Research led by the University of Nottingham has uncovered genomic traits linked to the severity of cholera symptoms and how it spreads.
Cholera, caused by infection with Vibrio cholerae, is largely caused by either contaminated water or food and results in severe diarrhea and vomiting that can be fatal if not treated quickly. Around the world there are around four million cases and up to 143,000 deaths each year.
While the disease can be successfully treated, for example, with oral rehydration therapy and antibiotics, there is concern about ongoing genomic evolution of V. cholerae lineages in countries such as Bangladesh that appears to be making infections more severe and more transmissible.
In this study, lead investigator Tania Dottorini, a professor from the University of Nottingham, and colleagues used a combination of genomic analysis, machine learning, genome-scale metabolic modeling, and 3D structural analysis of V. cholerae to assess what could be making the bacteria more virulent using samples collected from cholera patients in Bangladesh between 2015 and 2021.
As reported in the journal Nature Communications, the team were able to identify genetic traits (accessory genes, and core coding and intergenic single nucleotide polymorphisms) in the bacterial genome linked to the most severe symptoms such as prolonged diarrhea, severe abdominal pain, and serious vomiting and dehydration. These genetic features were also linked to bacteriophage resistance and bacterial movement.
The researchers used machine learning to more easily allow matching between genomic features and specific symptoms or disease traits in patients.
Notably, the researchers found a significant overlap between genes or mutations causing more severe disease and more transmissible disease.
“By identifying the key genetic factors that drive both the transmission and severity of cholera, we’ve taken a significant step toward developing more effective treatments and targeted interventions. This could save thousands of lives, not just in Bangladesh, but globally,” said Dottorini in a press statement.
The researchers are hoping that their findings can help develop better treatments and methods to control future outbreaks of the disease.
“Our findings open the door to a new era of cholera research, where we can develop tools to predict and potentially prevent severe outbreaks before they occur. The ultimate goal is to translate these insights into real-world solutions that protect vulnerable populations,” concluded Dottorini.
