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96-533: As in many countries, burial within city limits became illegal in Rotterdam in 1827. Crooswijk was taken into use in 1832, although the cemetery had not been finished yet. Due to the outbreak of a Cholera epidemic, burial space was needed quickly. In 1915 a new entrance was taken into use. The old entrance still exists. When the Walloon church was demolished in 1922 the contents of the graves were transferred to

192-699: A reservoir of infection, and seafood shipped long distances can spread the disease. Escherichia coli Escherichia coli ( / ˌ ɛ ʃ ə ˈ r ɪ k i ə ˈ k oʊ l aɪ / ESH -ə- RIK -ee-ə KOH -lye ) is a gram-negative , facultative anaerobic , rod-shaped , coliform bacterium of the genus Escherichia that is commonly found in the lower intestine of warm-blooded organisms. Most E. coli strains are harmless, but some serotypes such as EPEC and ETEC are pathogenic, can cause serious food poisoning in their hosts and are occasionally responsible for food contamination incidents that prompt product recalls. Most strains are part of

288-436: A temperate bacteriophage called CTXφ . Microbiologists have studied the genetic mechanisms by which the V. cholerae bacteria turn off the production of some proteins and turn on the production of other proteins as they respond to the series of chemical environments they encounter, passing through the stomach, through the mucous layer of the small intestine, and on to the intestinal wall. Of particular interest have been

384-420: A bout of diarrhea that is often self-limiting in healthy adults but is frequently lethal to children in the developing world. More virulent strains, such as O157:H7 , cause serious illness or death in the elderly, the very young, or the immunocompromised . The genera Escherichia and Salmonella diverged around 102 million years ago (credibility interval: 57–176 mya), an event unrelated to

480-428: A day. Severe cholera, without treatment, kills about half of affected individuals. If the severe diarrhea is not treated, it can result in life-threatening dehydration and electrolyte imbalances. Estimates of the ratio of asymptomatic to symptomatic infections have ranged from 3 to 100. Cholera has been nicknamed the "blue death" because a person's skin may turn bluish-gray from extreme loss of fluids. Fever

576-428: A greatly reduced pathogen count—though it will not necessarily be perfectly safe, it is an improvement for poor people with limited options. In Bangladesh this practice was found to decrease rates of cholera by nearly half. It involves folding a sari four to eight times. Between uses the cloth should be rinsed in clean water and dried in the sun to kill any bacteria on it. A nylon cloth appears to work as well but

672-520: A laboratory setting, and has been intensively investigated for over 60 years. E. coli is a chemoheterotroph whose chemically defined medium must include a source of carbon and energy . E. coli is the most widely studied prokaryotic model organism , and an important species in the fields of biotechnology and microbiology , where it has served as the host organism for the majority of work with recombinant DNA . Under favourable conditions, it takes as little as 20 minutes to reproduce. E. coli

768-534: A massive inoculation program in British India . Persons who survive an episode of cholera have long-lasting immunity for at least 3 years (the period tested.) A number of safe and effective oral vaccines for cholera are available. The World Health Organization (WHO) has three prequalified oral cholera vaccines (OCVs): Dukoral, Sanchol, and Euvichol. Dukoral , an orally administered, inactivated whole-cell vaccine , has an overall efficacy of about 52% during

864-541: A non-toxic B-subunit of cholera toxin and providing protection against V. cholerae O1; and two vaccines developed using the same transfer of technology—ShanChol (Shantha Biotec) and Euvichol (EuBiologics Co.), which have bivalent O1 and O139 oral killed cholera vaccines. Oral cholera vaccination could be deployed in a diverse range of situations from cholera-endemic areas and locations of humanitarian crises, but no clear consensus exists. Developed for use in Bangladesh ,

960-408: A one-million fold increase in numbers of V. cholerae in the environment. The source of the contamination is typically other people with cholera when their untreated diarrheal discharge is allowed to get into waterways, groundwater or drinking water supplies. Drinking any contaminated water and eating any foods washed in the water, as well as shellfish living in the affected waterway , can cause

1056-430: A person to contract an infection. Cholera is rarely spread directly from person to person . V. cholerae also exists outside the human body in natural water sources, either by itself or through interacting with phytoplankton , zooplankton , or biotic and abiotic detritus. Drinking such water can also result in the disease, even without prior contamination through fecal matter. Selective pressures exist however in

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1152-530: A result of transmission by food, while in developing countries it is more often water. Food transmission can occur when people harvest seafood such as oysters in waters infected with sewage , as Vibrio cholerae accumulates in planktonic crustaceans and the oysters eat the zooplankton . People infected with cholera often have diarrhea, and disease transmission may occur if this highly liquid stool, colloquially referred to as "rice-water", contaminates water used by others. A single diarrheal event can cause

