Vibrio cholerae

Dr. Jyotsna Agarwal

Dept. Microbiology
Cholera: Introduction
 Transmitted
to humans via contaminated
food and water

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

 Historical Perspective:

 1854- John Snow hypothesized

water as primary reservoir for
transmission
– Broad Street pump incident
– 56 deaths in 2 days
 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.
Cholera affected countries
General Characteristics of Vibrio
 Similarities to Enterobacteriaceae
Gram-negative
Facultative anaerobes
Fermentative bacilli
 Differences from Enterobacteriaceae
Polar flagella
Oxidase positive
Vibrio spp. (Family Vibrionaceae)
Associated with Human Disease
 General Characteristics of Vibrio
 Comma-shaped bacilli
 pH range for growth on media
 pH 7.0 - 9.0
 V. cholerae grow without salt, Most other
vibrios are halophilic
 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)
Difference between El Tor &
classical Vibrio cholerae
 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
 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
Laboratory Identification of Vibrios
Transport medium or holding medium
- Cary-Blair
-Venkatraman Ramakrishnan medium- liquid

Enrichment medium - alkaline peptone broth

 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
Treatment & Prevention of cholera

 Untreated: 60% fatality

 Treated: <1% fatality
 Rehydration & supportive therapy
 Oral
 Intravenous
 Doxycycline or tetracycline

 Water purification, sanitation &

sewage treatment
 Vaccines
 Summary
 General characters of vibrio, history
 Vibrio cholerae
 Cholera: mode of spread, clinical features
 Laboratory diagnosis
 Treatment/prevention