EPIDEMIOLOGY & ECOLOGY OF VIBRIO CHOLERAE IN BANGLADESH

流行病学

• 批准号: 2517317
• 负责人: Richard BRADLEY SACK
• 金额: $ 88.09万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 1996
• 资助国家: 美国
• 起止时间: 1996-09-01 至 2001-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/2517317
• 关键词: Bangladesh; Vibrio cholerae; aquatic organism; bioperiodicity; cholera; clinical research; communicable disease transmission; disease outbreaks; disease reservoirs; epidemiology; gastrointestinal disorder diagnosis; human subject; laboratory mouse; monoclonal antibody; polymerase chain reaction; public health; serology /serodiagnosis; water microbiology; water sampling /testing

DESCRIPTION: (Adapted from Applicant's Abstract). Cholera, the most severe of all diarrheal diseases, caused by Vibrio cholerae 01 (and most recently also by serogroup 0139) is one of the few pandemic infections of man. Its known history includes waves of severe, often fatal, disease covering the entire globe over decades of time, usually having originated from the cholera endemic area of the Ganges delta. In the heavily endemic regions of southeast Asia, cholera also exhibits a regular twice-yearly periodicity. Unfortunately, the mechanisms controlling the periodicity and pandemicity of cholera are not known. No studies to date have been able to explain this epidemiologic behavior of cholera. The primary objective of this proposal is to test the hypothesis that environmental factors involving surface waters are responsible for the observed epidemiology of cholera. We postulate that plankton living in surface waters are the reservoir for cholera vibrios, and that their growth and life cycle(s) control vibrio populations in surface water, and thus determine how vibrios are spread and when outbreaks of disease will occur. This information could 1) lead to an improved warning system for prediction of cholera outbreaks, both in endemic areas, and in areas into which a cholera pandemic is threatening, and possibly lead to new strategies for controlling the disease through environmental interventions directed toward growth of plankton. This joint project, involving also investigators from the International Center for Diarrheal Disease Research, Bangladesh, (ICDDR,B), the University of Maryland and Emory University, involves establishing four sentinel surveillance sites in bangladesh, three of which are known to exhibit cholera periodicity, and one that is usually free of cholera. A combined year-round effort will monitor 1) the clinical cases/infections with V.cholerae, 2) the occurrence and density of V. cholerae in the surface waters of these sites, including those attached to plankton, both as viable and as non-culturable forms, using sensitive sampling techniques (including PCR), 3) the growth of phytoplankton and zooplankton in these areas, using direct sampling and identification techniques as well as remote sensing by satellite, and 4) the genetic and phenotypic markers of isolates to determine whether V.cholerae isolated from surface waters are identical with those isolated from patients with cholera in the same vicinity. Based on these data, a model of cholera epidemiology will be developed which may be useful in predicting outbreaks of cholera, thereby allowing early mobilization of preventive and treatment measures. Solving this problem would be an enormous step toward our understanding of "emerging" infectious diseases on the planet.

描述：（改编自申请人摘要）。 霍乱，最严重的 在所有由霍乱弧菌01引起的肠道疾病中， 也是血清群0139）是少数几种人类大流行感染之一。 已知的历史包括一波又一波的严重、通常是致命的疾病，覆盖了整个 整个地球仪，通常起源于 恒河三角洲的霍乱流行区。 在严重流行的地区， 在东南亚，霍乱也表现出每年两次的周期性。 不幸的是，控制疾病周期性和流行性的机制 霍乱是未知的。 迄今为止没有任何研究能够解释这一点 霍乱的流行病学行为。 本提案的主要目的是 是为了验证一个假设，即环境因素， 沃茨是引起霍乱流行的原因。 我们 假设生活在表层沃茨中的浮游生物是 霍乱弧菌，以及它们的生长和生命周期控制弧菌 在地表水中的种群，从而确定如何弧菌传播， 当疾病爆发的时候。 这些信息可能会导致1） 改进预测霍乱爆发的预警系统， 地区，以及霍乱大流行威胁的地区， 可能导致新的策略来控制疾病， 对浮游生物生长的环境干预。 这一联合 项目，也涉及国际中心的调查人员， 腹泻病研究，孟加拉国，（ICDDR，B）， 马里兰州和埃默里大学，涉及建立四个哨兵 孟加拉国的监视点，其中三个已知显示 霍乱周期性，一个是通常没有霍乱。 组合 全年的努力将监测1）临床病例/感染， 2）表层霍乱弧菌的出现和密度 这些地点的沃茨，包括附着浮游生物的水域， 和不可培养的形式，使用敏感的采样技术（包括 PCR），3）浮游植物和浮游动物的生长在这些地区，使用 直接取样和鉴定技术以及遥感技术， 卫星，和4）分离物的遗传和表型标记， 确定从地表沃茨中分离的霍乱弧菌是否与 从同一地区的霍乱病人身上分离出来的。 基于 根据这些数据，将建立一个霍乱流行病学模型， 有助于预测霍乱的爆发， 动员预防和治疗措施。 解决这个问题 将是我们理解“新兴”传染病 地球上的疾病