1248-421: A severe case if they become infected. Any individual, even a healthy adult in middle age, can undergo a severe case, and each person's case should be measured by the loss of fluids, preferably in consultation with a professional health care provider . The cystic fibrosis genetic mutation known as delta-F508 in humans has been said to maintain a selective heterozygous advantage : heterozygous carriers of

1344-425: A single subspecies of E. coli in a phylogenomic study that included the type strain. All commonly used research strains of E. coli belong to group A and are derived mainly from Clifton's K-12 strain (λ F ; O16) and to a lesser degree from d'Herelle 's " Bacillus coli " strain (B strain; O7). There have been multiple proposals to revise the taxonomy to match phylogeny. However, all these proposals need to face

1440-414: A variety of defined laboratory media, such as lysogeny broth , or any medium that contains glucose , ammonium phosphate monobasic , sodium chloride , magnesium sulfate , potassium phosphate dibasic , and water . Growth can be driven by aerobic or anaerobic respiration , using a large variety of redox pairs , including the oxidation of pyruvic acid , formic acid , hydrogen , and amino acids , and

1536-519: A wide variety of substrates and uses mixed acid fermentation in anaerobic conditions, producing lactate , succinate , ethanol , acetate , and carbon dioxide . Since many pathways in mixed-acid fermentation produce hydrogen gas, these pathways require the levels of hydrogen to be low, as is the case when E. coli lives together with hydrogen-consuming organisms, such as methanogens or sulphate-reducing bacteria . In addition, E. coli ' s metabolism can be rewired to solely use CO 2 as

1632-442: A year (uncertainty range: 21,000–143,000) as of 2015 . This occurs mainly in the developing world. In the early 1980s, death rates are believed to have still been higher than three million a year. It is difficult to calculate exact numbers of cases, as many go unreported due to concerns that an outbreak may have a negative impact on the tourism of a country. As of 2004, cholera remained both epidemic and endemic in many areas of

1728-555: A year. To date, seven cholera pandemics have occurred, with the most recent beginning in 1961, and continuing today. The illness is rare in high-income countries , and affects children most severely. Cholera occurs as both outbreaks and chronically in certain areas . Areas with an ongoing risk of disease include Africa and Southeast Asia . The risk of death among those affected is usually less than 5%, given improved treatment, but may be as high as 50% without such access to treatment. Descriptions of cholera are found as early as

1824-596: Is endemic . If people are immunized broadly, herd immunity results, with a decrease in the amount of contamination in the environment. WHO recommends that oral cholera vaccination be considered in areas where the disease is endemic (with seasonal peaks), as part of the response to outbreaks, or in a humanitarian crisis during which the risk of cholera is high. Oral Cholera Vaccine (OCV) has been recognized as an adjunct tool for prevention and control of cholera. The World Health Organization (WHO) has prequalified three bivalent cholera vaccines—Dukoral (SBL Vaccines), containing

1920-547: Is oral rehydration salts (ORS), the replacement of fluids and electrolytes by using slightly sweet and salty solutions. Rice-based solutions are preferred. In children, zinc supplementation has also been found to improve outcomes. In severe cases, intravenous fluids , such as Ringer's lactate , may be required, and antibiotics may be beneficial. The choice of antibiotic is aided by antibiotic sensitivity testing . Cholera continues to affect an estimated 3–5 million people worldwide and causes 28,800–130,000 deaths

2016-421: Is a subgroup within the species that has unique characteristics that distinguish it from other strains . These differences are often detectable only at the molecular level; however, they may result in changes to the physiology or lifecycle of the bacterium. For example, a strain may gain pathogenic capacity , the ability to use a unique carbon source , the ability to take upon a particular ecological niche , or

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2112-422: Is a common problem. Stool and swab samples collected in the acute stage of the disease, before antibiotics have been administered, are the most useful specimens for laboratory diagnosis. If an epidemic of cholera is suspected, the most common causative agent is V. cholerae O1. If V. cholerae serogroup O1 is not isolated, the laboratory should test for V. cholerae O139. However, if neither of these organisms

2208-503: Is a common source. Humans are the only known host for the bacteria . Risk factors for the disease include poor sanitation , insufficient clean drinking water , and poverty . Cholera can be diagnosed by a stool test , or a rapid dipstick test , although the dipstick test is less accurate. Prevention methods against cholera include improved sanitation and access to clean water . Cholera vaccines that are given by mouth provide reasonable protection for about six months, and confer

