Search Results (73)

Thai medicinal flowers, namely Mesua ferrea L. (Bunnak), Mammea siamensis T. Anderson (Saraphi), and Clitoria ternatea (Anchan) have long been valued for their traditional medicinal. This study investigated their phytochemical composition and bioactivities, with a particular focus on antioxidant and antibacterial properties. Methods: Ethanolic flower extracts were analyzed by high-performance liquid chromatography (HPLC) and liquid chromatography–mass spectrometry (LC–MS). Antioxidant activities were determined by DPPH, ABTS, and FRAP assays. Antibacterial activity against Escherichia coli, E. coli O157:H7, Salmonella Typhi, Shigella dysenteriae, and Vibrio cholerae were assessed by agar well diffusion, broth dilution methods, and time–kill assays. Biofilm formation, biofilm disruption, and bacterial adhesion to Caco-2 cells were evaluated. Morphological changes in E. coli O157:H7 were examined using scanning electron microscopy (SEM), and leakage of intracellular contents (DNA, RNA, proteins) were quantified. Results: HPLC analysis revealed the highest level of gallic acid in M. ferrea and quercetin in M. siamensis. LC–MS analysis identified fifteen putative metabolites across the flower extracts, including quercetin, kaempferol, catechin, and luteolin derivatives, with species-specific profiles. C. ternatea extract exhibited the greatest total flavonoid content and antioxidant activity. Among the extracts, M. ferrea exhibited the strongest inhibitory effect, with inhibition zone of 13.00–15.00 mm and MIC/MBC values of 31.25–62.5 mg/mL. All extracts exhibited time-dependent bactericidal activity, significantly inhibited biofilm formation, disrupted established biofilms, and reduced bacterial adhesion to intestinal epithelial cells. SEM revealed membrane disruption in E. coli O157:H7 and leakage of intracellular components. Conclusions: Thai medicinal flower extracts, particularly M. ferrea, possess strong antioxidant and antibacterial activities. Their ability to inhibit biofilm formation, interfere with bacterial adhesion, and disrupt bacterial membranes highlights their potential as natural alternatives for preventing or controlling enteric bacterial infections. Full article

Brucellosis, a zoonotic infection caused by the intracellular pathogen Brucella, leads to chronic multi-organ damage. Currently, rapid, accurate, and sensitive diagnostic technologies are crucial for the prevention and control of brucellosis. This study describes the development of a chemiluminescent immunoassay (Bru-CLIA) for sheep and bovine brucellosis antibody detection, utilizing Brucella abortus strain A19 lipopolysaccharide-coated magnetic particles (LPS-MPs) as the serum antigen and acridinium ester-labeled recombinant streptococcal protein G (AE-SPG) for signal generation. After optimizing the assay’s parameters, the Bru-CLIA demonstrated a sensitivity of approximately 1 IU/mL and 2 IU/mL for detecting sheep and bovine brucellosis, respectively. No cross-reactivity was observed with sera from animals immunized with Escherichia coli O157:H7, Mycobacterium tuberculosis, Vibrio cholerae, Legionella, Salmonella, Foot and Mouth Disease virus types O and A, Bovine viral diarrhea virus, Sheep contagious pleuropneumonia, Goat pox virus, or Peste des Petits Ruminants virus, indicating strong specificity. The testing of 81 sheep serum samples and 96 bovine serum samples revealed that Bru-CLIA showed 87.65% and 93.75% concordance with the ID-VET commercial kits for sheep and bovine brucellosis detection, respectively. These results demonstrate that Bru-CLIA offers high specificity, sensitivity, repeatability, and reliability, making it a viable rapid diagnostic tool for the epidemiological surveillance of brucellosis. Full article

