Cholera-Modern Pandemic Disease of Ancient Lineage
Cholera-Modern Pandemic Disease of Ancient Lineage
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DOI：
10.3201/eid1711.111109
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发表时间：
2011-11-01
影响因子：
11.8
通讯作者：
Morris, J. Glenn, Jr.
中科院分区：
文献类型：
--
作者：
Morris, J. Glenn, Jr.
霍乱已经影响人类至少一千年，并且一直是全世界疾病和死亡的主要原因，最近在津巴布韦（2008-2009年）和海地（2010年）爆发了霍乱。临床上，有证据表明，疾病严重程度的增加与非典型霍乱弧菌有机体的出现有关，这些非典型霍乱弧菌有机体已将经典生物型菌株的遗传物质纳入埃尔托生物型背景。传播的一个关键因素可能是最近认识到的过度感染阶段，该阶段在通过腹泻粪便后持续数小时。我们提出了一种传播模型，其中环境触发因素（例如温度）导致环境储存库中霍乱弧菌的增加，并溢出到人群中。然而，一旦微生物被引入人群，传播主要通过人与人之间的“快速”传播（利用超感染状态）而发生，而不会返回水生环境。
Cholera has affected humans for at least a millennium and persists as a major cause of illness and death worldwide, with recent epidemics in Zimbabwe (2008-2009) and Haiti (2010). Clinically, evidence exists of increasing severity of disease linked with emergence of atypical Vibrio cholerae organisms that have incorporated genetic material from classical biotype strains into an El Tor biotype background. A key element in transmission may be a recently recognized hyperinfectious phase, which persists for hours after passage in diarrheal feces. We propose a model of transmission in which environmental triggers (such as temperature) lead to increases in V cholerae in environmental reservoirs, with spillover into human populations. However, once the microorganism is introduced into a human population, transmission occurs primary by "fast" transmission from person to person (taking advantage of the hyperinfectious state), without returning to the aquatic environment.