2304-407: Is a general process, affecting prokaryotes and eukaryotes alike. E. coli and related bacteria possess the ability to transfer DNA via bacterial conjugation or transduction , which allows genetic material to spread horizontally through an existing population. The process of transduction, which uses the bacterial virus called a bacteriophage , is where the spread of the gene encoding for

2400-405: Is a gram-negative, facultative anaerobe , nonsporulating coliform bacterium . Cells are typically rod-shaped, and are about 2.0 μm long and 0.25–1.0  μm in diameter, with a cell volume of 0.6–0.7 μm . E. coli stains gram-negative because its cell wall is composed of a thin peptidoglycan layer and an outer membrane. During the staining process, E. coli picks up the color of

2496-442: Is available to determine the presence of V. cholerae . In those samples that test positive, further testing should be done to determine antibiotic resistance. In epidemic situations, a clinical diagnosis may be made by taking a patient history and doing a brief examination. Treatment via hydration and over-the-counter hydration solutions can be started without or before confirmation by laboratory analysis, especially where cholera

2592-519: Is by serotype, which is based on major surface antigens (O antigen: part of lipopolysaccharide layer; H: flagellin ; K antigen : capsule), e.g. O157:H7 ). It is, however, common to cite only the serogroup , i.e. the O-antigen . At present, about 190 serogroups are known. The common laboratory strain has a mutation that prevents the formation of an O-antigen and is thus not typeable. Like all lifeforms, new strains of E. coli evolve through

2688-446: Is effective for adults aged 18–64 as a single dose. One injectable vaccine was found to be effective for two to three years. The protective efficacy was 28% lower in children less than five years old. However, as of 2010 , it has limited availability. Work is under way to investigate the role of mass vaccination. The WHO recommends immunization of high-risk groups, such as children and people with HIV , in countries where this disease

2784-416: Is increasing within cholera bacteria. In Bangladesh , for example, most cases are resistant to tetracycline , trimethoprim-sulfamethoxazole , and erythromycin . Rapid diagnostic assay methods are available for the identification of multi-drug resistant cases. New generation antimicrobials have been discovered which are effective against cholera bacteria in in vitro studies. A rapid dipstick test

2880-487: Is isolated, it is necessary to send stool specimens to a reference laboratory. Infection with V. cholerae O139 should be reported and handled in the same manner as that caused by V. cholerae O1. The associated diarrheal illness should be referred to as cholera and must be reported in the United States. The World Health Organization (WHO) recommends focusing on prevention, preparedness, and response to combat

2976-460: Is less in those with lowered gastric acidity (for instance those using proton pump inhibitors ). Children are also more susceptible, with two- to four-year-olds having the highest rates of infection. Individuals' susceptibility to cholera is also affected by their blood type , with those with type O blood being the most susceptible. Persons with lowered immunity , such as persons with AIDS or malnourished children, are more likely to develop

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3072-754: Is maintained. The WHO only recommends antibiotics in those with severe dehydration. Doxycycline is typically used first line, although some strains of V. cholerae have shown resistance . Testing for resistance during an outbreak can help determine appropriate future choices. Other antibiotics proven to be effective include cotrimoxazole , erythromycin , tetracycline , chloramphenicol , and furazolidone . Fluoroquinolones , such as ciprofloxacin , also may be used, but resistance has been reported. Antibiotics improve outcomes in those who are both severely and not severely dehydrated. Azithromycin and tetracycline may work better than doxycycline or ciprofloxacin . In Bangladesh zinc supplementation reduced

3168-469: Is not as affordable. Continued eating speeds the recovery of normal intestinal function. The WHO recommends this generally for cases of diarrhea no matter what the underlying cause. A CDC training manual specifically for cholera states: "Continue to breastfeed your baby if the baby has watery diarrhea, even when traveling to get treatment. Adults and older children should continue to eat frequently." The most common error in caring for patients with cholera

3264-416: Is on Kerkhoflaan (near the junction with Rusthoflaan). The cemetery is open daily. A booklet containing a cultural route through the cemetery is available from the office located at the entrance (also contains a map). 51°56′19″N 4°29′29″E  /  51.93861°N 4.49139°E  / 51.93861; 4.49139 Cholera Cholera ( / ˈ k ɒ l ər ə / ) is an infection of

3360-412: Is pathogenic to chickens and has an O1:K1:H7 serotype . However, in most studies, either O157:H7 , K-12 MG1655, or K-12 W3110 were used as a representative E. coli . The genome of the type strain has only lately been sequenced. Many strains belonging to this species have been isolated and characterised. In addition to serotype ( vide supra ), they can be classified according to their phylogeny , i.e.