Access to clean and safe drinking water is crucial for global health and well-being, formally recognised as a fundamental human right within the United Nations’ Sustainable Development Goals. However, the integrity of water supply is increasingly threatened by microbial contamination, a risk aggravated by the conditions driven from climate change, which promotes the proliferation, resilience, and facilitation of the dissemination of microorganisms. Pathogens like Legionella, Cryptosporidium, Giardia, Escherichia coli, and Vibrio cholerae can be present in water supplies, developing survival strategies (e.g., biofilm, cysts, inside protozoa). The risk of microorganisms in water requires both effective treatment at drinking water treatment plants and vigilant process control throughout drinking water distribution systems. Globally, a great number of disease outbreaks have been linked to contaminated drinking water. Despite strong regulations in the European Union and the Drinking Water Directive aim to guarantee the safety and quality of potable water, outbreaks persist; recent Legionella cases in Italy in 2024 and Cryptosporidiosis in 2019 linked to rainfalls and insufficient disinfection treatment, respectively, are an example of this. Although cholera is not common in Europe, there is evidence of high incidence of this disease in Africa mainly due to the poor hygienic conditions in the DWTS. In Europe, the data of waterborne diseases and outbreaks are submitted by European Countries to the European Centre for Disease Prevention and Control (ECDC) to give faster and effective response to outbreaks. Determining the origin of the contamination is essential to face the solution of outbreaks and ensure public health safety. Full article

Climate change has magnified health disparities across the Southern African Development Community (SADC) region by destabilizing the critical natural systems, which include water security, food production, and disease ecology. The IPCC (2007) underscores the disproportionate impact on low-income populations characterized by limited adaptive capacity, exacerbating existing vulnerabilities. Rising temperatures, erratic precipitation patterns, and increased frequency of extreme weather events ranging from prolonged droughts to catastrophic floods have created favourable conditions for the spread of waterborne diseases such as cholera, dysentery, and typhoid, as well as the expansion of vector-borne diseases zone also characterized by warmer and wetter conditions where diseases like malaria thrives. This study employed a comparative analysis of climate and health data across Malawi, Zimbabwe, Mozambique, and South Africa examining the interplay between climatic shifts and disease patterns. Through reviews of national surveillance reports, adaptation policies, and outbreak records, the analysis reveals the existence of critical gaps in preparedness and response. Zimbabwe’s Matabeleland region experienced a doubling of diarrheal diseases in 2019 due to drought-driven water shortages, forcing communities to rely on unsafe alternatives. Mozambique faced a similar crisis following Cyclone Idai in 2019, where floodwaters precipitated a threefold surge in cholera cases, predominantly affecting children under five. In Malawi, Cyclone Ana’s catastrophic flooding in 2022 contaminated water sources, leading to a devastating cholera outbreak that claimed over 1200 lives. Meanwhile, in South Africa, inadequate sanitation in KwaZulu-Natal’s informal settlements amplified cholera transmission during the 2023 rainy season. Malaria incidence has also risen in these regions, with warmer temperatures extending the geographic range of Anopheles mosquitoes and lengthening the transmission seasons. The findings underscore an urgent need for integrated, multisectoral interventions. Strengthening disease surveillance systems to incorporate climate data could enhance early warning capabilities, while national adaptation plans must prioritize health resilience by bridging gaps between water, agriculture, and infrastructure policies. Community-level interventions, such as water purification programs and targeted vector control, are essential to reduce outbreaks in high-risk areas. Beyond these findings, there is a critical need to invest in longitudinal research so as to elucidate the causal pathways between climate change and disease burden, particularly for understudied linkages like malaria expansion and urbanization. Without coordinated action, climate-related health inequalities will continue to widen, leaving marginalized populations increasingly vulnerable to preventable diseases. The SADC region must adopt evidence-based, equity-centred strategies to mitigate these growing threats and safeguard public health in a warming world. Full article

