Second strain of cholera found in Haiti

Cholera has two faces in Haiti. Alongside the strain causing an epidemic is another that does not lead to epidemics but can cause severe symptoms. Better sanitation is key to fighting it.

Since an outbreak in October 2010, epidemic cholera has killed at least 7500 people in Haiti. Epidemiological and DNA studies have shown that the outbreak was caused by the "El Tor" strain of Vibrio cholerae bacteria probably carried by Nepalese peacekeepers.

But Rita Colwell of Johns Hopkins University in Baltimore, Maryland, and colleagues report this week that of faecal samples taken from 81 people in November 2010, 17 had a different V. cholerae that does not make the deadly toxin made by the El Tor strain.

Such "non-toxigenic" cholera can cause severe diarrhoea, but not epidemics, says Colin Stine of the University of Maryland Medical School in Baltimore. "This reinforces that the epidemic was caused by imported El Tor, but underscores the role of these bacteria," which were probably causing disease before the epidemic but were not identified.

Haiti badly needs sanitation to keep pathogens of all kinds out of drinking water, says Colwell. Proposed vaccination against El Tor would not protect Haitians from other gut pathogens.

Journal reference: Proceedings of the National Academy of Sciences, DOI: 10.1073/pnas.1207359109

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