3456-442: Is rapid and thready, and urine output decreases with time. Muscle cramping and weakness, altered consciousness, seizures , or even coma due to electrolyte imbalances are common, especially in children. Cholera bacteria have been found in shellfish and plankton . Transmission is usually through the fecal-oral route of contaminated food or water caused by poor sanitation . Most cholera cases in developed countries are

3552-412: Is rare and should raise suspicion for secondary infection. Patients can be lethargic and might have sunken eyes, dry mouth, cold clammy skin, or wrinkled hands and feet. Kussmaul breathing , a deep and labored breathing pattern, can occur because of acidosis from stool bicarbonate losses and lactic acidosis associated with poor perfusion . Blood pressure drops due to dehydration, peripheral pulse

3648-406: Is rare. For example, the last major outbreak of cholera in the United States occurred in 1910–1911. Cholera is mainly a risk in developing countries in those areas where access to WASH (water, sanitation and hygiene) infrastructure is still inadequate. Effective sanitation practices, if instituted and adhered to in time, are usually sufficient to stop an epidemic. There are several points along

3744-464: Is small, e.g. the O157:H7 serotype strains, which form a clade ("an exclusive group")—group E below—are all enterohaemorragic strains (EHEC), but not all EHEC strains are closely related. In fact, four different species of Shigella are nested among E. coli strains ( vide supra ), while E. albertii and E. fergusonii are outside this group. Indeed, all Shigella species were placed within

3840-586: Is the preferred solution, often with added potassium. Large volumes and continued replacement until diarrhea has subsided may be needed. Ten percent of a person's body weight in fluid may need to be given in the first two to four hours. This method was first tried on a mass scale during the Bangladesh Liberation War , and was found to have much success. Despite widespread beliefs, fruit juices and commercial fizzy drinks like cola are not ideal for rehydration of people with serious infections of

3936-642: Is then referred to being asynchronous. However, asynchrony can be caused by mutations to for instance DnaA or DnaA initiator-associating protein DiaA . Although E. coli reproduces by binary fission the two supposedly identical cells produced by cell division are functionally asymmetric with the old pole cell acting as an aging parent that repeatedly produces rejuvenated offspring. When exposed to an elevated stress level, damage accumulation in an old E. coli lineage may surpass its immortality threshold so that it arrests division and becomes mortal. Cellular aging

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4032-404: Is to underestimate the speed and volume of fluids required. In most cases, cholera can be successfully treated with oral rehydration therapy (ORT), which is highly effective, safe, and simple to administer. Rice-based solutions are preferred to glucose-based ones due to greater efficiency. In severe cases with significant dehydration, intravenous rehydration may be necessary. Ringer's lactate

4128-486: The DNA and overlapping cell cycles. The number of replication forks in fast growing E. coli typically follows 2n (n = 1, 2 or 3). This only happens if replication is initiated simultaneously from all origins of replications , and is referred to as synchronous replication . However, not all cells in a culture replicate synchronously. In this case cells do not have multiples of two replication forks . Replication initiation

4224-449: The Gs alpha subunit of the heterotrimeric G protein . This results in constitutive cAMP production, which in turn leads to the secretion of water, sodium, potassium, and bicarbonate into the lumen of the small intestine and rapid dehydration. The gene encoding the cholera toxin was introduced into V. cholerae by horizontal gene transfer . Virulent strains of V. cholerae carry a variant of

4320-667: The Shiga toxin from the Shigella bacteria to E. coli helped produce E. coli O157:H7 , the Shiga toxin-producing strain of E. coli. E. coli encompasses an enormous population of bacteria that exhibit a very high degree of both genetic and phenotypic diversity. Genome sequencing of many isolates of E. coli and related bacteria shows that a taxonomic reclassification would be desirable. However, this has not been done, largely due to its medical importance, and E. coli remains one of

4416-406: The human stomach . The few surviving bacteria conserve their energy and stored nutrients during the passage through the stomach by shutting down protein production. When the surviving bacteria exit the stomach and reach the small intestine , they must propel themselves through the thick mucus that lines the small intestine to reach the intestinal walls where they can attach and thrive. Once

4512-479: The potassium level may be normal, even though large losses have occurred. As the dehydration is corrected, potassium levels may decrease rapidly, and thus need to be replaced. This is best done by Oral Rehydration Solution (ORS). Antibiotic treatments for one to three days shorten the course of the disease and reduce the severity of the symptoms. Use of antibiotics also reduces fluid requirements. People will recover without them, however, if sufficient hydration

