- INTRODUCTION
- MATERIALS AND METHODS
- RESULTS
- Patient visits during flood periods.
- Demographic and clinical characteristics of patients in flood versus non-flood periods.
- Pathogens isolated during floods.
- Toxin types and colonization factors expressed by ETEC isolated in the 2007 flood compared with 2004.
- Clinical features of cholera and ETEC patients during the 2007 floods.
- DISCUSSION
ProCite
RefWorks
Reference Manager
BibTeX
Zotero
EndNote
-
1
Rashid SF, 2000. The urban poor in Dhaka City: their struggles and coping strategies during the floods of 1998. Disasters 24 :240–253.
-
2
Siddique AK, Baqui AH, Eusof A, Zaman K, 1991. 1988 floods in Bangladesh: pattern of illness and causes of death. J Diarrhoeal Dis Res 9 :310–314.
-
3
WHO, 2004. Cholera, 2003. Wkly Epidemiol Rec 79 :281–288.
-
4
Schwartz BS, Harris JB, Khan AI, Larocque RC, Sack DA, Malek MA, Faruque AS, Qadri F, Calderwood SB, Luby SP, Ryan ET, 2006. Diarrheal epidemics in Dhaka, Bangladesh, during three consecutive floods: 1988, 1998, and 2004. Am J Trop Med Hyg 74 :1067–1073.
-
5
Qadri F, Khan AI, Faruque AS, Begum YA, Chowdhury F, Nair GB, Salam MA, Sack DA, Svennerholm AM, 2005. Enterotoxigenic Escherichia coli and Vibrio cholerae diarrhea, Bangladesh, 2004. Emerg Infect Dis 11 :1104–1107.
-
6
Kaper JB, Morris JG, Levine MM, 1995. Cholera. Clin Microbiol Rev 8 :48–86.
-
7
Qadri F, Svennerholm AM, Faruque AS, Sack RB, 2005. Enterotoxigenic Escherichia coli in developing countries: epidemiology, microbiology, clinical features, treatment, and prevention. Clin Microbiol Rev 18 :465–483.
-
8
Stoll B, Glass R, Huq MI, Khan MU, Holt J, Banu H, 1982. Surveillance of patients attending a diarrhoeal disease hospital in Bangladesh. BMJ 285 :1185–1188.
-
9
WHO, Division of Diarrhoeal and Acute Respiratory Disease Control, 1994. 25 years of ORS. Joint WHO/ICDDR,B Consultative Meeting on ORS Formulation. Dhaka, Bangladesh, December 10–12, 1994.
-
10
WHO, 1987. Programme for control of diarrhoeal disease. Manual for Laboratory Investigation of Acute Enteric Infections. Document CDD/93.3; Rev 1. Geneva, Switzerland: WHO, 9–20.
-
11
Unicomb LE, Kilgore PE, Faruque SG, Hamadani JD, Fuchs GJ, Albert MJ, Glass RI, 1997. Anticipating rotavirus vaccines: hospital-based surveillance for rotavirus diarrhea and estimates of disease burden in Bangladesh. Pediatr Infect Dis J 16 :947–951.
-
12
Qadri F, Das SK, Faruque AS, Fuchs GJ, Albert MJ, Sack RB, Svennerholm AM, 2000. Prevalence of toxin types and colonization factors in enterotoxigenic Escherichia coli isolated during a 2-year period from diarrheal patients in Bangladesh. J Clin Microbiol 38 :27–31.
-
13
Rahman M, Sack DA, Mahmood S, Hossain A, 1987. Rapid diagnosis of cholera by coagglutination test using 4-h fecal enrichment cultures. J Clin Microbiol 25 :2204–2206.
-
14
Sjöling Å, Wiklund G, Savarino S, Cohen D, Svennerholm A-M, 2007. Comparative analyses of phenotypic and genotypic methods for detection of enterotoxigenic Escherichia coli toxins and colonization factors. J Clin Microbiol 45 :3295–3301.
