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2016 ; 113
(48
): E7730-E7739
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Origins of the current seventh cholera pandemic
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Hu D
; Liu B
; Feng L
; Ding P
; Guo X
; Wang M
; Cao B
; Reeves PR
; Wang L
Proc Natl Acad Sci U S A
2016[Nov]; 113
(48
): E7730-E7739
PMID27849586
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Vibrio cholerae has caused seven cholera pandemics since 1817, imposing terror on
much of the world, but bacterial strains are currently only available for the
sixth and seventh pandemics. The El Tor biotype seventh pandemic began in 1961 in
Indonesia, but did not originate directly from the classical biotype
sixth-pandemic strain. Previous studies focused mainly on the spread of the
seventh pandemic after 1970. Here, we analyze in unprecedented detail the origin,
evolution, and transition to pandemicity of the seventh-pandemic strain. We used
high-resolution comparative genomic analysis of strains collected from 1930 to
1964, covering the evolution from the first available El Tor biotype strain to
the start of the seventh pandemic. We define six stages leading to the pandemic
strain and reveal all key events. The seventh pandemic originated from a
nonpathogenic strain in the Middle East, first observed in 1897. It subsequently
underwent explosive diversification, including the spawning of the pandemic
lineage. This rapid diversification suggests that, when first observed, the
strain had only recently arrived in the Middle East, possibly from the Asian
homeland of cholera. The lineage migrated to Makassar, Indonesia, where it gained
the important virulence-associated elements Vibrio seventh pandemic island I
(VSP-I), VSP-II, and El Tor type cholera toxin prophage by 1954, and it then
became pandemic in 1961 after only 12 additional mutations. Our data indicate
that specific niches in the Middle East and Makassar were important in generating
the pandemic strain by providing gene sources and the driving forces for genetic
events.