4608-455: The small intestine by some strains of the bacterium Vibrio cholerae . Symptoms may range from none, to mild, to severe. The classic symptom is large amounts of watery diarrhea lasting a few days. Vomiting and muscle cramps may also occur. Diarrhea can be so severe that it leads within hours to severe dehydration and electrolyte imbalance . This may result in sunken eyes , cold skin, decreased skin elasticity, and wrinkling of

4704-411: The "sari filter" is a simple and cost-effective appropriate technology method for reducing the contamination of drinking water. Used sari cloth is preferable but other types of used cloth can be used with some effect, though the effectiveness will vary significantly. Used cloth is more effective than new cloth, as the repeated washing reduces the space between the fibers. Water collected in this way has

4800-512: The 5th century BC in Sanskrit . In Europe, cholera was a term initially used to describe any kind of gastroenteritis, and was not used for this disease until the early 19th century. The study of cholera in England by John Snow between 1849 and 1854 led to significant advances in the field of epidemiology because of his insights about transmission via contaminated water, and a map of the same

4896-567: The EDP is the more thermodynamically favourable of the three pathways, E. coli do not use the EDP for glucose metabolism , relying mainly on the EMPP and the OPPP. The EDP mainly remains inactive except for during growth with gluconate . When growing in the presence of a mixture of sugars, bacteria will often consume the sugars sequentially through a process known as catabolite repression. By repressing

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4992-484: The ability to resist antimicrobial agents . Different strains of E. coli are often host-specific, making it possible to determine the source of fecal contamination in environmental samples. For example, knowing which E. coli strains are present in a water sample allows researchers to make assumptions about whether the contamination originated from a human, another mammal , or a bird . A common subdivision system of E. coli , but not based on evolutionary relatedness,

5088-412: The absence of oxygen is an advantage to bacteria because their survival is increased in environments where water predominates. The bacterial cell cycle is divided into three stages. The B period occurs between the completion of cell division and the beginning of DNA replication . The C period encompasses the time it takes to replicate the chromosomal DNA. The D period refers to the stage between

5184-566: The added benefit of protecting against another type of diarrhea caused by E. coli . In 2017, the US Food and Drug Administration (FDA) approved a single-dose, live, oral cholera vaccine called Vaxchora for adults aged 18–64 who are travelling to an area of active cholera transmission. It offers limited protection to young children. People who survive an episode of cholera have long-lasting immunity for at least three years (the period tested). The primary treatment for affected individuals

5280-474: The aquatic environment that may reduce the virulence of V. cholerae . Specifically, animal models indicate that the transcriptional profile of the pathogen changes as it prepares to enter an aquatic environment. This transcriptional change results in a loss of ability of V. cholerae to be cultured on standard media, a phenotype referred to as ' viable but non-culturable ' (VBNC) or more conservatively ' active but non-culturable ' (ABNC). One study indicates that

5376-425: The bacterium cause disease. Cells are able to survive outside the body for a limited amount of time, which makes them potential indicator organisms to test environmental samples for fecal contamination . A growing body of research, though, has examined environmentally persistent E. coli which can survive for many days and grow outside a host. The bacterium can be grown and cultured easily and inexpensively in

5472-631: The bacterium on glucose and lactose , where E. coli will consume glucose before lactose . Catabolite repression has also been observed in E. coli in the presence of other non-glucose sugars, such as arabinose and xylose , sorbitol , rhamnose , and ribose . In E. coli , glucose catabolite repression is regulated by the phosphotransferase system , a multi-protein phosphorylation cascade that couples glucose uptake and metabolism . Optimum growth of E. coli occurs at 37 °C (99 °F), but some laboratory strains can multiply at temperatures up to 49 °C (120 °F). E. coli grows in

5568-533: The cemetery and a memorial was put in place. When the Laurenskerk was severely damaged by bombing in 1940, many of the graves were also transferred to Crooswijk. The cemetery is laid out as a park. The cemetery is a general ( non-denominational ) cemetery. There are sections for casualties of wars, the resistance in the Second World War . There is also a fast-growing Islamic section . Many of

5664-422: The cholera bacteria reach the intestinal wall, they no longer need the flagella to move. The bacteria stop producing the protein flagellin to conserve energy and nutrients by changing the mix of proteins that they express in response to the changed chemical surroundings. On reaching the intestinal wall, V. cholerae start producing the toxic proteins that give the infected person a watery diarrhea. This carries

5760-612: The cholera transmission path at which its spread may be halted: Handwashing with soap or ash after using a toilet and before handling food or eating is also recommended for cholera prevention by WHO Africa. Surveillance and prompt reporting allow for containing cholera epidemics rapidly. Cholera exists as a seasonal disease in many endemic countries, occurring annually mostly during rainy seasons . Surveillance systems can provide early alerts to outbreaks, therefore leading to coordinated response and assist in preparation of preparedness plans. Efficient surveillance systems can also improve

