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PLoS Negl Trop Dis. 2017 Jun 16;11(6):e0005671. doi: 10.1371/journal.pntd.0005671. eCollection 2017 Jun.

Minimal genetic change in Vibrio cholerae in Mozambique over time: Multilocus variable number tandem repeat analysis and whole genome sequencing.

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Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique.
Instituto Nacional de Saúde (INS), Ministério da Saúde, Maputo, Mozambique.
Department of Epidemiology and Public Health, University of Maryland Baltimore, Baltimore, Maryland, United States of America.
Institute for Applied Computer Sciences, University of Maryland, College Park, Maryland, United States of America.
Department of Biostatistics, Dana-Farber Cancer Institute, Boston, Massachusetts, United States of America.
Infection Genomics, Wellcome Trust Sanger Instititue, Hinxton, England, United Kingdom.
ISGlobal Barcelona Ctr. Int. Health Res. (CRESIB), Hospital Clínic / Universitat de Barcelona, Barcelona, Spain.


Although cholera is a major public health concern in Mozambique, its transmission patterns remain unknown. We surveyed the genetic relatedness of 75 Vibrio cholerae isolates from patients at Manhiça District Hospital between 2002-2012 and 3 isolates from river using multilocus variable-number tandem-repeat analysis (MLVA) and whole genome sequencing (WGS). MLVA revealed 22 genotypes in two clonal complexes and four unrelated genotypes. WGS revealed i) the presence of recombination, ii) 67 isolates descended monophyletically from a single source connected to Wave 3 of the Seventh Pandemic, and iii) four clinical isolates lacking the cholera toxin gene. This Wave 3 strain persisted for at least eight years in either an environmental reservoir or circulating within the human population. Our data raises important questions related to where these isolates persist and how identical isolates can be collected years apart despite our understanding of high change rate of MLVA loci and the V. cholerae molecular clock.

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