The National Adaptation Plan of Bangladesh identifies eleven climate-stressed zones, placing nearly 100 million people at high risk of climate-related hazards. Vulnerable groups such as the poor, floating populations, daily laborers, and slum dwellers are particularly affected. However, there is a lack of data on climate-sensitive diseases and related hospital visits in these areas. This study explored the prevalence of such diseases using the Delphi method through focus group discussions with 493 healthcare professionals from 153 hospitals in 156 upazilas across 21 districts and ten zones. Participants were selected by district Civil Surgeons. Key climate-sensitive diseases identified included malnutrition, diarrhea, pneumonia, respiratory infections, typhoid, skin diseases, hypertension, cholera, mental health disorders, hepatitis, heat stroke, and dengue. Seasonal surges in hospital visits were noted, influenced by factors like extreme heat, air pollution, floods, water contamination, poor sanitation, salinity, and disease vectors. Some diseases were zone-specific, while others were widespread. Regions with fewer hospital visits often had higher disease burdens, indicating under-reporting or lack of access. The findings highlight the need for area-specific adaptation strategies and updates to the Health National Adaptation Plan. Strengthening resilience through targeted investment and preventive measures is crucial to reducing health risks from climate change. Full article

Monkeypox virus (MPXV) has caused 148,892 confirmed cases and 341 deaths from 137 countries worldwide, as reported by the World Health Organization (WHO), highlighting the urgent need for effective vaccines to prevent the spread of MPXV. Traditional vaccine development is low-throughput, expensive, time consuming, and susceptible to reversion to virulence. Alternatively, a reverse vaccinology approach offers a rapid, efficient, and safer alternative for MPXV vaccine design. Here, MPXV proteins associated with viral infection were analyzed for immunogenic epitopes to design multi-epitope vaccines based on B-cell, CD4+, and CD8+ epitopes. Epitopes were selected based on allergenicity, antigenicity, and toxicity parameters. The prioritized epitopes were then combined via peptide linkers and N-terminally fused to various protein adjuvants, including PADRE, beta-defensin 3, 50S ribosomal protein L7/12, RS-09, and the cholera toxin B subunit (CTB). All vaccine constructs were computationally validated for physicochemical properties, antigenicity, allergenicity, safety, solubility, and structural stability. The three-dimensional structure of the selected construct was also predicted. Moreover, molecular docking and molecular dynamics (MD) simulations between the vaccine and the TLR-4 immune receptor demonstrated a strong and stable interaction. The vaccine construct was codon-optimized for high expression in the E. coli and was finally cloned in silico into the pET21a (+) vector. Collectively, these results could represent innovative tools for vaccine formulation against MPXV and be transformative for other infectious diseases. Full article

Objectives: In this study, we examine the allocation of oral cholera vaccines (OCVs) across 25 African countries between 2013 and 2019. Methods: We constructed a dataset combining cholera outbreaks and requests, decisions, and deliveries of OCVs from the Global Task Force on Cholera Control, alongside additional covariates. Using machine learning algorithms, we assess the relative importance of socio-demographic, governance, and weather variables in predicting cholera outbreaks. We constructed and used an “index of cholera risk” as an instrumental variable to predict the likelihood of suspected cases and estimate the impact of cholera outbreaks on OCV allocation. Results: The majority of OCVs (77.4%) were allocated reactively. Governments took an average of 299.6 days to request doses, international agencies took 10.4 days to decide, and it took 84 days for vaccines to be delivered. Countries experiencing a cholera outbreak were 31.7 and 36.5 percentage points more likely to request and receive a vaccine delivery in the same month as the outbreak, respectively. We confirmed that the probability of obtaining vaccines through a reactive mechanism was 48.4 percentage points higher compared to preventive allocation. When exploring the heterogeneity of impacts, OCVs were more likely to be requested, allocated, and delivered in countries with strong institutions and those not facing crisis situations. OCVs were also more likely to be allocated in the central parts of the continent. Conclusions: While OCV allocation is responsive to cholera outbreaks, addressing delays, particularly in high-risk countries, could improve their distribution and mitigate the impact of cholera outbreaks. This study highlights the need for targeted strategies to ensure vaccine access in fragile and conflict-affected settings, where institutional capacity is weaker. Full article