5856-431: The conclusion of DNA replication and the end of cell division. The doubling rate of E. coli is higher when more nutrients are available. However, the length of the C and D periods do not change, even when the doubling time becomes less than the sum of the C and D periods. At the fastest growth rates, replication begins before the previous round of replication has completed, resulting in multiple replication forks along

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5952-409: The counterstain safranin and stains pink. The outer membrane surrounding the cell wall provides a barrier to certain antibiotics such that E. coli is not damaged by penicillin . The flagella which allow the bacteria to swim have a peritrichous arrangement . It also attaches and effaces to the microvilli of the intestines via an adhesion molecule known as intimin . E. coli can live on

6048-424: The culturability of V. cholerae drops 90% within 24 hours of entering the water, and furthermore that this loss in culturability is associated with a loss in virulence. Both toxic and non-toxic strains exist. Non-toxic strains can acquire toxicity through a temperate bacteriophage . About 100   million bacteria must typically be ingested to cause cholera in a normal healthy adult. This dose, however,

6144-433: The duration and severity of diarrhea in children with cholera when given with antibiotics and rehydration therapy as needed. It reduced the length of disease by eight hours and the amount of diarrhea stool by 10%. Supplementation appears to be also effective in both treating and preventing infectious diarrhea due to other causes among children in the developing world. If people with cholera are treated quickly and properly,

6240-411: The expression of the genes involved in metabolizing the less preferred sugars, cells will usually first consume the sugar yielding the highest growth rate, followed by the sugar yielding the next highest growth rate, and so on. In doing so the cells ensure that their limited metabolic resources are being used to maximize the rate of growth. The well-used example of this with E. coli involves the growth of

6336-489: The first to immunize humans against a bacterial disease. His vaccine and inoculation was rather controversial and was rejected by his peers and several investigation commissions but it ended up demonstrating its effectiveness and being recognized for it: out of the 30 thousand people he vaccinated only 54 died. Russian-Jewish bacteriologist Waldemar Haffkine also developed a human cholera vaccine in July 1892. He conducted

6432-480: The first year after being given and 62% in the second year, with minimal side effects. It is available in over 60 countries. However, it is not currently recommended by the Centers for Disease Control and Prevention (CDC) for most people traveling from the United States to endemic countries. The vaccine that the US Food and Drug Administration (FDA) recommends, Vaxchora , is an oral attenuated live vaccine , that

6528-420: The genetic mechanisms by which cholera bacteria turn on the protein production of the toxins that interact with host cell mechanisms to pump chloride ions into the small intestine, creating an ionic pressure which prevents sodium ions from entering the cell. The chloride and sodium ions create a salt-water environment in the small intestines, which through osmosis can pull up to six liters of water per day through

6624-462: The genetic structure. Two clusters have been identified: Cluster I and Cluster II. For the most part, Cluster I consists of strains from the 1960s and 1970s, while Cluster II largely contains strains from the 1980s and 1990s, based on the change in the clone structure. This grouping of strains is best seen in the strains from the African continent. In many areas of the world, antibiotic resistance

6720-442: The genus Enterobacter + "i" (sic.) + " aceae ", but from "enterobacterium" + "aceae" (enterobacterium being not a genus, but an alternative trivial name to enteric bacterium). The original strain described by Escherich is believed to be lost, consequently a new type strain (neotype) was chosen as a representative: the neotype strain is U5/41 , also known under the deposit names DSM 30083 , ATCC 11775 , and NCTC 9001, which

6816-401: The hands and feet. Dehydration can cause the skin to turn bluish . Symptoms start two hours to five days after exposure. Cholera is caused by a number of types of Vibrio cholerae , with some types producing more severe disease than others. It is spread mostly by unsafe water and unsafe food that has been contaminated with human feces containing the bacteria. Undercooked shellfish

6912-434: The humans and the E. coli are benefitting each other. E. coli is expelled into the environment within fecal matter. The bacterium grows massively in fresh fecal matter under aerobic conditions for three days, but its numbers decline slowly afterwards. E. coli and other facultative anaerobes constitute about 0.1% of gut microbiota , and fecal–oral transmission is the major route through which pathogenic strains of

7008-404: The inferred evolutionary history, as shown below where the species is divided into six groups as of 2014. Particularly the use of whole genome sequences yields highly supported phylogenies. The phylogroup structure remains robust to newer methods and sequences, which sometimes adds newer groups, giving 8 or 14 as of 2023. The link between phylogenetic distance ("relatedness") and pathology

