Abbey Spink

The 2010 Cholera Outbreak in Haiti: How Science Solved a Controversy

Orata et al., PloS Pathogens, April 2014
1. Define the following terms:

(1 pt)

- Pathogenic means that a bacteria or virus is able to create a disease.

- A bacteriophage attaches itself to bacteria, infects the bacteria, and then reproduces the virus.
- Horizontal gene transfer is the sharing/transferring of genes between organisms.
- A serogroup is a group of bacteria containing a common antigen.
- Comparative genomics compare the genes of different organisms.
- A nucleotide is the basic structural unit of nucleic acids like DNA and RNA.
2. What are the hypotheses of this study? If you were designing this study, and someone asked you to simplify, how
would you state it as a single hypothesis?
(4 pts)
If the cholera outbreak happens after the Nepalese soldiers arrived in Haiti, then human transmission is the cause of
the issue.
3. What does cholera toxin do in the body?
(3 pts)
V.Cholerae makes many toxins that are dangerous to eukaryotic cells. Choleragen (CT) is the toxin that causes
cholera. In this toxin, are two subtoxins: Toxin A is in control of enzymatic and intracellular functions, while Toxin B is
responsible for attaching the toxin to the cell receptor. Along with these toxins, Neuraminidase; which is an enzyme
that makes it easier to bind the toxin to enterocytes (intestinal lining), Disulfide Isomerase; which is known for
unfolding and separating Toxin A from the cholera holotoxin, Protease; an enzyme that breaks down proteins, etc.
also have a large part of the bacteria infecting the body.
4. Figure 1 illustrates how Vibrio cholerae bacteria become toxigenic. Explain this process, referencing the figure
when necessary.
(5 pts)
When genes first come in contact with the disease, the bacteriophage attaches itself to the cell. Inside the phage are
the cholera toxin genes (CTX). The bacteriophage gene transfers the CTX genes to the bacteria. Using the ToxinCoregulated Pili (TCP), the infected cell now colonizes in the human intestines. In each cell replication, the part of the
DNA that contains the CTX genes is also replicated. This process continues to repeat itself. 1
5. Describe the results of the epidemiological studies.
(6 pts)
After the outbreak began, media quickly questioned if the epidemic was a cause of the earthquake that created
perfect conditions for an outbreak to occur, or if the Nepalese soldiers brought it and spread by it dumping sewage.
This accusation was brought up because shortly before the Nepalese soldiers arrived in Haiti, there was a cholera
outbreak in Nepal. These two possible causes became the hypotheses for the outbreak. Was cholera caused by
growth-promoting weather or did the soldiers bring it from Nepal? Surveys were performed in order to compare the
cholera genomes in a database. After doing lots of research (comparing genomes of Nepalese Soldiers to those in
Haiti), it can be assumed that the sewage dumping caused the cholera outbreak. Although at the time,
epidemiological studies were still new, it is still a viable source and can be trusted with results. 2
6. Describe the results of the comparative genomics studies.
(6 pts)
The study of comparative genomics began right after the outbreak began. The first study obtained strains from
Haitian and Bangladesh outbreaks. The results show that the two are identical, based on very similar biotypedistinguishing characteristics.3 Theses comparisons were made by using molecular clocks to determine the history of
the strains. Phylogenetic studies were also used to show the similarity of sequencing, between the two. Although the
sample size was relatively small, the result was consistent and allows us to assume that human transmission was
responsible for the Haitian outbreak. Despite this evidence some still believe that the outbreak was due to the climate
hypothesis. 4
7. As stated in the article, a lawsuit has been filed against the UN for damages caused by the outbreak. What
evidence would you use (existing or yet to be discovered) to help the case against the UN? (2 pts)
Although the sample size was small, the gene sequences between the two locations were identical. Another way to
tell the strains are identical is to compare the Vibrio seventh pandemic islands, which would show the identical
relationship because this is where RNA is transferred. This is obvious evidence against the UN. The identical strains
of cholera were not coincidental. The strain was brought from Nepalese soldiers into Haiti and then led to the
outbreak. 5

8. Name and briefly describe a technique that you learned about in this article. How is it useful in biology research?
(3 pts)
One technique I found interesting is comparative genomics. Comparative genomics is the process of comparing the
different DNA and gene sequences among different species and even within the same species. When comparing,
scientists will use databases to compare single-nucleotide variations and hypervariable chromosomal elements.
This technique can be used to understand human diseases, discover why some bacteria cause infection, and even
learn more about human evolution.

Sources

1 http://cosmos.ucdavis.edu/archives/2007/cluster7/cabuguason_gleisel.pdf

2 http://www.ph.ucla.edu/epi/snow/emerg_infect_dis11-0059.pdf

3 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3209127/

4http://www.newbridgeorganicmarket.com/ns/DisplayMonograph.asp?
StoreID=76D652A7CA694C50B591A77DBFB31E9D&DocID=genomic-comparativegenomics

5 http://www.ph.ucla.edu/epi/snow/emerg_infect_dis11-0059.pdf