Background/Objectives: Bacterial vaccines were first developed and used in the late 1800s to prevent chicken cholera and anthrax. Bacterial pneumonia vaccines were widely used during the 1918 influenza pandemic, despite the influenza A/H1N1 virus not yet being identified. Studies showed that bacterial pathogens, including Haemophilus influenzae, Streptococcus pneumoniae, and Streptococcus pyogenes, contributed significantly to fatal secondary bacterial pneumonias during the pandemic. In this study, we aimed to characterize the microbial composition of two ampules of a mixed bacterial influenza vaccine produced in 1916, which were labeled as containing killed Bacillus influenzae, Pneumococci, and Streptococcus pyogenes. Methods: DNA was extracted from two 1916-era vaccine ampules, and due to low DNA yields, whole genome amplification (WGA) was performed prior to construction of Illumina sequencing libraries. Deep sequencing was conducted, followed by bioinformatic analysis to identify bacterial DNA content. Consensus genomes were assembled for predominant species, and further analyzed for serotype, phylogeny, and antibiotic resistance genes. Results: The amount of recoverable DNA from these century-old vaccine ampules was limited. The sequencing results revealed minimal detectable S. pneumoniae DNA. The first ampule contained predominantly H. influenzae DNA, while the second vial primarily contained Enterococcus faecium DNA, in addition to S. pyogenes DNA. Consensus genomes for H. influenzae, S. pyogenes, and E. faecium were assembled and analyzed for serotype, phylogeny, and antibiotic resistance genes. Conclusions: This study presents the first genomic analysis of century-old bacterial pneumonia vaccine ampules from the 1918 influenza pandemic era. The findings provide a unique historical perspective on early vaccine formulations and highlight the limitations of early vaccine production. Full article

The first immune response controls many bacterial and viral inflammatory diseases. Oral immunization with cholera toxin (CT) elicits antibodies and can prevent cholerae in endemic environments. While the IgG immune response to the toxin is well-documented, the IgA and IgM epitopes responsible for the initial immune reaction to the toxin remained uncharted. In this study, our objective was to identify and characterize immunologically and structurally these IgA and IgM epitopes. We conducted SPOT synthesis to create two libraries, each containing one hundred twenty-two 15-mer peptides, encompassing the entire sequence of the three chains of the CT protein. We could map continuous IgA and IgM epitopes by testing these membrane-bound peptides with sera from mice immunized with an oral vaccine (Schankol™). Our approach involved topological studies, peptide synthesis, and the development of an ELISA. We successfully identified seven IgA epitopes, two in CTA, two in CTB, and three in protein P. Additionally, we discovered eleven IgM epitopes, all situated within CTA. Three IgA-specific and three IgM-specific epitopes were synthesized as MAP4 and validated using ELISA. We then used two chimeric 45-mer peptides, which included these six epitopes, to coat ELISA plates and screened them with sera from immunized mice. This yielded sensitivities and specificities of 100%. Our findings have unveiled a significant collection of IgA and IgM-specific peptide epitopes from cholera toxins A, B, and P. These epitopes, along with those IgG previously identified by our group, reflect the immunoreactivity associated with the dynamic of the immunoglobulins switching associated with the cholera toxin vaccination. Full article

This study examined the link between traditional practices, water stewardship, and cholera outbreaks in three rural Nigerian communities (Enugu, Delta, and Ondo States) in 2020. A sample of 180 participants, representing different socio-economic backgrounds, was surveyed using a mixed-methods approach. Knowledge-based pre-test and post-test measures were employed to assess changes in the understanding of cholera transmission, prevention, and water infrastructure. Chi-square and logistic regression analyses were applied to examine the relationship between socioeconomic status, trust in traditional water sources, and cholera knowledge. Educational seminars were conducted, followed by six months, before administering the post-test to the same population. Key findings revealed that 47% of respondents washed animals in water sources, 42% did not treat their water, and 53% were unaware of cholera-reporting practices. The post-test results showed that 80% of participants could correctly identify cholera symptoms following educational interventions (p < 0.001). Water, sanitation, and hygiene (WaSH) program awareness was significantly associated with reduced cholera incidence (p = 0.005), while certain cultural practices, such as washing slaughtered animals in main water sources, were associated with increased cholera (p < 0.002). This study highlights the need for increased awareness of source water quality, better stewardship, and trust-building efforts to provide culturally appropriate interventions in mitigating these outbreaks. Full article