7104-466: The intestinal cells, creating the massive amounts of diarrhea. The host can become rapidly dehydrated unless treated properly. By inserting separate, successive sections of V. cholerae DNA into the DNA of other bacteria, such as E. coli that would not naturally produce the protein toxins, researchers have investigated the mechanisms by which V. cholerae responds to the changing chemical environments of

7200-400: The intestines, and their excessive sugar content may even harm water uptake. If commercially produced oral rehydration solutions are too expensive or difficult to obtain, solutions can be made. One such recipe calls for 1 liter of boiled water, 1/2 teaspoon of salt, 6 teaspoons of sugar, and added mashed banana for potassium and to improve taste. As there frequently is initially acidosis ,

7296-465: The laboratory. For instance, E. coli typically do not have the ability to grow aerobically with citrate as a carbon source , which is used as a diagnostic criterion with which to differentiate E. coli from other, closely, related bacteria such as Salmonella . In this experiment, one population of E. coli unexpectedly evolved the ability to aerobically metabolize citrate , a major evolutionary shift with some hallmarks of microbial speciation . In

7392-547: The microbial world, a relationship of predation can be established similar to that observed in the animal world. Considered, it has been seen that E. coli is the prey of multiple generalist predators, such as Myxococcus xanthus . In this predator-prey relationship, a parallel evolution of both species is observed through genomic and phenotypic modifications, in the case of E. coli the modifications are modified in two aspects involved in their virulence such as mucoid production (excessive production of exoplasmic acid alginate ) and

7488-505: The mortality rate is less than 1%; however, with untreated cholera, the mortality rate rises to 50–60%. For certain genetic strains of cholera, such as the one present during the 2010 epidemic in Haiti and the 2004 outbreak in India, death can occur within two hours of becoming ill. Cholera affects an estimated 2.8 million people worldwide, and causes approximately 95,000 deaths

7584-582: The most diverse bacterial species: only 20% of the genes in a typical E. coli genome is shared among all strains. In fact, from the more constructive point of view, the members of genus Shigella ( S. dysenteriae , S. flexneri , S. boydii , and S. sonnei ) should be classified as E. coli strains, a phenomenon termed taxa in disguise . Similarly, other strains of E. coli (e.g. the K-12 strain commonly used in recombinant DNA work) are sufficiently different that they would merit reclassification. A strain

7680-558: The much earlier (see Synapsid ) divergence of their hosts: the former being found in mammals and the latter in birds and reptiles. This was followed by a split of an Escherichia ancestor into five species ( E. albertii , E. coli , E. fergusonii , E. hermannii , and E. vulneris ). The last E. coli ancestor split between 20 and 30 million years ago. The long-term evolution experiments using E. coli , begun by Richard Lenski in 1988, have allowed direct observation of genome evolution over more than 65,000 generations in

7776-448: The multiplying new generations of V. cholerae bacteria out into the drinking water of the next host if proper sanitation measures are not in place. The cholera toxin (CTX or CT) is an oligomeric complex made up of six protein subunits : a single copy of the A subunit (part A), and five copies of the B subunit (part B), connected by a disulfide bond . The five B subunits form a five-membered ring that binds to GM1 gangliosides on

7872-400: The mutation (who are not affected by cystic fibrosis) are more resistant to V. cholerae infections. In this model, the genetic deficiency in the cystic fibrosis transmembrane conductance regulator channel proteins interferes with bacteria binding to the intestinal epithelium , thus reducing the effects of an infection. When consumed, most bacteria do not survive the acidic conditions of

7968-502: The natural biological processes of mutation , gene duplication , and horizontal gene transfer ; in particular, 18% of the genome of the laboratory strain MG1655 was horizontally acquired since the divergence from Salmonella . E. coli K-12 and E. coli B strains are the most frequently used varieties for laboratory purposes. Some strains develop traits that can be harmful to a host animal. These virulent strains typically cause

8064-459: The normal microbiota of the gut and are harmless or even beneficial to humans (although these strains tend to be less studied than the pathogenic ones ). For example, some strains of E. coli benefit their hosts by producing vitamin K 2 or by preventing the colonization of the intestine by pathogenic bacteria . These mutually beneficial relationships between E. coli and humans are a type of mutualistic biological relationship — where both

8160-428: The reduction of substrates such as oxygen , nitrate , fumarate , dimethyl sulfoxide , and trimethylamine N-oxide . E. coli is classified as a facultative anaerobe . It uses oxygen when it is present and available. It can, however, continue to grow in the absence of oxygen using fermentation or anaerobic respiration . Respiration type is managed in part by the arc system . The ability to continue growing in

