Toxigenic Vibrio cholerae O1, seventh pandemic lineage and third transfer to Latin America
Keywords:
Cholera, Vibrio cholerae, diarrhea, epidemiological monitoring, disease outbreaks, genomics, Dominican RepublicAbstract
Introduction: Cholera is an infectious disease caused by the Vibrio cholerae bacterium, which contaminates water and food. It is characterized by acute, watery, and profuse diarrhea with a white, rice-water appearance, accompanied by nausea and vomiting.
Objective: To describe the clinical manifestations, bacteriological findings, and genomic sequence of the first reported cholera case in the Dominican Republic in four years. This imported case marked the beginning of a cholera outbreak in 2022.
Case presentation: A 35-year-old Haitian female patient developed symptoms, including abdominal cramps, colic, and foul-smelling rice-water diarrhea, for more than a day after attending her father's funeral in Haiti (cause of death unknown) and while returning to her residence in the Dominican Republic. She was hospitalized and treated with intravenous 0.9% saline solution 1000 mL, ciprofloxacin 500 mg, paracetamol 1000 mg, diphenhydramine 25 mg, doxycycline 300 mg, omeprazole 40 mg, and Ringer's lactate 100 mL over seven days. Bacteriological analysis identified Vibrio cholerae serogroup O1, serotype Ogawa, resistant to nalidixic acid and trimethoprim-sulfamethoxazole. Genomic sequencing revealed strain VC0006A, corresponding to the seventh pandemic lineage and the third introduction into Latin America.
Conclusions: The symptoms presented by the patient were those typical of cholera. The results of the genomic sequencing confirmed cholera disease caused by toxigenic Vibrio cholerae O1, seventh pandemic lineage and third introduction into Latin America. This represents the first genomic sequencing of this microorganism conducted in the Dominican Republic. Continued epidemiological surveillance using rapid molecular identification methods is essential, along with the establishment of effective waste disposal systems and the ongoing administration of inactivated oral cholera vaccines, which are used globally and have recently been introduced for the first time in our country.
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