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Demystifying cholera epidemiology using phylogenetic inference & next generation sequencing

Nick Thomson, François-Xavier Weill, Marie-Laure Quilici, Daryl Domman, Matthew Dorman

Hosted by Professors Val Curtis & David Conway

Cholera is thought by many to be a disease of the Victorian era. However, current reports from Yemen show that cholera continues to be a serious concern (one death per hour currently; >1 million cases annually; WHO statistics). Low-resolution tools and sparse sampling continue to confound our understanding of cholera transmission.

We have applied high-resolution whole-genome approaches to study V. cholerae that represent every known significant cholera outbreak from across two continents, Latin America and Africa, over the last 50 years. In Africa we observe consistent and predictable patterns of spread linked into three global radiations of pandemic cholera. In Latin America we provide phylogenetic clarity to what has been until now a confusing picture of pandemic disease.

These studies explain how all significant reported cholera outbreaks within the seventh pandemic are related to one another. But more importantly that the current models of cholera do not accurately describe pandemic cholera or its transmission.

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