-
15
Flood Forecasting Watch Center Bangladesh, Available at: www.ffwc.net. Accessed March 3, 2008.
-
16
Kunii O, Nakamura S, Abdur R, Wakai S, 2002. The impact on health and risk factors of the diarrhoea epidemics in the 1998 Bangladesh floods. Public Health 116 :68–74.
-
17
Nair GB, Qadri F, Holmgren J, Svennerholm AM, Safa A, Bhuiyan NA, Ahmad QS, Faruque SM, Faruque AS, Takeda Y, Sack DA, 2006. Cholera due to altered El Tor strains of Vibrio cholerae O1 in Bangladesh. J Clin Microbioo 44 :4211–4213.
-
18
Svennerholm A-M, Qadri F, 2008. Mucosal immune responses against enterotoxigenic Escherichia coli (ETEC) in humans. Vajdy M, ed. Immunity Against Mucosal Pathogens, Springer Verlag, Part III, Chapter 6, The Netherlands.
-
19
Kondo H, Seo N, Yasuda T, Hasizume M, Koido Y, Ninomiya N, Yamamoto Y, 2002. Post-flood epidemics of infectious disease in Mozambique. Prehosp Disast Med 17 :126–133.
-
20
Tanabe K, Nakamura S, Kunii O, 1999. Bacteriological survey of diarrheal epidemics in the 1998 Bangladesh floods. J Japanese Assoc Infect Dis 73 :918–922.
-
21
Faruque AS, Salam MA, Faruque SM, Fuchs GJ, 1998. Aetiological, clinical and epidemiological characteristics of a seasonal peak of diarrhea in Dhaka, Bangladesh. Scand J Infect Dis 30 :393–396.
-
22
Khan MU, Eeckels R, Alam AN, Rahman N, 1988. Cholera, rotavirus and ETEC diarrhea: some clinico-epidemiological features. Trans R Soc Trop Med Hyg 82 :485–488.
-
23
Albert MJ, Faruque SM, Faruque AS, Neogi PK, Ansaruzzaman M, Bhuiyan NA, Alam K, Akbar MS, 1995. Controlled study of Escherichia coli diarrheal infections in Bangladeshi children. J Clin Microbiol 33 :973–977.
-
24
Albert MJ, Faruque AS, Faruque SM, Sack RB, Mahalanabis D, 1999. Case-control study of enteropathogens associated with childhood diarrhea in Dhaka, Bangladesh. J Clin Microbioo 37 :3458–3464.
-
25
World Health Organization, 2004. Report of the Meeting on Future Directions for Research on ETEC Vaccines for Developing Countries. Geneva, Switzerland: World Health Organization.
-
26
Gaastra W, Svennerholm AM, 1996. Colonization factors of human enterotoxigenic Escherichia coli (ETEC). Trends Microbiol 4 :444–452.
-
27
Svennerholm AM, Ahren C, Jertborn M, 1997. Oral Inactivated Vaccines Against Enterotoxigenic Escherichia coli. Second edition. New York, NY: Marcel Dekker Inc.