8256-399: The risk assessment for potential cholera outbreaks. Understanding the seasonality and location of outbreaks provides guidance for improving cholera control activities for the most vulnerable. For prevention to be effective, it is important that cases be reported to national health authorities. Spanish physician Jaume Ferran i Clua developed the first successful cholera inoculation in 1885,

8352-754: The source of carbon for biomass production. In other words, this obligate heterotroph's metabolism can be altered to display autotrophic capabilities by heterologously expressing carbon fixation genes as well as formate dehydrogenase and conducting laboratory evolution experiments. This may be done by using formate to reduce electron carriers and supply the ATP required in anabolic pathways inside of these synthetic autotrophs. E. coli has three native glycolytic pathways: EMPP , EDP , and OPPP . The EMPP employs ten enzymatic steps to yield two pyruvates , two ATP , and two NADH per glucose molecule while OPPP serves as an oxidation route for NADPH synthesis. Although

8448-406: The spread of cholera. They also stress the importance of an effective surveillance system. Governments can play a role in all of these areas. Although cholera may be life-threatening, prevention of the disease is normally straightforward if proper sanitation practices are followed. In developed countries , due to their nearly universal advanced water treatment and sanitation practices, cholera

8544-646: The stomach, mucous layers, and intestinal wall. Researchers have discovered a complex cascade of regulatory proteins controls expression of V. cholerae virulence determinants. In responding to the chemical environment at the intestinal wall, the V. cholerae bacteria produce the TcpP/TcpH proteins, which, together with the ToxR/ToxS proteins, activate the expression of the ToxT regulatory protein. ToxT then directly activates expression of virulence genes that produce

8640-528: The suppression of the OmpT gene, producing in future generations a better adaptation of one of the species that is counteracted by the evolution of the other, following a co-evolutionary model demonstrated by the Red Queen hypothesis . E. coli is the type species of the genus ( Escherichia ) and in turn Escherichia is the type genus of the family Enterobacteriaceae , where the family name does not stem from

8736-613: The surface of the intestinal epithelium cells. The A1 portion of the A subunit is an enzyme that ADP-ribosylates G proteins , while the A2 chain fits into the central pore of the B subunit ring. Upon binding, the complex is taken into the cell via receptor-mediated endocytosis . Once inside the cell, the disulfide bond is reduced, and the A1 subunit is freed to bind with a human partner protein called ADP-ribosylation factor 6 (Arf6). Binding exposes its active site, allowing it to permanently ribosylate

8832-410: The toxins, causing diarrhea in the infected person and allowing the bacteria to colonize the intestine. Current research aims at discovering "the signal that makes the cholera bacteria stop swimming and start to colonize (that is, adhere to the cells of) the small intestine." Amplified fragment length polymorphism fingerprinting of the pandemic isolates of V. cholerae has revealed variation in

8928-659: The trees symbolise grief such as Weeping Beech , Silver Birch ( Betula pendula var. Tristis , which in Dutch is known as the Weeping Birch), Dutch Elm (in Dutch known as Weeping Elm) and Weeping Willow . The cemetery is a national heritage site ( Rijksmonument ) in the Netherlands, as are some of the buildings in the cemetery and are therefore protected. The cemetery is located in Crooswijk . The new entrance

9024-451: The world. Recent major outbreaks are the 2010s Haiti cholera outbreak and the 2016–2022 Yemen cholera outbreak . In October 2016, an outbreak of cholera began in war-ravaged Yemen . WHO called it "the worst cholera outbreak in the world". In 2019, 93% of the reported 923,037 cholera cases were from Yemen (with 1911 deaths reported). Between September 2019 and September 2020, a global total of over 450,000 cases and over 900 deaths

9120-629: Was reported; however, the accuracy of these numbers suffer from over-reporting from countries that report suspected cases (and not laboratory confirmed cases), as well as under-reporting from countries that do not report official cases (such as Bangladesh, India and Philippines). Although much is known about the mechanisms behind the spread of cholera, researchers still do not have a full understanding of what makes cholera outbreaks happen in some places and not others. Lack of treatment of human feces and lack of treatment of drinking water greatly facilitate its spread. Bodies of water have been found to serve as

9216-440: Was the first recorded incidence of epidemiological tracking. The primary symptoms of cholera are profuse diarrhea and vomiting of clear fluid. These symptoms usually start suddenly, half a day to five days after ingestion of the bacteria. The diarrhea is frequently described as "rice water" in nature and may have a fishy odor. An untreated person with cholera may produce 10 to 20 litres (3 to 5 US gal) of diarrhea

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