Journal Article > ResearchAbstract Only
Science. 10 November 2017; Volume 358 (Issue 6364); 785-789.; DOI:10.1126/science.aad5901
Weill FX, Domman D, Njamkepo E, Tarr C, Rauzier J, et al.
Science. 10 November 2017; Volume 358 (Issue 6364); 785-789.; DOI:10.1126/science.aad5901
The seventh cholera pandemic has heavily affected Africa, although the origin and continental spread of the disease remain undefined. We used genomic data from 1070 Vibrio cholerae O1 isolates, across 45 African countries and over a 49-year period, to show that past epidemics were attributable to a single expanded lineage. This lineage was introduced at least 11 times since 1970, into two main regions, West Africa and East/Southern Africa, causing epidemics that lasted up to 28 years. The last five introductions into Africa, all from Asia, involved multidrug-resistant sublineages that replaced antibiotic-susceptible sublineages after 2000. This phylogenetic framework describes the periodicity of lineage introduction and the stable routes of cholera spread, which should inform the rational design of control measures for cholera in Africa.
Journal Article > ResearchFull Text
J Infect Dis. 11 May 2018; Volume 218 (Issue 7); 1164-1168.; DOI:10.1093/infdis/jiy283
Azman AS, Lugero FJ, Salje H, Naibei N, Adalbert N, et al.
J Infect Dis. 11 May 2018; Volume 218 (Issue 7); 1164-1168.; DOI:10.1093/infdis/jiy283
Targeted interventions have been delivered to neighbors of cholera cases in major epidemic responses globally despite limited evidence for the impact of such targeting. Using data from urban epidemics in Chad and D.R. Congo we estimate the extent of spatiotemporal zones of increased cholera risk around cases. In both cities, we found zones of increased risk of at least 200-meters during the 5-days immediately following case presentation to a clinic. Risk was highest for those living closest to cases and diminished in time and space similarly across settings. These results provide a rational basis for rapidly delivering targeting interventions.