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Shifting Prevalence of Major Diarrheal Pathogens in Patients Seeking Hospital Care during Floods in 1998, 2004, and 2007 in Dhaka, Bangladesh
Aaron M. Harris
Aaron M. Harris
International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh; Institute of Biomedicine, Department of Microbiology and Immunology, The Sahlgrenska Academy at University of Gothenburg, Goteborg, Sweden; Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts; Department of Medicine, Harvard Medical School, Boston, Massachusetts; Department of Microbiology and Molecular Genetics, Harvard Medical School, Boston, Massachusetts
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Fahima Chowdhury
Fahima Chowdhury
International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh; Institute of Biomedicine, Department of Microbiology and Immunology, The Sahlgrenska Academy at University of Gothenburg, Goteborg, Sweden; Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts; Department of Medicine, Harvard Medical School, Boston, Massachusetts; Department of Microbiology and Molecular Genetics, Harvard Medical School, Boston, Massachusetts
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Yasmin Ara Begum
Yasmin Ara Begum
International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh; Institute of Biomedicine, Department of Microbiology and Immunology, The Sahlgrenska Academy at University of Gothenburg, Goteborg, Sweden; Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts; Department of Medicine, Harvard Medical School, Boston, Massachusetts; Department of Microbiology and Molecular Genetics, Harvard Medical School, Boston, Massachusetts
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Ashraful Islam Khan
Ashraful Islam Khan
International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh; Institute of Biomedicine, Department of Microbiology and Immunology, The Sahlgrenska Academy at University of Gothenburg, Goteborg, Sweden; Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts; Department of Medicine, Harvard Medical School, Boston, Massachusetts; Department of Microbiology and Molecular Genetics, Harvard Medical School, Boston, Massachusetts
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Abu S. G. Faruque
Abu S. G. Faruque
International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh; Institute of Biomedicine, Department of Microbiology and Immunology, The Sahlgrenska Academy at University of Gothenburg, Goteborg, Sweden; Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts; Department of Medicine, Harvard Medical School, Boston, Massachusetts; Department of Microbiology and Molecular Genetics, Harvard Medical School, Boston, Massachusetts
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Ann-Mari Svennerholm
Ann-Mari Svennerholm
International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh; Institute of Biomedicine, Department of Microbiology and Immunology, The Sahlgrenska Academy at University of Gothenburg, Goteborg, Sweden; Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts; Department of Medicine, Harvard Medical School, Boston, Massachusetts; Department of Microbiology and Molecular Genetics, Harvard Medical School, Boston, Massachusetts
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Jason B. Harris
Jason B. Harris
International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh; Institute of Biomedicine, Department of Microbiology and Immunology, The Sahlgrenska Academy at University of Gothenburg, Goteborg, Sweden; Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts; Department of Medicine, Harvard Medical School, Boston, Massachusetts; Department of Microbiology and Molecular Genetics, Harvard Medical School, Boston, Massachusetts
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Edward T. Ryan
Edward T. Ryan
International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh; Institute of Biomedicine, Department of Microbiology and Immunology, The Sahlgrenska Academy at University of Gothenburg, Goteborg, Sweden; Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts; Department of Medicine, Harvard Medical School, Boston, Massachusetts; Department of Microbiology and Molecular Genetics, Harvard Medical School, Boston, Massachusetts
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Alejandro Cravioto
Alejandro Cravioto
International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh; Institute of Biomedicine, Department of Microbiology and Immunology, The Sahlgrenska Academy at University of Gothenburg, Goteborg, Sweden; Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts; Department of Medicine, Harvard Medical School, Boston, Massachusetts; Department of Microbiology and Molecular Genetics, Harvard Medical School, Boston, Massachusetts
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Stephen B. Calderwood
Stephen B. Calderwood
International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh; Institute of Biomedicine, Department of Microbiology and Immunology, The Sahlgrenska Academy at University of Gothenburg, Goteborg, Sweden; Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts; Department of Medicine, Harvard Medical School, Boston, Massachusetts; Department of Microbiology and Molecular Genetics, Harvard Medical School, Boston, Massachusetts
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Firdausi Qadri
Firdausi Qadri
International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh; Institute of Biomedicine, Department of Microbiology and Immunology, The Sahlgrenska Academy at University of Gothenburg, Goteborg, Sweden; Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts; Department of Medicine, Harvard Medical School, Boston, Massachusetts; Department of Microbiology and Molecular Genetics, Harvard Medical School, Boston, Massachusetts
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Bangladesh experienced severe flooding and diarrheal epidemics in 2007. We compared flood data from 2007 with 2004 and 1998 for diarrheal patients attending the ICDDR,B hospital in Dhaka. In 2007, Vibrio cholerae O1 (33%), rotavirus (12%), and enterotoxigenic Escherichia coli (ETEC) (12%) were most prevalent. More severe dehydration was seen in 2007 compared with 2004 and 1998 (P < 0.001). In 2007, V. cholerae O1 Inaba (52%) and Ogawa (48%) were seen, whereas in 2004 and 1998 it was primarily Inaba and the Ogawa types, respectively (P < 0.001). In 2007, 51% of ETEC produced the heat labile toxin (LT) (P < 0.001 compared with 2004), 22% expressed the heat stable (ST) (P < 0.001), and 27% were ST/LT positive (P = 0.231). The CS7 colonization factor (CF) was the most prevalent in 2007 (20% compared with 6% in 2004; P = 0.05). Our findings demonstrate alterations in clinical features and phenotypic changes of major bacterial pathogens in the recent Bangladesh flood.
