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Origins of the current seventh cholera pandemic #MMPMID27849586
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): E7730-9 PMID27849586show ga
Cholera, a major disease in human history, has terrorized the world through seven pandemics. The seventh pandemic started in Indonesia in 1961 and spread globally, currently infecting 3?5 million people annually. By combining all available historical records and genomic analysis of available preseventh pandemic and some early pandemic strains, we revealed the complex six-step evolution of the pandemic strain from its probable origin in South Asia to its nonpathogenic form in the Middle East in ?1900 to Indonesia in ?1925, where it evolved into a pandemic strain before becoming widespread in 1961. This pathway relates to human traffic routes, including the annual Hajj pilgrimage, and involved novel niches that provided gene sources and the driving forces for stepwise evolution.