Background: Vaccination constitutes a low-cost, safe, and efficient public health measure that can help prevent the spread of infectious diseases and benefit the community. The fact that vaccination effectiveness varies among populations, and that the causes of this are still unclear, indicates that several factors are involved and should be thoroughly examined. The “intestinal microbiota” is the most crucial of these elements. Numerous clinical studies demonstrate the intestinal microbiota’s significance in determining the alleged “immunogenicity” and efficacy of vaccines. This systematic review aimed to review all relevant scientific literature and highlight the role of intestinal microbiota in COVID-19, Salmonella typhi, Vibrio cholerae, and rotavirus vaccinations. Materials and Methods: The MESH terms “vaccines” and “microbiota” were used to search the major scientific databases PubMed, SciVerse Scopus, Web of Knowledge, and the Cochrane Central Register of Controlled Clinical Trials. Results: Between February 2024 and October 2024, the analysis was conducted using electronic databases, yielding a total of 235 references. Finally, 24 RCTs were chosen after meeting all inclusion criteria: eight studies of COVID-19, two studies of Salmonella typhi, three studies of Vibrio cholerae, and eleven studies of rotavirus. Only six of these demonstrated good study quality with a Jadad score of three or four. Conclusions: According to the review’s results, the intestinal microbiota surely plays a role in vaccinations’ enhanced immunogenicity, especially in younger people. As it is still unclear what mechanisms underlie this effect, more research is needed to better understand the role of the intestinal microbiota. Full article

Cholera is linked to penury, making low- and middle-income countries (LMICs) particularly vulnerable to outbreaks. In this systematic review, we analyzed the drivers contributing to these outbreaks, focusing on the epidemiology of cholera in LMICs. This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and was registered in PROSPERO (ID: CRD42024591613). We searched PubMed, Scopus, Web of Science, and Google Scholar to include studies on cholera outbreaks that occurred in LMICs from 1 January 2014 to 21 September 2024. Studies on outbreaks outside LMICs and focusing on sporadic cases were excluded. The risk of bias among included studies was assessed using a modified Downes et al. appraisal tool. Thematic analysis was used to synthesize the qualitative data, and meta-analyses to estimate the pooled prevalence. From 1662 records, 95 studies met inclusion criteria, primarily documenting outbreaks in Africa (74%) and Asia (26%). Contaminated water was the main route of disease transmission. The pooled fatality prevalence was 1.3% (95% CI: 1.1–1.6), and the detection rate among suspected cases was 57.8% (95% CI: 49.2–66.4). Vibrio cholerae O1 was the dominant serogroup while Ogawa was the dominant serotype. All studies reporting biotypes indicated El Tor. Although the isolates were 100% susceptible to ofloxacin, levofloxacin, norfloxacin, cefuroxime, and doxycycline, they were also fully resistant to amikacin, sulfamethoxazole, trimethoprim, and furazolidone. The persistence of cholera outbreaks in destitute areas with limited access to clean water and sanitation emphasizes the need for socioeconomic improvements, infrastructure development, and ongoing surveillance to support timely responses and achieve long-term prevention. Full article

The H9N2 subtype avian influenza viruses mainly cause respiratory symptoms, reduce the egg production and fertility of poultry, and result in secondary infections, posing a great threat to the poultry industry and human health. Currently, all H9N2 avian influenza commercial vaccines are inactivated vaccines, which provide protection for immunized animals but cannot inhibit the spread of the virus and make it difficult to distinguish between the infected animals and vaccinated animals. In this study, a trimeric consensus H9 hemagglutinin (HA) subunit vaccine for the H9N2 subtype avian influenza virus based on a baculovirus expression system was first generated, and then the effects of three molecular adjuvants on the H9 HA subunit vaccine, Cholera toxin subunit B (CTB), flagellin, and granulocyte-macrophage colony-stimulating factor (GM-CSF) fused with H9 HA, and one synthetic compound, a polyinosinic–polycytidylic acid (PolyI:C) adjuvant, were evaluated in mice by intranasal administration. The results showed that these four adjuvants enhanced the immunogenicity of the H9 HA subunit vaccine for avian influenza viruses, and that GM-CSF and PolyI:C present better mucosal adjuvant activity for the H9 HA subunit vaccine. These results demonstrate that we have developed a potential universal H9 HA mucosal subunit vaccine with adjuvants in a baculovirus system that would be helpful for the prevention and control of H9N2 subtype avian influenza viruses. Full article