Author Notes
- INTRODUCTION
- MATERIALS AND METHODS
- RESULTS
- Patient visits during flood periods.
- Demographic and clinical characteristics of patients in flood versus non-flood periods.
- Pathogens isolated during floods.
- Toxin types and colonization factors expressed by ETEC isolated in the 2007 flood compared with 2004.
- Clinical features of cholera and ETEC patients during the 2007 floods.
- DISCUSSION
ProCite
RefWorks
Reference Manager
BibTeX
Zotero
EndNote
-
1
Rashid SF, 2000. The urban poor in Dhaka City: their struggles and coping strategies during the floods of 1998. Disasters 24 :240–253.
-
2
Siddique AK, Baqui AH, Eusof A, Zaman K, 1991. 1988 floods in Bangladesh: pattern of illness and causes of death. J Diarrhoeal Dis Res 9 :310–314.
-
3
WHO, 2004. Cholera, 2003. Wkly Epidemiol Rec 79 :281–288.
-
4
Schwartz BS, Harris JB, Khan AI, Larocque RC, Sack DA, Malek MA, Faruque AS, Qadri F, Calderwood SB, Luby SP, Ryan ET, 2006. Diarrheal epidemics in Dhaka, Bangladesh, during three consecutive floods: 1988, 1998, and 2004. Am J Trop Med Hyg 74 :1067–1073.
-
5
Qadri F, Khan AI, Faruque AS, Begum YA, Chowdhury F, Nair GB, Salam MA, Sack DA, Svennerholm AM, 2005. Enterotoxigenic Escherichia coli and Vibrio cholerae diarrhea, Bangladesh, 2004. Emerg Infect Dis 11 :1104–1107.
-
6
Kaper JB, Morris JG, Levine MM, 1995. Cholera. Clin Microbiol Rev 8 :48–86.
-
7
Qadri F, Svennerholm AM, Faruque AS, Sack RB, 2005. Enterotoxigenic Escherichia coli in developing countries: epidemiology, microbiology, clinical features, treatment, and prevention. Clin Microbiol Rev 18 :465–483.
-
8
Stoll B, Glass R, Huq MI, Khan MU, Holt J, Banu H, 1982. Surveillance of patients attending a diarrhoeal disease hospital in Bangladesh. BMJ 285 :1185–1188.
-
9
WHO, Division of Diarrhoeal and Acute Respiratory Disease Control, 1994. 25 years of ORS. Joint WHO/ICDDR,B Consultative Meeting on ORS Formulation. Dhaka, Bangladesh, December 10–12, 1994.
-
10
WHO, 1987. Programme for control of diarrhoeal disease. Manual for Laboratory Investigation of Acute Enteric Infections. Document CDD/93.3; Rev 1. Geneva, Switzerland: WHO, 9–20.
-
11
Unicomb LE, Kilgore PE, Faruque SG, Hamadani JD, Fuchs GJ, Albert MJ, Glass RI, 1997. Anticipating rotavirus vaccines: hospital-based surveillance for rotavirus diarrhea and estimates of disease burden in Bangladesh. Pediatr Infect Dis J 16 :947–951.
