New cholera substrains in Bangladesh uncovered by genomic surveillance confirm the importance of vaccination NatureComms
. This may explain the higher frequency of purging events and/or prevalence of LWS over RWS observed in patients infected with Clade 3 strains. Speculating further, it is possible that the increased frequency of purging associated with Clade 3 may result in increased rates of transmission and could therefore contribute to its global distribution, compared to Clade 5. Notably, the number of purging events was also lower in vaccinated patients than unvaccinated ones.
In addition to strain differences, our data also show that different groups living within Cox’s Bazar might be at different levels of risk of more severe disease. For example, we observed a higher prevalence of RWS in the adjacent host population than the FDMNs, and a higher proportion of FDMNs had limited or severe dehydration than the BGDNs, both of which agree with results from a recent epidemiological study on the same population.
Here we showed that the isolates causing sporadic disease in the Rohingya and Bangladesh host population belonged to the high-risk 7PETclone still causing large-scale cholera epidemics globally. Given the risk posed by this lineage, it’s difficult not to conclude that the pre-emptive mass vaccination campaign played an important role in preventing an epidemic within a highly vulnerable community .
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