cholerae microbiology

1. Dr. Jyotsna Agarwal
Dept. Microbiology
Vibrio cholerae

2. Cholera: Introduction
 Transmitted to humans via contaminated
food and water
 Part of normal flora of brackish water and
estuaries

3. Epidemiology of Vibrio cholerae
 Cholera recognized for more than two millennia
with sporadic disease and epidemics
 Endemic in communities with poor sanitation
 Seven pandemics (possible beginning of 8th)
since 1817
 Human carriers and environmental reservoirs

4. Historical Perspective:
 1817-1820
First Pandemic
spread out of India to
Europe
spread from India -> Middle
East (reaching Turkey &
Persia) -> Far East
(Singapore, Japan,
Philippines)
 1829-1851
Second pandemic
Entered US through NY
and New Orleans ->
proceeded through
entire country

5. Historical Perspective: Identification
 1854 - Filippo Pacini identified curved or comma shaped
bacterium associated with this disease, which he called
Vibrio cholerae
 1883- Rober Koch isolated the bacteria

6. Historical Perspective:
 1854- John Snow hypothesized
water as primary reservoir for
transmission
– Broad Street pump incident
– 56 deaths in 2 days

7. Recent Cholera Pandemics
7th pandemic:
 V. cholerae O1 biotype El Tor
 Began in Asia in 1961
8th pandemic (??)
 V. cholerae O139 Bengal
 Began in India in 1992 and spread to Asia, Europe
and U.S.

8. Cholera affected countries

9.  Similarities to Enterobacteriaceae
 Gram-negative
 Facultative anaerobes
 Fermentative bacilli
 Differences from Enterobacteriaceae
 Polar flagella
 Oxidase positive
General Characteristics of Vibrio

10. Vibrio spp. (Family Vibrionaceae)
Associated with Human Disease

11.  Comma-shaped bacilli
 pH range for growth on media
 pH 7.0 - 9.0
 V. cholerae grow without salt, Most other
vibrios are halophilic
General Characteristics of Vibrio

12. Taxonomy of Vibrio cholerae
 >200 serogroups based on somatic O-antigen
 O1 and O139 serogroups are responsible for
epidemic cholera
 O1 serogroup subdivided into
 Two biotypes: El Tor and classical
 Three serotypes: ogawa, inaba, hikojima
Non-cholera vibrio (NCV) or non-
agglutinating vibrios (NAG) or non-O1
vibrio cholerae)

14. Difference between El Tor &
classical Vibrio cholerae

15. Pathogenesis of V.cholerae
 Incubation period: 2-3 days
 High infectious dose
 Abrupt onset of life-threatening watery
diarrhea
 Rice-water stools:
 Colorless
 Odorless
 Speckled with mucus

16. Pathogenesis of V. cholerae
Cholera toxin leads to profuse loss of fluids
and electrolytes (Na, K HCO3)
A-B type of toxin, receptor GM1, increase
intracellular cAMP
Death attributable to:
 Hypovolemic shock
 Metabolic acidosis

17. Laboratory Identification of Vibrios
 Transport medium or holding medium
- Cary-Blair
- Venkatraman Ramakrishnan medium- liquid
 Enrichment medium - alkaline peptone broth

18. Yellow colonies on TCBS
 Selective/differential
culture medium -
TCBS agar
– V. cholerae grow as
yellow colonies
– Gram stain
– Biochemical and
serological tests
– Motility- Darting
motility on hanging
drop preparation

19. Treatment & Prevention of cholera
 Untreated: 60% fatality
 Treated: <1% fatality
 Rehydration & supportive therapy
 Oral
 Intravenous
 Doxycycline or tetracycline
 Water purification, sanitation &
sewage treatment
 Vaccines

20. Summary
 General characters of vibrio, history
 Vibrio cholerae
 Cholera: mode of spread, clinical features
 Laboratory diagnosis
 Treatment/prevention