Environmental Factors Influencing Epidemic Cholera

Antarpreet Jutla Department of Civil and Environmental Engineering, West Virginia University, Morgantown, West Virginia; Maryland Pathogen Research Institute, University of Maryland, College Park, Maryland; Center for Bioinformatics and Computational Biology, University of Maryland, College Park, Maryland; Department of Civil and Environmental Engineering, University of Rhode Island, Kingston, Rhode Island; International Center for Diarrhoeal Disease Research, Dhaka, Bangladesh; Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland

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Elizabeth Whitcombe Department of Civil and Environmental Engineering, West Virginia University, Morgantown, West Virginia; Maryland Pathogen Research Institute, University of Maryland, College Park, Maryland; Center for Bioinformatics and Computational Biology, University of Maryland, College Park, Maryland; Department of Civil and Environmental Engineering, University of Rhode Island, Kingston, Rhode Island; International Center for Diarrhoeal Disease Research, Dhaka, Bangladesh; Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland

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Nur Hasan Department of Civil and Environmental Engineering, West Virginia University, Morgantown, West Virginia; Maryland Pathogen Research Institute, University of Maryland, College Park, Maryland; Center for Bioinformatics and Computational Biology, University of Maryland, College Park, Maryland; Department of Civil and Environmental Engineering, University of Rhode Island, Kingston, Rhode Island; International Center for Diarrhoeal Disease Research, Dhaka, Bangladesh; Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland

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Bradd Haley Department of Civil and Environmental Engineering, West Virginia University, Morgantown, West Virginia; Maryland Pathogen Research Institute, University of Maryland, College Park, Maryland; Center for Bioinformatics and Computational Biology, University of Maryland, College Park, Maryland; Department of Civil and Environmental Engineering, University of Rhode Island, Kingston, Rhode Island; International Center for Diarrhoeal Disease Research, Dhaka, Bangladesh; Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland

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Ali Akanda Department of Civil and Environmental Engineering, West Virginia University, Morgantown, West Virginia; Maryland Pathogen Research Institute, University of Maryland, College Park, Maryland; Center for Bioinformatics and Computational Biology, University of Maryland, College Park, Maryland; Department of Civil and Environmental Engineering, University of Rhode Island, Kingston, Rhode Island; International Center for Diarrhoeal Disease Research, Dhaka, Bangladesh; Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland

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Anwar Huq Department of Civil and Environmental Engineering, West Virginia University, Morgantown, West Virginia; Maryland Pathogen Research Institute, University of Maryland, College Park, Maryland; Center for Bioinformatics and Computational Biology, University of Maryland, College Park, Maryland; Department of Civil and Environmental Engineering, University of Rhode Island, Kingston, Rhode Island; International Center for Diarrhoeal Disease Research, Dhaka, Bangladesh; Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland

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Munir Alam Department of Civil and Environmental Engineering, West Virginia University, Morgantown, West Virginia; Maryland Pathogen Research Institute, University of Maryland, College Park, Maryland; Center for Bioinformatics and Computational Biology, University of Maryland, College Park, Maryland; Department of Civil and Environmental Engineering, University of Rhode Island, Kingston, Rhode Island; International Center for Diarrhoeal Disease Research, Dhaka, Bangladesh; Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland

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R. Bradley Sack Department of Civil and Environmental Engineering, West Virginia University, Morgantown, West Virginia; Maryland Pathogen Research Institute, University of Maryland, College Park, Maryland; Center for Bioinformatics and Computational Biology, University of Maryland, College Park, Maryland; Department of Civil and Environmental Engineering, University of Rhode Island, Kingston, Rhode Island; International Center for Diarrhoeal Disease Research, Dhaka, Bangladesh; Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland

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Rita Colwell Department of Civil and Environmental Engineering, West Virginia University, Morgantown, West Virginia; Maryland Pathogen Research Institute, University of Maryland, College Park, Maryland; Center for Bioinformatics and Computational Biology, University of Maryland, College Park, Maryland; Department of Civil and Environmental Engineering, University of Rhode Island, Kingston, Rhode Island; International Center for Diarrhoeal Disease Research, Dhaka, Bangladesh; Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland

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Cholera outbreak following the earthquake of 2010 in Haiti has reaffirmed that the disease is a major public health threat. Vibrio cholerae is autochthonous to aquatic environment, hence, it cannot be eradicated but hydroclimatology-based prediction and prevention is an achievable goal. Using data from the 1800s, we describe uniqueness in seasonality and mechanism of occurrence of cholera in the epidemic regions of Asia and Latin America. Epidemic regions are located near regional rivers and are characterized by sporadic outbreaks, which are likely to be initiated during episodes of prevailing warm air temperature with low river flows, creating favorable environmental conditions for growth of cholera bacteria. Heavy rainfall, through inundation or breakdown of sanitary infrastructure, accelerates interaction between contaminated water and human activities, resulting in an epidemic. This causal mechanism is markedly different from endemic cholera where tidal intrusion of seawater carrying bacteria from estuary to inland regions, results in outbreaks.

Author Notes

* Address correspondence to Antarpreet Jutla, PO 6013, Morgantown, WV 26506. E-mail: asjutla@mail.wvu.edu

Authors' addresses: Antarpreet Jutla, Department of Civil and Environmental Engineering, West Virginia University, Morgantown, WV, E-mail: asjutla@mail.wvu.edu. Elizabeth Whitcombe, Nur Hasan, Bradd Haley, Anwar Huq, and Rita Colwell, University of Maryland, Maryland Pathogen Research Institute, College Park, MD, E-mails: ewhitcombe@xtra.co.nz, nur.hasan@cosmosid.net, bradd.haley@gmail.com, huqanwar@gmail.com, and rcolwell@umiacs.umd.edu. Ali Akanda, University of Rhode Island, Civil and Environmental Engineering, Kingston, RI, E-mail: akanda@egr.uri.edu. Munir Alam, International Centre for Diarrheal Disease Research, Bangladesh – Microbiology, Dhaka, Bangladesh, E-mail: munirul@icddrb.org. R. Bradley Sack, Johns Hopkins School of Public Health, Department of International Health, Baltimore, MD, E-mail: rsack@jhsph.edu.

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