系引起的：自 1961 年以来正在全球传播的第七次大流行与生物型 El Tor 的 L2 谱系有关。之前对第七次大流行病学的基因组研究确定了 L2 内的三个连续亚谱系，指定为第 1 波至第 3 波，它们多次从孟加拉湾向全球传播。然而，这些研究并不包括来自中国的样本，近几十年来，中国也经历了多次霍乱疫情。我们对 1961 年至 2010 年间在中国分离的 71 个菌株以及其他来源的 8 个菌株进行了基因组测序，并将它们与 181 个已发表的基因组进行了比较。结果表明，1960年至1990年间中国的疫情与第一波相关，而后来的疫情与第二波相关。然而，先前定义的波在时间上重叠，不足以代表全球谱系的形状。因此，我们建议用一系列严格划分的分支来取代它们。 1960年至1990年间，多个此类进化枝被引入中国，在那里经历了进一步的微进化，然后传播到其他国家。因此，中国在霍乱弧菌大流行期间既是传播源又是传播源，需要将其纳入霍乱全球传播模式的重建中。霍乱是一种由霍乱弧菌引起的危及生命的腹泻疾病。在经历了数十年没有流行病的长期空白后，自 1961 年以来第七次霍乱大流行在全球蔓延，造成了相当大的发病率和死亡率。我们对已发表和新测序的基因组的分析提供了霍乱弧菌内遗传分组（所谓的进化枝）的详细信息，这些遗传分组是在这些细菌最近的大流行传播期间发展起来的，并且在某些情况下一直持续到现代。我们重建了当前大流行自印度尼西亚起源以来所采取的一些途径，并表明南亚和东亚都是重要的病原库和国际传播源。
Epidemics and pandemics of cholera, a severe diarrheal disease, have occurred since the early 19th century and waves of epidemic disease continue today. Cholera epidemics are caused by individual, genetically monomorphic lineages of Vibrio cholerae: the ongoing seventh pandemic, which has spread globally since 1961, is associated with lineage L2 of biotype El Tor. Previous genomic studies of the epidemiology of the seventh pandemic identified three successive sub-lineages within L2, designated waves 1 to 3, which spread globally from the Bay of Bengal on multiple occasions. However, these studies did not include samples from China, which also experienced multiple epidemics of cholera in recent decades. We sequenced the genomes of 71 strains isolated in China between 1961 and 2010, as well as eight from other sources, and compared them with 181 published genomes. The results indicated that outbreaks in China between 1960 and 1990 were associated with wave 1 whereas later outbreaks were associated with wave 2. However, the previously defined waves overlapped temporally, and are an inadequate representation of the shape of the global genealogy. We therefore suggest replacing them by a series of tightly delineated clades. Between 1960 and 1990 multiple such clades were imported into China, underwent further microevolution there and then spread to other countries. China was thus both a sink and source during the pandemic spread of V. cholerae, and needs to be included in reconstructions of the global patterns of spread of cholera. Cholera is a life-threatening, diarrheal disease caused by the bacterium Vibrio cholerae. After a long interregnum of decades without epidemics, the seventh cholera pandemic spread globally since 1961, causing considerable morbidity and mortality. Our analysis of published and newly sequenced genomes provides details on genetic groupings within V. cholerae, so-called clades, that have developed during the recent pandemic spread of these bacteria, and, in some cases, persisted to modern times. We reconstructed some of the pathways taken by the current pandemic since its origins in Indonesia, and show that both South Asia and East Asia are important pathogenic reservoirs and sources of international transmissions.
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