Oral cholera vaccination (OCV) campaigns are increasingly used to prevent cholera outbreaks; however, little is known about their cost-effectiveness in refugee camps. We conducted a cost-effectiveness analysis of a pre-emptive OCV campaign in the Maela refugee camp in Thailand, where outbreaks occurred with an annual incidence rate (IR) of up to 10.7 cases per 1000. Data were collected via health sector records and interviews and household interviews. In the base-case scenario comparing the OCV campaign with no campaign, we estimated the campaign effect on the cholera IR and case fatality rate (CFR: 0.09%) from a static cohort model and calculated incremental cost-effectiveness ratios for the outcomes of death, disability-adjusted life-years (DALYs), and cases averted. In sensitivity analyses, we varied the CFR and IR. The household economic cost of illness was USD 21, and the health sector economic cost of illness was USD 51 per case. The OCV campaign economic cost was USD 289,561, 42% attributable to vaccine costs and 58% to service delivery costs. In our base case, the incremental cost was USD 1.9 million per death averted, USD 1745 per case averted, and USD 69,892 per DALY averted. Sensitivity analyses that increased the CFR to 0.35% or the IR to 10.4 cases per 1000 resulted in a cost per DALY of USD 15,666. The low multi-year average CFR and incidence of the cholera outbreaks in the Maela camp were key factors associated with the high cost per DALY averted. However, the sensitivity analyses indicated higher cost-effectiveness in a setting with a higher CFR or cholera incidence, indicating when to consider campaign use to reduce the outbreak risk. Full article

CTXΦ is a lysogenic filamentous phage that carries the genes encoding cholera toxin (ctxAB), the main virulence factor of Vibrio cholerae. The toxigenic conversion of environmental V. cholerae strains through CTXΦ lysogenic infection is crucial for the emergence of new pathogenic clones. A special allelic form of CTXΦ, called pre-CTXΦ, is a precursor of CTXΦ and without ctxAB. Different members of the pre-CTXΦ and CTXΦ families are distinguished by the sequence of the transcriptional repressor-coding gene rstR. Multiple rstR alleles can coexist within a single strain, demonstrating the diverse structure and complex genomic integration patterns of CTXΦ/pre-CTXΦ prophage on the chromosome. Exploration of the diversity and co-integration patterns of CTXΦ/pre-CTXΦ prophages in V. cholerae can help to understand the evolution of this phage family. In this study, 21 V. cholerae strains, which were shown to carry the CTXΦ/pre-CTXΦ prophages as opposed to typical CTX^ETΦ-RS1 structure, were selected from approximately 1000 strains with diverse genomes. We identified two CTXΦ members and six pre-CTXΦ members with distinct rstR alleles, revealing complex chromosomal DNA integration patterns and arrangements of different prophages in these strains. Promoter activity assays showed that the transcriptional repressor RstR protected against CTXΦ superinfection by preventing the replication and integration of CTXΦ/pre-CTXΦ phages containing the same rstR allele, supporting the co-integration of the diverse CTXΦ/pre-CTXΦ members observed. The numbers and types of prophages and their co-integration arrangements in serogroup O139 strains were more complex than those in serogroup O1 strains. Also, these CTXΦ/pre-CTXΦ members were shown to present the bloom period of the CTXΦ/pre-CTXΦ family during wave 2 of the seventh cholera pandemic. Together, these analyses deepen our comprehension of the genetic variation of CTXΦ and pre-CTXΦ and provide insights into the evolution of the CTXΦ/pre-CTXΦ family in the seventh cholera pandemic. Full article