-
12
Qadri F, Das SK, Faruque AS, Fuchs GJ, Albert MJ, Sack RB, Svennerholm AM, 2000. Prevalence of toxin types and colonization factors in enterotoxigenic Escherichia coli isolated during a 2-year period from diarrheal patients in Bangladesh. J Clin Microbiol 38 :27–31.
-
13
Rahman M, Sack DA, Mahmood S, Hossain A, 1987. Rapid diagnosis of cholera by coagglutination test using 4-h fecal enrichment cultures. J Clin Microbiol 25 :2204–2206.
-
14
Sjöling Å, Wiklund G, Savarino S, Cohen D, Svennerholm A-M, 2007. Comparative analyses of phenotypic and genotypic methods for detection of enterotoxigenic Escherichia coli toxins and colonization factors. J Clin Microbiol 45 :3295–3301.
-
15
Flood Forecasting Watch Center Bangladesh, Available at: www.ffwc.net. Accessed March 3, 2008.
-
16
Kunii O, Nakamura S, Abdur R, Wakai S, 2002. The impact on health and risk factors of the diarrhoea epidemics in the 1998 Bangladesh floods. Public Health 116 :68–74.
-
17
Nair GB, Qadri F, Holmgren J, Svennerholm AM, Safa A, Bhuiyan NA, Ahmad QS, Faruque SM, Faruque AS, Takeda Y, Sack DA, 2006. Cholera due to altered El Tor strains of Vibrio cholerae O1 in Bangladesh. J Clin Microbioo 44 :4211–4213.
-
18
Svennerholm A-M, Qadri F, 2008. Mucosal immune responses against enterotoxigenic Escherichia coli (ETEC) in humans. Vajdy M, ed. Immunity Against Mucosal Pathogens, Springer Verlag, Part III, Chapter 6, The Netherlands.
-
19
Kondo H, Seo N, Yasuda T, Hasizume M, Koido Y, Ninomiya N, Yamamoto Y, 2002. Post-flood epidemics of infectious disease in Mozambique. Prehosp Disast Med 17 :126–133.
-
20
Tanabe K, Nakamura S, Kunii O, 1999. Bacteriological survey of diarrheal epidemics in the 1998 Bangladesh floods. J Japanese Assoc Infect Dis 73 :918–922.
-
21
Faruque AS, Salam MA, Faruque SM, Fuchs GJ, 1998. Aetiological, clinical and epidemiological characteristics of a seasonal peak of diarrhea in Dhaka, Bangladesh. Scand J Infect Dis 30 :393–396.
-
22
Khan MU, Eeckels R, Alam AN, Rahman N, 1988. Cholera, rotavirus and ETEC diarrhea: some clinico-epidemiological features. Trans R Soc Trop Med Hyg 82 :485–488.
-
23
Albert MJ, Faruque SM, Faruque AS, Neogi PK, Ansaruzzaman M, Bhuiyan NA, Alam K, Akbar MS, 1995. Controlled study of Escherichia coli diarrheal infections in Bangladeshi children. J Clin Microbiol 33 :973–977.
-
24
Albert MJ, Faruque AS, Faruque SM, Sack RB, Mahalanabis D, 1999. Case-control study of enteropathogens associated with childhood diarrhea in Dhaka, Bangladesh. J Clin Microbioo 37 :3458–3464.
-
25
World Health Organization, 2004. Report of the Meeting on Future Directions for Research on ETEC Vaccines for Developing Countries. Geneva, Switzerland: World Health Organization.
-
26
Gaastra W, Svennerholm AM, 1996. Colonization factors of human enterotoxigenic Escherichia coli (ETEC). Trends Microbiol 4 :444–452.
-
27
Svennerholm AM, Ahren C, Jertborn M, 1997. Oral Inactivated Vaccines Against Enterotoxigenic Escherichia coli. Second edition. New York, NY: Marcel Dekker Inc.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 250 | 165 | 13 |
| Full Text Views | 475 | 7 | 0 |
| PDF Downloads | 120 | 6 | 0 |